Color doppler ultrasound for the assessment of palatal fibromucosa thickness and the trajectory of the greater palatine artery: A pilot study.

Background: The primary objective of this study was to determine the position and course of the greater palatine artery using color doppler ultrasound. The secondary objective was to determine the thickness of the palatine fibromucosa. Material and Methods: A pilot case series study was performed in a private clinic during February 2020. The scans were performed with a Mindray® M9 ultrasound machine (Mindray North America, NJ, USA) coupled to an L16-4Hs® hockey-type angled probe. For each participant, the arterial path and thickness of the palatal fibromucosa were determined at 5 different points. Results: A total of 6 volunteers (3 males and 3 females) with a mean age of 39.2 (±16) years were included. While the thickness of the fibromucosa decreased along the anterior area, the distance from the cementoenamel junction to the position of the artery was generally maintained up to the canine position, where it was found to be closed to teeth. Conclusions: Color doppler ultrasound allows accurate localization of the artery as well as measurement of the thickness of the palatine fibromucosa. It would help to select the best area for graft harvesting in order to avoid bleeding complications due to vascular sectioning. Key words:Hard palate, doppler ultrasonography, diagnosis, connective tissue graft.

Critical assessment of the latest classification of jaw cysts proposed by the World Health Organization (2017).

BACKGROUND: The fourth edition of the World Health Organization Classification of Head and Neck Tumors was published in January 2017, and includes a classification of odontogenic tumors and odontogenic cysts. The present review assesses the changes made in this new classification in relation to odontogenic and non-odontogenic jaw cysts. MATERIAL AND METHODS: An electronic search was conducted in the Cochrane Library, PubMed-MEDLINE and Scopus databases using the search terms: "odontogenic cyst" "WHO classification" "update". Studies written in English and published between January 2005 and April 2020 with a high level of scientific evidence were included, while studies not published in English, epidemiological studies, and studies with a low level of scientific evidence were excluded. RESULTS: The initial search identified 311 articles, and after the deletion of duplicates, 7 studies were selected for full-text assessment. After excluding two studies that failed to provide relevant information and had a low level of scientific evidence, 5 articles were finally included and stratified according to their level of scientific evidence based on the SORT (Strength of Recommendation Taxonomy) criteria. CONCLUSIONS: The incorporation of odontogenic and non-odontogenic cysts to the head and neck tumors classification underscores the recognition of the WHO of these important disorders of the jaws. Based on the current evidence, there is controversy as to whether odontogenic keratocysts should be regarded as cystic lesions or as neoplasms, though there is no such controversy in relation to calcifying odontogenic cysts. On the other hand, orthokeratinized odontogenic cysts have been included in the classification as a single entity differentiated from odontogenic keratocysts, while residual cysts have been removed from the classification. Key words:Odontogenic cyst, WHO classification, pseudocyst.

CBCT assessment of radicular volume loss after rapid maxillary expansion: A systematic review.

BACKGROUND: The present systematic review analyzed the current literature to investigate whether rapid maxillary expansion (RME) causes radicular resorption, assessed by cone-beam computed tomography (CBCT). MATERIAL AND METHODS: Eighteen electronic databases and reference lists of studies were searched up to November 2017. Grey literature was also screened. To be included, articles must be human studies on growing subjects with transversal maxillary deficiency treated with maxillary expansion protocol and with 3-D radiographic assessment of radicular volume by CBCT images. Two authors independently performed study selection, data extraction, and risk of bias assessment. Study characteristics (study design, sample size, age, sex, skeletal maturity, type of appliance, daily activation, teeth evaluated, CBCT settings), and study outcomes (radicular volume loss) were reported according to the PRISMA statement. RESULTS: Only 3 articles were considered eligible and an individual analysis of the selected articles was undertaken. The risk of bias assessment revealed low methodological quality for all the studies included. In all the considered studies, significant radicular volume loss was observed in posterior teeth, following RME. When reported in percentage, the radicular volumetric loss was similar between anchored (first molars and first premolars) and unanchored teeth (second premolars). CONCLUSIONS: A preliminary evaluation of the patient-related risk factors for RR is warmly advisable when administering RME. Key words:RME, maxillary expansion, root resorption, external root resorption.

Assessment of Bone Regeneration Using Adipose-Derived Stem Cells in Critical-Size Alveolar Ridge Defects: An Experimental Study in a Dog Model.

PURPOSE: To assess bone regeneration potential of a fibronectin- and adipose-derived stem cell-covered ceramic biomaterial in three-wall critical-size alveolar ridge defects. MATERIALS AND METHODS: In 18 dogs, four dehiscence-type and critical-size defects were created surgically in the edentulous alveolar ridge. Defects were randomly regenerated using biomaterials coated with particulate ß-tricalcium phosphate (ß-TCP), ß-TCP with fibronectin (Fn) (ß-TCP-Fn), and ß-TCP with a combination of Fn and autologous adipose-derived stem cells (ADSCs) (ß-TCP-Fn-ADSCs), leaving one defect as control. The animals were divided into three groups according to the time of euthanasia (1, 2, or 3 months of healing). RESULTS: At the time of sacrifice, statistically significant differences between the four types of defects in the total area of bone regeneration, percentage of neoformed bone matrix, medullary space, or contact between particulate biomaterial and neoformed bone matrix were not found. All defects showed a significant increase in neoformed bone matrix as sacrifice was delayed, but a uniform pattern was not followed. Only defects treated with ß-TCP-Fn-ADSCs showed a significant increase in the bone regeneration area when animals sacrificed at 3 months were compared to those sacrificed at 1 month (P = .006). CONCLUSION: The use of ADSCs in bone regeneration processes of critical-size defects of the alveolar ridge did not entail an advantage regarding greater bone regeneration as compared with other biomaterials. However, the use of ß-TCP coated with a combination of Fn and ADSCs appeared to favor stabilization of the regenerated area, allowing a more efficient maintenance of the space at 3 months of healing.

Assessment of osteointegrative response around dental implants using technetium 99-methylene diphosphate scintigraphy: a comparison of two implant surfaces in a rabbit model.

PURPOSE: To compare the metabolic activity at the bone-implant interface of implants with machined and rough surfaces using bone scintigraphy during the in vivo process of osseointegration in a rabbit model, as well to establish a correlation between activity index (AI) and the bone-implant contact percentage (%BIC). MATERIALS AND METHODS: Twenty-four implants were placed (12 with a machined surface and 12 with a rough titanium oxide surface) in 12 New Zealand White rabbits. Preoperatively and during the postoperative period (at 15 days and at monthly intervals), animals underwent bone scintigraphy with technetium 99m-methylene diphosphate (Tc-99m-MDP), and the AI for each implant was calculated by planar and pinhole collimator scintigraphy. A total of 240 AIs were obtained; after animal sacrifice at 105 days postsurgery, the %BIC was measured by scanning electron microscopy in 10 samples of each implant surface type. RESULTS: The activity-time curve showed a similar morphology for both implant types and both scintigraphy techniques. The maximum mean AI appeared after 15 days of implantation and was higher in machined implants. Significant differences were not found in the %BIC according to implant type. A significant correlation between the mean activity registered in the first postoperative scintigraph and the mean %BIC at the end of the study was observed for machined implants only. CONCLUSIONS: Tc-99m-MDP is useful for the assessment of osseous metabolic activity associated with different microsurfaces. The association between mean AI and %BIC was only demonstrated for machined implants in the first postoperative scintigraphy image.

Analysis of the antibiotic prophylaxis prescribed by Spanish Oral Surgeons.

AIM: To identify prophylactic antibiotic prescription practices among Spanish dentists with preferential dedication to Oral Surgery in different types of tooth extraction surgeries. METHOD: Members of the Spanish Oral Surgery Society were surveyed on antibiotic prophylaxis use in 4 different tooth extraction modalities scaled according to their surgical invasiveness. RESULTS: Sixty-nine of the 105 distributed questionnaires were returned completed. Thirteen percent of the surveyed surgeons would prescribe antibiotics to prevent postoperative wound infection when confronted with conventional tooth extraction lasting less than 5 minutes. In the case of surgery lasting more than 5 minutes, the percentage of participants that would prescribe antibiotics increased to 39%. When a mucoperiosteal flap was elevated or an ostectomy was performed, 87% and 100%, respectively, would prescribe antibiotic prophylaxis. Amoxicillin and its combination with clavulanic acid were the most commonly prescribed antibiotics. All participants would prescribe the antibiotic orally, starting after surgery and with a duration that ranged from 2-8 days. CONCLUSIONS: The results obtained suggest that antibiotic prophylaxis for preventing local odontogenic infection is not being correctly implemented in Spain. This can generate new bacterial resistances, facilitate adverse drug reactions and favor opportunistic infections. Better designed studies are needed in order to clarify the role of antibiotics in the prevention of postsurgical wound infection.

Day case oral surgery in pediatric patients during the year 2000 in the University of Barcelona Dental Clinic (Spain).

AIM: A study is made to show that most pediatric oral surgical interventions can be performed on a day case surgery or ambulatory basis, and to describe the activity of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Spain) in the year 2000. DESIGN: The study documents the surgical activity of the Units of Oral Surgery and Laser Surgery in pediatric patients, in the context of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Spain). RESULTS: Of the 3187 operations carried out in our Service in this period, 489 involved patients under 18 years of age. The surgical removal of third molars was the most common intervention (55.6%), followed by other surgical or non-surgical tooth extractions (33.6%) and other interventions (10.6%) comprising fenestration of impacted canines or other teeth, frenectomies, the removal of mucoceles, and tooth relocations. Complications after surgical third molar extraction were recorded in 15.93% of cases, the most frequent problem being the pain and swelling (4.35% each) characteristic of postoperative inflammation. CONCLUSIONS: Our experience shows that day case oral surgery can be safely performed in pediatric patients, provided the required means and health care personnel resources are available.