Distribution and absorption of local anesthetics in inferior alveolar nerve block: evaluation by magnetic resonance imaging.

PURPOSE: The aim of this study was to evaluate the distribution and absorption of local anesthetic solutions in inferior alveolar nerve block using magnetic resonance imaging. MATERIALS AND METHODS: Forty healthy volunteers were divided into 4 groups and injected with 1.5 mL for inferior alveolar nerve block and 0.3 mL for lingual nerve block. The solutions used for the different groups were 2% lidocaine, 2% lidocaine with 0.125 mg/mL epinephrine, 4% articaine with 0.006 mg/mL epinephrine, and 4% articaine with 0.012 mg/mL epinephrine. All subjects had axial T2-weighted and fat-suppressed images at 0, 60, and 120 minutes after injection. The localization, area, and intensity (signal characteristics) of the solutions were analyzed and onset and duration times of the anesthesia were recorded. RESULTS: There were no significant differences between groups with regard to the intensity and area of the solutions at 0, 60, and 120 minutes after injection, but differences were found within each group. CONCLUSIONS: No between-group differences were found on magnetic resonance imaging in the distribution and absorption of lidocaine with or without epinephrine and articaine with 0.006 and 0.012 mg/mL epinephrine. All solutions were noticeably absorbed at 120 minutes after injection.

Large dentigerous cyst in the maxillary sinus leading to diplopia and nasal obstruction: case report.

Dentigerous cysts are the most common developmental odontogenic cyst of the jaws. They are more frequent in males and although most often affected teeth are maxillary canines and mandibular third molars, they may also be related with supernumerary or an ectopically erupted tooth. Our aim was to report the management of ectopic third molar tooth related with a dentigerous cyst in maxillary sinus. 16 years old girl referred to our clinic with a complaint of painful swelling over her right cheek since past six months. All permanent teeth were present except the right upper third molar. External examination showed that the face was gently asymmetrical; levels of eye globes were abnormal. Radiographic examination revealed a cystic lesion related with ectopic third molar which located in the roof of the left maxillary sinus. Under local anesthesia, hard drain was inserted into the hole and the cystic pressure was decreased. After the six month of followup, the operation was performed under general anesthesia. The patient's symptoms were resolved completely after surgery and remained symptom-free for over a postoperative follow-up period of 3 year. To avoid unwanted effects of a dentigerous cyst, unerupted tooth should be observed with radiographic imaging. Some untreated dentigerous cysts may grow large and have a potential to develop into an odontogenic tumor.

Effect of Capparis spinosa extract on sutural ossification: A stereological study.

OBJECTIVE: To investigate the effects of systemically administered Capparis spinosa extract (CSE) on expanded sutures in rats via three dimensionally morphometric method (stereological method). MATERIALS AND METHODS: Thirty-two Wistar rats were used. Subjects were divided into four groups, each with eight rats. Orthopaedic expansion force was applied for 5 days to maxillary incisors by attaching springs. Control-1 and CSE-1 waited 1 week for consolidation, and Control-2 and CSE-2 waited 2 weeks for consolidation. After the consolidation period, the subjects were sacrificed. Stereological examination was performed to determine the volume and area of new bone, connective tissue, and capillaries. RESULTS: New bone area, new bone volume, connective tissue space, and connective tissue volume were statistically different in CSE-1 compared to Control-1. But there were no statistically difference between CSE-2 and Control_2. In terms of the volume of blood vessels and vascular area, there were no statistically significant differences when comparing Groups CSE-1 and Control-1 or CSE-2 and Control-2. CONCLUSION: Systemic use of CSE accelerated fastened osteoblastic activity in the early period.

Clinical evaluation of lateral and osteotome techniques for sinus floor elevation in the presence of an antral pseudocyst.

PURPOSE: The aim of this retrospective study was to evaluate results and complications in sinus floor augmentations performed in the presence of antral pseudocyst. MATERIALS AND METHODS: Two hundred thirty-five sinus floor augmentation procedures performed in 179 patients (102 men and 77 women; mean age, 46.3 years; range 24 to 77 years) were included in the study. All patients had been admitted between 2007 and 2010 and treated with sinus augmentation in a single-stage or two-stage procedure using lateral sinus floor elevation (LSFE) or in a single stage via osteotome sinus floor elevation (OSFE). RESULTS: A total of 29 (16.2%) patients had 32 (13.6%) sinus floor augmentation procedures performed in the presence of an antral pseudocyst. Faint dome-shaped radiopacities were detected at the floor of the antrum of these patients. No sinus membrane tears occurred during elevation in the LSFE group. Two patients in the LSFE group and one patient in the OSFE group developed acute sinusitis during the postoperative period and were treated with medical therapy. No symptoms of acute sinusitis or any other complications were encountered in the remaining patients after an average 17-month follow-up period. CONCLUSIONS: Pseudocysts of the maxillary sinus may not be a contraindication for sinus augmentation by OSFE or LSFE techniques. However, detailed evaluation of patients is crucial to prevent undesirable complications. Further studies of larger patient populations are needed to reach definitive conclusions.

Effects of boric acid on experimental periodontitis and alveolar bone loss in rats.

OBJECTIVE: The goal of the present study was to evaluate the histopathologic and morphometric effects of systemic boric acid in a rat periodontitis model. DESIGN: Twenty-four Wistar rats were divided into three groups of eight animals each: non-ligated (NL), ligature only (LO), and ligature and treated with boric acid (BA) (3mg/kg per day for 11 days). A 4/0 silk suture was placed in a subgingival position around the mandibular first molars; after 11 days the rats were sacrificed, and changes in alveolar bone levels were measured clinically and tissues were histopathologically examined to assess the differences amongst the study groups. RESULTS: The ratio of presence of inflammatory cell infiltration (ICI) and osteoclast number in the LO group was significantly higher than that of the NL and BA groups (p<0.05). The ratio of presence of osteoblastic activity in the LO group was significantly lower than that of the NL and BA groups (p<0.05). Alveolar bone loss was also significantly higher in the LO group compared to the BA and NL groups (p<005). CONCLUSIONS: This study has demonstrated that systemic administration of boric acid reduced periodontal inflammation and alveolar bone loss in periodontal disease in rats.

Thymoquinone accelerates new bone formation in the rapid maxillary expansion procedure.

OBJECTIVE: The aim of this study was to evaluate the effect of systemic thymoquinone (TQ) in a rat rapid maxillary expansion (RME) study. DESIGN: Thirty-two Wistar albino rats were divided into 4 equal groups: only-expansion (OE), expansion plus TQ (TQ1 group, TQ given to the rats during their nursery phase and during the expansion and retention period), expansion plus TQ (TQ2 group, TQ given to the rats only during the retention period), and control group (no procedure done). Expansion appliances were placed on the maxillary incisors of all animals for 5days. The appliance was deactivated during the 12day retention period. The rats were sacrificed at the end of the retention period. Histomorphometric evaluation was carried out in order to compare the number of osteoclasts, osteoblasts, and capillaries, as well as the intensities of inflammatory cells, and new bone formation amongst the groups. RESULTS: New bone formation, number of capillaries and the ratio of intensities of inflammatory cells in maxillary sutures was higher in the TQ groups than in the other groups. Statistical analysis also demonstrated that osteoblast and osteoclast numbers were also highest in the TQ1 group. CONCLUSION: Histomorphometric analysis demonstrated that systemic use of thymoquinone may be effective in accelerating new bone formation in the RME procedure and that TQ may be beneficial in preventing relapse following the RME procedure.

Comparison of local and systemic alendronate on distraction osteogenesis.

This study compared the effect of systemic and local administration of alendronate on distraction osteogenesis in rabbit mandibles. Thirty New Zealand white rabbits were allocated to 3 groups: 10 rabbits for systemic alendronate; 9 for local alendronate; and 11 as controls. After a 5 day latency period, distraction was performed at a rate of 0.8mm/day for 9 days via a custom-made distractor. Animals were killed at the end of the consolidation period of 28 days. The distracted mandibles were harvested and evaluated by plain radiography, computed tomography (CT), dual energy X-ray absorptiometry (DEXA), and histomorphometry. Histologically, comparing the systemic and local alendronate groups, there were no statistically significant differences in the bone healing parameters, but each group showed a statistically superior effect over the control group (p<0.05). Quantitative CT evaluation showed a significant difference mean in the density of the regeneration between experimental and control groups. There was a significant increase in mean bone mineral density in the experimental groups compared with the control group. Histologic, CT, and DEXA analysis demonstrated that using systemic and local alendronate may be effective in accelerating new bone formation in the distraction gap in rabbit mandibles.

Genetic analysis of intraoral KIT-positive gastrointestinal stromal tumor (GIST).

Gastrointestinal stromal tumors (GISTs), mesenchymal neoplasms originating from the cells of Cajal, usually appear in the gastrointestinal tract and abdomen. They often mimic other lesions, including smooth muscle cell tumors and neurogenic tumors. This study presents a case in which a GIST appeared over a 2-month period and was treated by excision and curettage, with no sign of recurrence during the next 42 months. The study also aims to characterize the GIST. Histopathologic analysis and KIT gene amplification and sequencing were performed. On mutation analysis of the GIST material, the novel 69338Tdel mutation was found in exon 11, and the diagnosis of intraoral stromal tumor was made. GISTs in the intraoral region display pathologic properties similar to others developed throughout the gastrointestinal system. Diagnosis is the first step of treatment for a patient. The discovery of oncogenic KIT mutations in GISTs has led to the development of targeted molecular therapy using tyrosine kinase inhibitors. This study investigates the histopathologic and molecular diagnostics of GISTs, and, to the authors' knowledge, it represents the first genetic study of a GIST developing in the intraoral region.

Penetrated shotgun pellets: a case report.

Shotgun wounds can result in devastating functional and aesthetic consequences for patients. There is no consensus in terms of removing or retaining foreign bodies such as shotgun pellets. In this report a 54-year-old man who suffered from accidental shotgun wounds on the face approximately 26 years ago is presented. Although most of pellets were still present, there were no symptoms such as poisoning, fistula formation, recurrent infections, or secondary hemorrhage to date except feeling cold in cold days.

Maxillary tuberosity fracture associated with first molar extraction: a case report.

Maxillary tuberosity fractures during molar teeth extraction can occur commonly in dental practice; however, very few cases are reported and discussed in the literature. This article presents a case of large fracture of maxillary tuberosity during extraction of first maxillary molar tooth and its conservative treatment outcomes.