Epidemiological Features and Clinical Repercussions of Supernumerary Teeth in a Multicenter Study: A Review of 518 Patients with Hyperdontia in Spanish Population.

OBJECTIVES: The aim of this study was to establish the prevalence of supernumerary teeth (ST) in a sector of the population of Madrid, as well as possible complications associated with the presence of these teeth. MATERIALS AND METHODS: The study investigated patients (n = 28,114) who sought dental care at the Oral Surgery Service of three different centers between May 2005 and April 2018. Cases that did not present this numeric dental developmental variation were discarded, registering only those presenting ST. STATISTICAL ANALYSIS: Statistical analysis consisted of univariate analysis (mean, standard deviation, median, etc.), bivariate analysis applying the chi-squared test, whereby statistical significance was established with a confidence interval (CI) of 95% (p < 0.05), and multivariate analysis by means of classification and decision trees. RESULTS: The study found ST in 518 patients, representing a prevalence of 1.84%. The 518 patients presented a total of 726 ST. Distomolars were the most common, representing 37.7% of the sample, followed by premolars (20.1%). About 70.5% of the sample were located in the maxilla and 78% of ST were impacted. Radiographs revealed that 39.7% of STs were associated with disorders. Supplementary morphology appeared in 52.1% of the sample. CONCLUSIONS: Although mesiodens is considered the most common ST, the present study found distomolars and supernumerary premolars to be the most frequently occurring. Pathology was associated with 39.7% of the ST sample. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need.

Comparison of peri-implant soft tissues in submerged versus transmucosal healing: A split mouth prospective immunohistochemical study.

OBJECTIVE: The present split-mouth prospective study involves an immunohistochemical evaluation of peri-implant soft tissue healing after the osseointegration period, comparing submerged and transmucosal approaches using two-piece implant systems. The null hypothesis was that both surgical procedures elicit a similar immune response of the peri-implant soft tissues. DESIGN: Thirty-one healthy patients were included in this study, in which two implants were placed in the right and left maxillary pre-molar regions. A total of 62 dental implants were analyzed, establishing a control side with 31 submerged implants, and a study side with 31 exposed implants bearing healing abutments. After a three-month healing period, a soft tissue biopsy was collected and prepared for immunohistochemical analysis of the proportions of different lymphocyte subpopulations. RESULTS: The comparative analysis between the submerged and transmucosal approaches failed to identify statistically significant differences in CD19+ B cells, CD4+ T cells, CD8+ T cells, CD25+ T cells or γd T cells. However, significant differences in NK lymphocytes (p = 0.012) were recorded with the submerged surgical procedure. CONCLUSIONS: Peri-implant soft tissue immune response with submerged or transmucosal healing protocols demonstrated comparable outcomes after the osseointegration period. There is sufficient evidence that the null hypothesis of no difference cannot be rejected. To the best of our knowledge, this is the first study of its kind. Further research is therefore needed to further clarify the role of these lymphocyte subpopulations in peri-implant soft tissues.

Dental considerations in diagnosis of maxillary sinus carcinoma: A patient series of 24 cases.

BACKGROUND: Maxillary sinus carcinoma is a rare entity with an incidence of 0.2% and a low patient survival rate due to the frequency of late diagnosis. METHODS: In this multicenter, transversal, retrospective, observational study, the authors analyzed patients who had received a diagnosis of maxillary sinus carcinoma, registering their oral symptoms, histologic type, treatment efficacy, and survival rate. RESULTS: Maxillary sinus carcinoma was diagnosed in 24 patients (15 men and 9 women), of which 75% were squamous cell carcinomas. All patients had dental mobility, and some had swelling, orosinus fistula, or some dental loss. Mean patient survival rate was 38.83 months. CONCLUSIONS: A history of pain or swelling of unknown origin, an unexplained widening of periodontal ligament space, or mobility of the teeth should be considered warning signs of maxillary sinus carcinoma. PRACTICAL IMPLICATIONS: Recognition of oral symptoms by the dentist would help in making an early diagnosis of maxillary sinus carcinoma, improving the patient's chances of survival and quality of life.

Does the postoperative administration of antibiotics reduce the symptoms of lower third molar removal? A randomized double blind clinical study.

BACKGROUND: To date there is little scientific evidence that clarifies the therapeutic effect of antibiotics for managing the postoperative symptoms of impacted third molar surgery. The aim of this study was to evaluate the efficacy of antibiotic treatment for reducing non-infectious clinical symptoms. MATERIAL AND METHODS: Patient data was collected from the patients´ medical records and the results were statistically evaluated with SPSS versión 21.0; SPSS, IBM; Chicago, IL, USA). This longitudinal prospective study consisted of a randomized simple-blind clinical assay of 293 patients attending the Department of Oral Medicine and Surgery, Faculty of Dentistry at the Complutense University of Madrid (Spain). The predictive variable evaluated was the effect of antibiotic treatment on non-infectious symptoms after third molar extraction. The variables evaluated were pain, swelling, and oral aperture. RESULTS: The 293 patients were divided into 2 groups: a control group of 147 patients treated with analgesics and anti-inflammatories after surgery and a study group of 146 patients, who were also administered antibiotics. Better outcomes were observed in the study group treated with antibiotics. Pain, swelling and oral aperture variables presented better results in the antibiotic group with statistically significant difference. CONCLUSIONS: The results suggest that antibiotic administration decreases the post-operative non-infectious clinical symptoms of impacted third molar surgery. However, the prolonged administration of antibiotics had no real medical indications to justify their use and can cause serious health problems in the long term. Key words:Antibiotic, post-operative, impacted lower third molar.

Manejo quirúrgico de la transmigración bilateral de caninos mandibulares. Reporte de caso / Surgical management of bilateral transmigration of mandibular canines. Case report

La transmigración se define como el fenómeno en el cual un diente incluido no erupcionado, traspasa en más de la mitad de su longitud la línea media. Es una anomalía poco frecuente y es aún más raro que ocurra de forma bilateral. Se presenta con mayor incidencia en los caninos mandibulares, en el sexo femenino, de forma unilateral, y siendo el canino izquierdo el más comúnmente afectado. El objetivo de este trabajo es describir el manejo quirúrgico satisfactorio en un paciente varón de 16 años, asintomático, el cual presentaba a la exploración clínica intraoral ausencia de ambos caninos mandibulares permanentes y persistencia de canino temporal inferior izquierdo, acompañado de una ligera malposición dentaria. En la exploración radiográfica (panorámica), se observaron ambos caninos inferiores derecho e izquierdo, en posición horizontal, bajo los ápices de incisivos inferiores. Se procedió a la extracción quirúrgica de ambos caninos, transcurriendo el postoperatorio sin incidencias. Se realizaron controles periódicos y radiográficos satisfactorios a los seis meses. Palabras clave: Diente impactado; Migración del diente; Diente incluido; Canino (fuente: DeCS BIREME)

Transmigration is defined as the phenomenon in which an unerupted included tooth tran-scends the midline by more than half of its length. It is a rare anomaly and it is even more rare to occur bilaterally. It is presented with greater incidence in the mandibular canines, in the female sex, unilaterally, and the left canine being the most commonly affected. The objective of this study is to describe satisfactory surgical management in a 16-year-old asymptomatic male patient, which presented to the intraoral clinical examination absence of both permanent mandibular canines and temporary biscuspid persistence. Lower left, accompanied by a slight dental malposition. In the radiographic exploration (panoramic), both right and left lower canines were observed, in a horizontal position, under the lower incisor apexes. We proceeded to the surgical extraction of both canines, passing the post-operative period without incidents. Satisfactory periodic and radiographic controls were performed at six months. Keywords: Tooth, impacted; Tooth migration; Tooth, unerupted; Cuspid (source: MeSH NLM).