Efficacy of photobiomodulation in the treatment of avulsed teeth: A systematic review of animal studies.

The objective of this systematic review was to evaluate the effectiveness of photobiomodulation therapy (PBM) in managing avulsed teeth. This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (i.e., "PRISMA") statement 2020 and was registered in the International Prospective Register of Systematic Reviews (i.e., PROSPERO) with number CRD42022362198. The participants, intervention, comparison, outcomes, and study design (i.e., PICOS) for the present study considered the following question: "Does the use of laser PBM in the treatment of teeth with avulsion influence tissue repair performance?" A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and ProQuest databases until January 2023. The SYRCLE's RoB tool (Systematic Review Center for Laboratory Animal Experimentation) for animal studies were used for quality assessment. A total of 7 in vivo studies published between 2011 and 2018 were included in this systematic review for qualitative analysis. All studies used Wistar rats, totaling 368 specimens that simulated tooth avulsion trauma. The effect of photodynamic therapy in the treatment of avulsed teeth was positive in 5 studies (significant increase in tissue repair) and negative in 2 studies, in which both studies with negative results kept teeth in saline solution before reimplantation and showed the longest time and power of laser application. PBM appears to be effective for tissue repair in the treatment of avulsed teeth, depending on the means of conservation of the avulsed tooth and the laser application protocol.

The effect of soy and whole milk as a means to store avulsed teeth: A histometric study.

BACKGROUND/AIM: An adequate storage medium can help preserve the viability of periodontal ligament cells, favoring the periodontal ligament repair process. The aim of this study was to evaluate the repair process following the delayed replantation of teeth stored in soy milk and whole milk. MATERIAL AND METHODS: The maxillary right incisors of 27 rats were divided into three equally sized groups: Group SM (delayed replantation with storage in soy milk), whose teeth were immersed in 50 mL of soy milk for 60 minutes; Group WM (delayed replantation with whole milk), teeth were kept for 60 minutes in 50 mL of whole milk; and Group D (delayed replantation with dry storage), teeth were kept in dry conditions for the same period (negative control). Next, the teeth of the animals of all groups were replanted into their sockets. Systemic antibiotics were given to all the animals, and then, they were euthanized after 60 days. Sections were obtained and stained with hematoxylin and eosin for histomorphometric study. The presence and location of acute and chronic inflammatory processes in the epithelial insertion of the protective and insertion periodontium were evaluated, as well as the presence, extension, depth, and repair of root resorption, and the resorption and ankylosis with bone. Statistical differences between groups were analyzed using the Dunn test. RESULTS: Groups SM and WM showed similar patterns in the repair of the periodontal ligament following delayed replantation, in relation to the inflammatory process in the proximities of the epithelial insertion, inflammation and organization of the periodontal ligament, plus root and bone resorption. However, in group WM, more ankylosis was observed than in group SM. CONCLUSION: The teeth stored in soy milk and whole milk had similar periodontal repair, which shows the potential of soy milk as a storage medium before tooth replantation.

Oral Myiasis in a Patient With HIV Manifestations and Neurologic Toxoplasmosis Treated by Ivermectin.

Myiasis has been defined as a pathologic condition where dipterous larvae are lodged in mammalian hosts causing an infestation, which feeds on living or dead tissue for at least a certain period inside the host and develops itself as parasites. In humans, the most commonly affected sites are the nose, eyes, skin wounds, sinuses, lungs, ears, gut, gall bladder, vagina, nasal cavities, and rarely the mouth because the oral tissues are rarely exposed to the external environment. The etiology of oral myiasis is usually related to local factors such as poor oral hygiene, periodontal disease and labial incompetence, and systemic factors such as neurologic deficits.

Simplified Access for Reduction and Fixation of a Frontal Bone Fracture.

The frontal bone fractures occur very often in service units in oral and maxillofacial surgery. Bicoronal access is the most common for the surgical treatment of frontal bone fractures. However, patients are surprised when they receive notice that such invasive access will be made. This approach allows adequate visualization of the fracture site, but may be associated with complications, which can be avoided by the use of less invasive techniques. We describe an alternative approach that aims to minimize the complications of a coronal incision.

Evaluation of the Osteoinductive Effect of PDGF-BB Associated With Different Carriers in Bone Regeneration in Bone Surgical Defects in Rats.

PURPOSE: Extensive bone defects in maxillofacial region can be corrected with autograft. However the disadvantages of this type of therapy lead to the search for new bone substitutes. Thus, we evaluated the biological behavior and osteoinductive platelet-derived growth factor type BB (PDGF-BB) associated with different carriers, by histological analysis and immunohistochemical histometric critical defects performed in rat calvaria. MATERIALS AND METHODS: Critical defects were created with 5-mm diameter calvaria of rats. Each defect was randomly divided into 8 experimental groups, evaluated at 15 and 30 postoperative days for histomorphometry and immunohistochemistry. RESULTS: The results showed new bone formation in all groups, independent of postoperative time. At 30 days, the beta-tricalcium phosphate matrix (TCP) group just did not differ from bone matrix mineralized bovine (BIO) group in the new bone formation (P = 0.1403). In none of the groups' analyzed biomaterials, growth factor stimulated increase in bone formation (P > 0.05). CONCLUSION: With the methodology used, the growth factor associated with the tested biomaterials did not induce new bone formation.

Submental Intubation in Cases of Panfacial Fractures: A Retrospective Study.

Surgical treatment of panfacial fractures usually requires intraoperative temporary occlusion of the teeth and simultaneous access to the nasal pyramid. In such cases, the standard method of airway management is to perform a tracheostomy, but this may be associated with a significant number of perioperative and late complications. This study aimed to determine if submental endotracheal intubation (SEI) is a viable alternative to tracheostomy, especially when short-term postoperative control of the airway is foreseen. This was an observational retrospective study, carried out between 2012 and 2014, which involved 32 consecutive patients who sustained panfacial fractures and were surgically treated during a 3-year period in a level I trauma center hospital. Only those who required SEI were included in the sample. Four cases were excluded because of incomplete registries, follow-up period less than 4 months after hospital discharge, or other unrelated complications. The medical charts of all patients involved in the sample were carefully reviewed in order to qualify and quantify perioperative and postoperative complications related to anesthetic management. We hypothesized that SEI would not interfere with the surgical procedures and would present less morbidity and reduced complication rates. Twenty-eight patients, 24 male and 4 female, met all the inclusion criteria. The mean age was 29.5 ± 9.05 years (range, 18-56 years). The mean duration time of surgery was 8.07 ± 4.0 hours (range, 4-16 hours). There were no perioperative complications. Postoperatively, only 1 patient (3.57%) experienced a cutaneous infection at the submental region, which was easily treated. Additionally, only 1 case (3.57%) of hypertrophic scar was reported. SEI appears to be a safe, simple, and effective technique of immediate perioperative airway management in selected cases of panfacial fractures.

Immediate tooth replantation in rats: effect of systemic antibiotic therapy with amoxicillin and tetracycline.

OBJECTIVES: The aim of this study was to evaluate the influence of systemic administration of antibiotics (amoxicillin and tetracycline) at the different phases of the repair process (7, 15, 30 days) in immediate rat tooth replantation. MATERIALS AND METHODS: Ninety rats had their incisors extracted and stored in saline for 5 min. Next, the teeth were replanted, and the animals were assigned to three groups according to the antibiotic administered by oral gavage: control group, amoxycillin group, and tetracycline group. Euthanasia was performed at 7, 15, and 30 days after replantation. RESULTS: Regardless of the evaluation period, the connective tissue underlying the epithelial attachment and the periodontal ligament showed statistically significant difference relative to the acute inflammatory infiltrate, which was more intense in the control group followed by the tetracycline group. CONCLUSION: These results point to the fact that systemic antibiotic therapy (SAT) in immediate tooth replantation is beneficial to pulpal and periodontal ligament repair and that amoxycillin is an excellent option. CLINICAL RELEVANCE: There is a lack of randomized studies assessing how the use of systemic antibiotics could influence tooth healing after immediate replantation.

Orthognathic Surgery in Patients With Large Condylar Destructions.

Condylar resorption is understood as changes in shape and volume of the condylar bone, due to local, systemic, and iatrogenic factors. The occurrence of condylar resorption after orthognathic surgery can occur when the condylar repositioning in mandibular fossa is performed improperly. In addition, systemic diseases such as osteoarthritis and rheumatoid arthritis seem to influence this process. The aim of this study was to report 3 cases of patients with severe condylar alterations, submitted to orthognathic surgery for treatment of dentofacial deformities. Considerations regarding the diagnosis, surgical planning (counterclockwise rotation), surgical techniques (bilateral sagittal split osteotomy, bimaxillary osteotomies, rigid fixation, maxillomandibular fixation period), and results (short terms) are discussed.

Orthognathic surgery in patients with cleidocranial dysplasia.

The aim of this study was to report the orthodontic-surgical approach of a 21-year-old female patient diagnosed with cleidocranial dysplasia. An orthognathic surgery was performed in the maxilla and mandible during the same procedure to correct an existing dentofacial deformity (class III malocclusion). In addition, malar prostheses were used to correct midface deficiency. After surgical intervention, orthodontic treatment continued in order to promote stability, function, and aesthetics. Cases of cleidocranial dysplasia treated with the defined criteria can bring aesthetic and functional benefits to the patient.

Delayed tooth replantation in rats: effect of systemic antibiotic therapy with amoxicillin and tetracycline.

Systemic antibiotic therapy (SAT) has usually been recommended after tooth replantation, but its actual value has been questioned. As there are no reports in the literature about its influence on tooth replantation, the aim of this study was to evaluate the influence of systemic administration of antibiotics (amoxicillin and tetracycline) at the different phases of the repair process (7, 15, 30 days) in delayed rat tooth replantation. Ninety Wistar rats (Rattus norvegicus albinus) had their maxillary right incisors extracted and bench-dried for 60 min. The dental papilla, enamel organ, pulp tissue, and root surface-adhered periodontal ligament were removed, and the teeth were replanted. The animals received no antibiotics (n = 30) or were medicated systemically with amoxicillin (n = 30) and tetracycline (n = 30), and were euthanized after 7, 15, and 30 days. Regardless of the evaluation period, the acute inflammatory infiltrate was less intense and root resorption presented smaller extent and depth in the group treated with amoxicillin. The results suggest that SAT has a positive influence on the repair process in delayed tooth replantation and that amoxicillin is an excellent treatment option.

Effect of the treatment of root surface-adhered necrotic periodontal ligament with propolis or fluoride in delayed rat tooth replantation.

OBJECTIVES: The purpose of this study was to evaluate the application of 15 % propolis and 2 % acidulated-phosphate sodium fluoride solutions on the root surface-adhered necrotic cemental periodontal ligament in delayed tooth replantation. MATERIALS AND METHODS: Thirty Wistar rats (Rattus norvegicus, albinus) had their right upper incisor extracted and maintained in dry storage for 60 min. After this period, the dental papilla, enamel organ, and pulp tissue were removed, and the animals were randomly assigned to three groups: group I = immersion in saline for 10 min; group II = immersion in a 2 % acidulated-phosphate sodium fluoride solution for 10 min; and group III = immersion in a 15 % propolis and propylene glycol solution for 10 min. The root canals were filled with a calcium hydroxide paste and the teeth were replanted. RESULTS: Inflammatory resorption, replacement resorption, and ankylosis were observed in all groups without a statistically significant difference (p > 0.05) among them. CONCLUSIONS: Under the tested conditions, the application of fluoride or propolis on root surface-adhered necrotic periodontal ligament did not favor the healing process in delayed tooth replantation.

Using conservative condylectomy for management of a large osteochondroma of the mandibular condyle with 6-year follow-up.

Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure.

Conservative approach: using decompression procedure for management of a large unicystic ameloblastoma of the mandible.

Ameloblastoma is a relatively uncommon benign odontogenic tumor, which is locally aggressive and has a high tendency to recur, despite its benign histopathologic features. This pathology can be classified into 4 groups: unicystic, solid or multicystic, peripheral, and malignant. There are 3 variants of unicystic ameloblastoma, as luminal, intraluminal, and mural. Therefore, in mural ameloblastoma, the fibrous wall of the cyst is infiltrated with tumor nodules, and for this reason it is considered the most aggressive variant of unicystic ameloblastomas. Various treatment techniques for ameloblastomas have been proposed, which include decompression, enucleation/curettage, sclerotizing solution, cryosurgery, marginal resection, and aggressive resection. Literature shows treatment of this lesion continues to be a subject of intense interest and some controversy. Thus, the authors aimed to describe a case of a mural unicystic ameloblastoma of follicular subtype in a 19-year-old subject who was successfully treated using conservative approaches, as decompression. The patient has been followed up for 3 years, and has remained clinically and radiographically disease-free.

Induction of ankylosis in the incisor for orthodontic tooth movement in rats.

BACKGROUND/AIM: The present research evaluated the induction of ankylosis and the eruption rate in rat incisors, with the aim of achieving stable anchorage for orthodontic tooth movement (OTM) of the molars. MATERIAL AND METHODS: Fifteen male Wistar rats were used. In the Experimental group, the right superior incisor of each animal was extracted, denuded of the PDL and the dental papilla, and reimplanted. The Control group was the left superior incisors. The eruption rate was measured at 7, 10, 12, 14, and 16 days after replantation. NiTi closed springs with a 50cN release force were installed for additional 9 days, and the eruption rate was determined. Then, the rats were sacrificed, and ankylosis was examined by microscopic analysis. Differences with P < 0.01 were defined as statistically significant. RESULTS: The eruption rates were 0 and 0.39 mm day(-1) in the Experimental group and Control group, respectively. All incisors of the Experimental group showed ankylosis according to histological analysis. CONCLUSIONS: The methodology used to induce ankylosis in this study was effective for anchoring the incisors during the OTM of rat molars, eliminating the undesirable effects consequent to continuous eruption.

Utilization of ethyl cyanoacrylate and 2-octyl cyanoacrylate adhesives for autogenous bone graft fixation: histomorphometric study in rats.

The present study analyzes the repair process of autogenous bone graft in a block fixed with ethyl cyanoacrylate and 2-octyl cyanoacrylate adhesives in rat calvaria. Forty-eight rats, divided into 3 groups, received round osteotomies at the right parietal bone for the attainment of autogenous bone graft fragment, which was fixed at the opposite side to the donor site with ethyl cyanoacrylate (ethyl group) and 2-octyl cyanoacrylate (octyl group) adhesives. In the control group, bone fragment was only juxtaposed at the parietal bone surface without any fixation material. The animals were euthanized after 10 and 60 postoperative days. The calvariae were processed in a laboratory for the attainment of slides stained through the hematoxylin and eosin technique for histological and histometric analysis. The qualitative analysis showed a discrete inflammatory infiltrate in the control group and moderate inflammatory infiltrate in the ethyl and octyl groups at the 10-day period, which remained at the 60-day period, mainly in the octyl group. The bone fragment remained bonded to the recipient site through the adhesive, but graft incorporation was not observed in any of the specimens. Resorption was higher in the octyl group followed by the ethyl and control groups, both at the 10- and 60-day periods, but with no statistical significance (P < .05). Although promoting graft fixation and its maintenance at the recipient site, both studied adhesives did not allow the graft incorporation, producing a localized and discrete inflammatory reaction, which persisted at 60 days, being more intense in the octyl cyanoacrylate group.

Epidermal cyst causing facial asymmetry.

Epidermoid cysts are rare benign tumors that are derived from the development of abnormally situated ectodermal tissue and are often an incidental finding. They are usually diagnosed between 15 and 50 years of age, with both sexes equally affected. In epidermoid cyst management, complete excision is the therapy of choice. The authors reported a case of a 24-year-old man with an epidermoid cyst located on the left side of the face, on the region of mandibular body, which was treated by complete surgical excision. The patient has been followed up for 2 years without signs of recurrence.

Using the "bottom-up and outside-in" sequence for panfacial fracture management: does it provide a clinical significance?

Panfacial fractures usually refer to simultaneous facial fractures, which affect the upper, middle, and lower thirds of the face. The management of panfacial fracture is complex because of the lack of reliable landmarks. Literature has shown many approaches for management of panfacial fractures. Every segment of bone has a precise function in the repair. Therefore, the "bottom-up and outside-in" sequence is the most widely used approach in the management of panfacial fractures. These facial fractures present remarkable challenges for both experienced and inexperienced surgeons. This article aimed to report a case of a panfacial fracture (mandibular condylar and symphysis fractures associated with an atypical Le Fort III fracture) in a 48-year-old man. The patient was successfully treated using bottom-up and outside-in sequence by accessing all facial injuries. Postoperatively, radiograph examination revealed good reduction and fixation of titanium plates, and physical examination revealed good functional and esthetic outcomes.

Tissue engineering: using collagen type I matrix for bone healing of bone defects.

Among the many tissues in the human body, bone has been considered as a powerful marker for regeneration and its formation serves as a prototype model for tissue engineering based on morphogenesis. Therefore, collagen type I is one of the most useful biomaterials used in tissue engineering as extracellular matrix components capable to promote bone healing. The literature reveals excellent biocompatibility and safety due to its biological characteristics, such as biodegradability and weak antigenicity, making collagen type I the primary resource in medical applications. Thus, it was also used for tissue engineering including skin replacement, bone substitutes, and artificial blood vessels and valves. The authors describe the treatment of an abscessed apical periodontal cyst and show good outcomes of bone healing, using tissue engineering, as collagen type I matrix.

Arthrocentesis procedure: using this therapeutic maneuver for TMJ closed lock management.

Temporomandibular joint (TMJ) disorder is a term that encompasses a number of overlapping conditions, such as closed lock. Closed lock of the TMJ is considered a consequence of a nonreducing deformed disc acting as an obstacle to the sliding condylar head that usually causes a decrease in the maximum mouth opening and acute pain. The management of the TMJ is still controversial. Thus, arthrocentesis of the TMJ is a valuable modification of the traditional method of arthroscopic lavage, which consists of washing the joint in order to remove chemical inflammatory mediators and intra-articular adhesions, changing intra-articular pressure. TMJ disorder has always presented as a therapeutic challenge to maxillofacial surgeons. Therefore, this paper aimed to describe a clinical report of a closed lock of the left TMJ in a 19-year-old female subject who was successfully treated by arthrocentesis procedure.

Conservative condylectomy for management of osteochondroma of the mandibular condyle.

Osteochondroma is one of the most common benign tumors of the skeleton. This tumor is rare in the craniofacial region, with the most common sites of occurrence being the coronoid process of the mandible and the mandibular condyle. Traditionally, the treatments of these lesions include total condylectomy or local resection of the lesion. Conservative condylectomy procedure with reshaping of the remaining condylar neck and repositioning of the articular disk has been suggested. This article aimed to describe a 35-year-old woman with osteochondroma in the left mandibular condyle who was treated by conservative condylectomy. The patient has been free of recurrence for 2 years, showing good aesthetic and functional stability.