Horizontal ridge augmentation using guided bone regeneration with an association of particulate allografts mixed with platelet-rich fibrin, collagen membrane and tent-screws: A prospective study.

BACKGROUND: Guided Bone Regeneration (GBR) is a versatile technique employed not only to correct pre-implant alveolar bone defects but also to facilitate bone defect correction during simultaneous implant placement. The effectiveness of GBR varies significantly among different protocols, as reported in the literature. This study specifically aimed to radiologically evaluate the horizontal bone gain obtained using a GBR procedure combining a particulate allograft, platelet-rich fibrin, resorbable collagen membrane, and screw tents. MATERIALS AND METHODS: A total of 42 patients with an insufficient alveolar bone width for dental implant placement were treated with a GBR technique using a mixture of particulate allograft (demineralised freeze-dried bone allograft 300-500 and 500-1000 µm), advanced platelet-rich fibrin (A-PRF), resorbable collagen membranes and screws tents (1.2 mm in diameter). Over the course of the study, a total of 63 GBR procedures were performed on these patients. Bone gains were measured by cone-beam computed tomography at 9.1 ± 2.0 months post-operative. RESULTS: A significant mean increase (P < 0.001) of 3.2 ± 0.9 mm at the sites of the greatest bone defect was observed. This improvement was consistent across various locations, including both maxillary and mandibular regions, and in cases of terminal and embedded edentulism, without any post-operative complications during the entire post-operative follow-up. All patients benefited from implant placement following the bone augmentation protocol. CONCLUSION: GBR combining particulate allografts, A-PRF, collagen membranes, and screw tents achieves reliable, predictable, and reproducible clinical gains that allow for future implant placement.

Pneumomediastinum after Third Molar Extraction: Case Report, Physiopathology, and Literature Review.

Wisdom tooth extraction is a common procedure in dentistry and stomatology. Subcutaneous emphysema is a rare postoperative complication and commonly remains localized. However, it may spread to the mediastinum, endangering the life of the patient. This present paper presents a case study of pneumomediastinum after wisdom tooth extraction without the use of a compressed air turbine and reviews the cases of subcutaneous emphysema after third molar extraction published in the literature since 2010. The aim of this work is to inform preventive measures, pathophysiological processes, and management related to this complication.

CT diagnosis of pituitary abscess, suppurative meningitis, and atlanto-occipital septic arthritis in a pony.

A 15-year-old pony was presented for acute neurological signs. Neurological examination suggested a brainstem lesion, blood laboratory tests detected an active inflammatory process, and upper respiratory endoscopy identified a suppurative lesion at the dorsal aspect of the right guttural pouch. Computed tomography was performed and findings were consistent with pituitary abscess, meningitis, and atlanto-occipital joint septic arthritis. Imaging findings were confirmed based on cerebrospinal and synovial fluid cultures and necropsy. Computed tomography provided important information for identifying the cause of the patient's neurological signs and helped the owner make a final decision for euthanasia.

Masseteric hernia: A case report and literature review.

Mandibular swellings are common, but a hernia of the masseter muscle is a rare condition. This case report describes the case of a young patient presenting a masseter muscle hernia and discusses the management of this condition.

Stomatological management and implant-supported rehabilitation in a patient with recessive dystrophic epidermolysis bullosa.

Inherited epidermolysis bullosa (EB) is a disease that causes epithelium fragility due to a protein anomaly caused by a genetic mutation. Epidermolysis bullosa clinical manifestations are bullae and cutaneous-mucosal erosions. Epidermolysis bullosa is a rare disease, with different clinical presentations depending on the type and subtype. The stomatological treatment depends on the oral manifestations and EB types. There is no high level of recommendations due to the limited cases described in the literature. We describe an implant-supported dento-maxillary rehabilitation of a 49-year-old patient suffering from a newly diagnosed hereditary recessive EB with disabling oral manifestations. In the current case, the diagnosis of recessive dystrophic epidermolysis bullosa has been confirmed, and adequate dental care was carried out taking into account the disease constraints.

Congenital Limb Deformities in a Neonatal Crossbred Pig.

Purpose: To describe the pathology and imaging findings in two neonatal piglets with congenital limb deformities. Methods: The litter from a second parity crossbred sow presented with four mummified fetuses, three stillborn piglets, and two live piglets with notable limb deformities that were unable to effectively ambulate. The piglets were euthanized and submitted for gross and histological evaluation. Results: Both pigs had bilateral secondary cleft palates, with hypoplasia of the nasal turbinates, and external rotation of the forelimbs. One pig displayed bilateral cryptorchidism, markedly thin and shortened hindlimbs, and syndactyly of both hind feet. Radiographs and gross dissection confirmed the presence of single ossified proximal to distal phalanges of both feet, bilaterally shortened tibias with fibular aplasia, and delayed ossification of tarsal as well as carpal bones. Conclusions: To the author's knowledge, this is the first reported case of hindlimb meromelia with syndactyly in a pig.

Comparison Between Ultrasonographic and Standing Magnetic Resonance Imaging Findings in the Podotrochlear Apparatus of Horses With Foot Pain.

This prospective study aimed to blindly compare the ultrasonographic and standing magnetic resonance imaging (sMRI) findings in deep digital flexor tendon (DDFT), navicular bone, and navicular bursa in horses with foot pain, positive digital analgesia, and without definitive radiographic diagnosis. Ultrasonography detected more DDFT abnormalities (32/34 feet vs. 27/34 with sMRI) but identified less palmar navicular abnormalities (23/34 feet vs. 30/34 with sMRI). In suprasesamoidean DDFT lesions, which were mainly dorsally located, changes in echogenicity did not correspond to a particular pattern of sMRI signal change. Transcuneal ultrasonography did not allow assessment of morphology and extent of distal DDFT lesions, and sporadically discriminated the affected lobe compared to sMRI. Defects of the palmar compact bone were identified with both modalities except a parasagittal defect, which was only seen at sMRI.

Prevalence and Features of Laryngopharyngeal Reflux in Patients with Primary Burning Mouth Syndrome.

OBJECTIVES/HYPOTHESIS: To investigate the prevalence and features of laryngopharyngeal reflux (LPR) in patients with primary burning mouth syndrome (BMS). STUDY DESIGN: Prospective uncontrolled study. METHODS: Patients who visited our Departments of Otolaryngology-Head and Neck and Maxillofacial surgery with BMS were prospectively recruited from September 2018 to September 2020. Patients benefited from dental, maxillofacial, otolaryngological examinations, and hypopharyngeal-esophageal impedance pH-monitoring (HEMII-pH). Oral, pharyngeal, and laryngeal findings and symptoms were rated with Reflux Sign Assessment (RSA) and Reflux Symptom Score-12 (RSS-12). Patients were treated with a combination of diet, pantoprazole, and alginate. RESULTS: From the 81 included patients, 76 reported >1 pharyngeal reflux events (93.8%), accounting for 35 (46.1%), 24 (31.6%), and 17 (22.3%) acid, mixed, and nonacid LPR, respectively. Thirty-two patients had both LPR and gastroesophageal reflux disease (GERD). Thirty-eight patients benefited from pepsin saliva measurement, which was positive in 86.8% of cases. The mean scores of mouth/tongue burning, RSS-12, and RSA significantly improved from pre- to post-treatment (P < .004). At 3-month post-treatment, 62.5% of patients reported an improvement of mouth/tongue burning score. Patients with both GERD and LPR reported higher baseline RSS-12 and RSA scores. CONCLUSION: Acid, weakly acid, and nonacid LPR may be involved in the development of BMS. The use of an appropriate treatment considering the reflux features is associated with an improvement of symptoms and findings. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E2627-E2633, 2021.

Unipodal stance influences radiographic evaluation of foot balance in horses.

Lifting the contralateral forelimb (unipodal stance) is often used as a method of restraint in horses. This experimental one group pretest, posttest study was conducted to evaluate the effects of unipodal stance on quantitative radiographic parameters in equine forefeet. Seven nonlame horses were randomly selected. Lateromedial (LM) and dorsopalmar (DP) projections were acquired for both forefeet, squarely placed on blocks, using two X-ray generators. Radiographs of each foot were acquired first in a bipodal stance, immediately followed by the same radiographic projections obtained in a unipodal stance. The following measurements were recorded for each stance: distal interphalangeal joint (DIPJ) space width on both projections; mediolateral joint balance as the difference between lateral and medial DIPJ space widths on DP projections; extensor process-to-middle phalangeal condyle distance; and deep digital flexor tendon angle on LM projections. A matched pairs design and Student's t-test with a 95% confidence level were used to test for statistical significance. Compared to a bipodal stance, lateral DIPJ space width was significantly reduced on unipodal DP views, whereas mediolateral joint imbalance and to a lesser extent medial DIPJ space width were significantly increased. On unipodal LM views, there was a significant higher degree of DIPJ flexion. These findings suggest that stance should be carefully taken into consideration when measuring radiographic parameters in equine forefeet, especially if assessing foot balance and conformation, as unipodal stance significantly affects the mediolateral balance of the DIPJ on DP radiographs and significantly alters the phalangeal axis on LM radiographs.

Low field magnetic resonance imaging of the equine distal interphalangeal joint: Comparison between weight-bearing and non-weight-bearing conditions.

This descriptive study aimed to compare the magnetic resonance appearance of the distal interphalangeal joint articular cartilage between standing weight-bearing and non-weight-bearing conditions. Ten forefeet of live horses were scanned in a standing low-field magnetic resonance system (0.27 T). After euthanasia for reasons unrelated to the study, the non-weight-bearing isolated feet were scanned in a vertical positioning reproducing limb orientation in live horses. The same acquisition settings as during the weight-bearing examination were used. Thickness and cross-sectional area of the distal interphalangeal articular cartilage and joint space were measured on tridimensional T1-weighted gradient echo high resolution frontal and sagittal images at predetermined landmarks in both conditions and were compared using a linear mixed-effects model. Frontal images were randomized and submitted to 9 blinded readers with 3 different experience levels for identification of weight-bearing versus non-weight-bearing acquisitions based on cartilage appearance. Weight-bearing limbs had significantly thinner distal interphalangeal cartilage (p = 0.0001) than non-weight-bearing limbs. This change was greater in the distal phalanx cartilage than that of the middle phalanx. Blinded readers correctly identified 83% (range 65 to 95%) of the images as weight-bearing or non-weight-bearing acquisitions, with significantly different results observed among the different readers (p < 0.001) and groups (p < 0.001). These results indicate that distal interphalangeal articular cartilage and particularly cartilage of the distal phalanx thins when weight-bearing compared to the non-weight-bearing standing postmortem conditions and suggest that cartilage abnormalities may be more difficult to identify on weight-bearing standing magnetic resonance imaging.

Dynamic flexion/extension and non-weight bearing ultrasonography is helpful for identifying manica flexoria tears in horses.

Lesions of the manica flexoria are a tenoscopic finding in horses with digital flexor tendon sheath tenosynovitis. This retrospective case series study describes the ultrasonographic findings in seven horses admitted for digital flexor tendon sheath swelling associated with lameness and tenoscopic confirmation of a manica flexoria tear. Six horses had a partial manica flexoria tear, one a complete rupture. The ultrasonographic examination included a static examination on the weight and non-weight bearing limb and a dynamic limb assessment during flexion and extension. The main ultrasonographic finding at the static weight bearing examination in horses with a partial tear was an asymmetrical appearance of the manica flexoria at the level of the junction with the lateral border of the superficial digital flexor tendon, or an incomplete visualization of the manica flexoria in case of complete rupture. The split edges of the completed ruptured manica flexoria were seen floating in the synovial fluid at the examination in flexion. In six of seven cases, the superficial digital flexor tendon slid abnormally relative to the deep digital flexor tendon, during flexion/extension movements, with medial displacement of the superficial digital flexor tendon, appearance of an anechoic gap between the flexor tendons or reduced superficial digital flexor tendon sliding. Because ultrasonographic diagnosis of the manica flexoria tear is considered challenging, detection of these ultrasonographic features is helpful to increase the likelihood of identifying manica flexoria tears prior to tenoscopy. Authors recommend static ultrasonographic examination of the manica flexoria using a flexed limb position and dynamic ultrasonographic examination using flexion and extension positioning for horses with suspected digital sheath injury.

Peri-Implant Bone Loss at Implants Placed in Preserved Alveolar Bone Versus Implants Placed in Native Bone: A Retrospective Radiographic Study.

OBJECTIVES: The aim of our study was to compare peri-implant bone loss at implants placed in alveolar sockets filled with a particulate allogenous bone graft (DFDBA 300-500 µm) and platelet concentrates versus at implants placed in the native bone. MATERIALS AND METHODS: A retrospective clinical study was performed. A total of 84 patients were included with 247 implants for the restoration of mono and pluri-radicular teeth: 169 implants in native bone and 78 in socket-grafted bone. The peri-implant bone loss was measured by 2 independent operators at 6 and 12 months. RESULTS: The overall mesial and distal peri-implant bone losses were 0.9 ± 0.7 mm and 0.9 ± 0.8 mm at 6 months, respectively, and 1 ± 0.65 mm and 1.2 ± 0.9 mm at 12 months, respectively. In the tested group, the bone loss was 0.8 ± 0.8 mm at 6 months and 1.2 ± 0.9 mm at 12 months. In the control group, the bone loss was 1.0 ± 0.7 mm at 6 months and 0.95 ± 0.6 mm at 12 months. There were no statistically significant differences in bone loss between the two groups. Taking both groups together, there were no statistically significant difference in bone loss between patients with or without histories of periodontitis, but there was a statistically significant difference in bone loss between the mandible and maxilla as well as between unitary and total edentations and between partially and total edentulous patients. CONCLUSION: At 6 and 12 months, the peri-implant bone loss in sockets preserved with DFDBA and platelet concentrates was similar to the peri-implant bone loss in native bone.

B-mode and power Doppler ultrasonography of the equine suspensory ligament branches: A descriptive study on 13 horses.

Ultrasonography is routinely used to achieve the diagnosis of equine suspensory ligament desmopathy. In human medicine, power Doppler ultrasonography has also been found to be useful for the diagnosis of tendon/ligament injuries. The aim of this prospective, pilot study was to assess the presence or absence of power Doppler signal in suspensory ligament branches and compare B-mode findings with power Doppler findings in suspensory ligament branches of lame and non-lame limbs. Thirteen horses were used (eight lame horses, with lameness related to pain in the suspensory ligament branches, and five non-lame horses). Ten lame limbs and 24 sound limbs were assessed by B-mode and power Doppler ultrasonography. The severity of power Doppler signal was scored by two independent readers. The B-mode ultrasonographic examination revealed abnormalities in branches of lame limbs and in branches of sound limbs. Suspensory ligament branches that were considered normal in B-mode showed no power Doppler signal. However, power Doppler signal was detected in suspensory ligament branches that were abnormal in B-mode, both in lame and sound limbs. Power Doppler scores were subjectively higher in suspensory ligament branches of lame limbs and in branches with more severe B-mode changes. Findings supported the use of power Doppler as an adjunctive diagnostic test for lame horses with suspected suspensory desmopathy.

Alveolar Ridge Preservation After Tooth Extraction with DFDBA and Platelet Concentrates: A Radiographic Retrospective Study.

OBJECTIVES: The purpose of this study was to evaluate vertical alveolar bone loss 3 months after tooth extraction when a technique of ridge preservation was applied using a particulate demineralized freeze-dried bone allograft 300 - 500 µm associated with platelet concentrates (platelet-rich-fibrin) in the form of gel and membranes. MATERIAL AND METHODS: A retrospective radiological clinical study was conducted on 56 patients for whom 95 extractions had been performed immediately followed by alveolar filling. Among the patients, 17 were smokers and 16 were provided with an immediate removable temporary prosthesis after extractions. Vertical bone loss was measured radiologically by panoramic X-ray before extractions and by a computed tomography scan 3 months after, at the level of mid-buccal bone wall, by two independent observers. For statistical analysis, Student's t-test was performed to compare the mean bone loss between mono- and pluri-radicular teeth and to compare the mean bone loss between tobacco users versus non users and finally to compare the mean bone loss between individuals that had provisional removable prosthesis and those that had not. RESULTS: Three months after tooth extraction, the mean of vertical loss of the mid-buccal bone wall was 0.72 (SD 0.71) mm (5.53% SD 5.19). No significant difference between bone loss at mono-radicular and pluri-radicular teeth (P = 0.982) was observed. There was no significant correlation between tobacco habits and bone loss (P = 0.2), nor between provisional removable prosthesis and bone loss (P = 0.786). CONCLUSION: These results indicate a good potential for the technique using Demineralized Freeze-Dried Bone Allograft 300 - 500 µm and platelet concentrates in alveolar bone preservation.

ULTRASONOGRAPHIC FINDINGS IN 13 HORSES WITH LYMPHOMA.

Ultrasonography and radiography are commonly used for staging of lymphoma in horses, however there is little published information on imaging characteristics for horses with confirmed disease. The purpose of this retrospective, case series study was to describe ultrasonographic and radiographic findings for a group of horses with a confirmed diagnosis of lymphoma. A total of 13 horses were sampled. Lymphadenopathy (8/13), peritoneal effusion (6/13), splenic (6/13), and hepatic (5/13) lesions were the most frequently identified. The predominant splenic and hepatic ultrasonographic lesions were hypoechoic nodules, organomegaly, and changes in echogenicity. Digestive tract lesions were detected in three horses and these included focal thickening and decreased echogenicity of the small (2/13) and large intestinal (2/13) wall. Thoracic lesions were predominantly pleural effusion (4/13), lymphadenopathy (4/13), and lung parenchymal changes (3/13). Enlarged lymph nodes were detected radiographically (4/13) and/or ultrasonographically (2/13) in the thorax and ultrasonographically in the abdomen (7/13) and in the caudal cervical region (4/13). Findings supported the use of abdominal and thoracic ultrasonography for lymphoma staging in horses. Ultrasound landmarks for localizing cecal and caudal deep cervical lymph nodes were also provided.

[Current therapeutic approach of the white sponge naevus of the oral cavity]. / Approche thérapeutique actuelle du white sponge naevus de la cavité buccale.

We report a case of White Sponge Naevus of the tongue in a 50 years-old man. White Sponge Naevus of the oral cavity is a rare, benign and dominant autosomic inherited disorder, which presents in the form of a white, hyperplasic and verrucous or spongious lesion of the oral mucosa. Differential diagnosis is clinically difficult with more common white lesions of the oral cavity. Various therapeutic approaches have been proposed. Systemic antibiotics or local applications of retinoic acid provide limited benefits but are poorly effective. To our knowledge, CO2 Laser has never been tried to treat a White Sponge Naevus of the oral cavity. We performed a complete removal of the lesion with CO2 Laser, but complete recurrence occurred. Finally, a surgical resection was realized, which proved to be effective. Two years later, the patient is free of recurrence. This article proposes a review of the literature on what is known on White Sponge Naevus of the oral mucosa. We stress the importance of confrontation between anamnesis, clinical examination and pathologic findings to lead to the proper diagnosis of this rare disease.

Leishmaniasis of the lip : report of a case.

Leishmaniasis is a parasitic disease caused by a protozoan flagellate of the genus Leishmania. This parasite infects numerous mammal species including humans. It is transmitted through the infective bite of a sand fly called phlebotominae. Cutaneous Leishmaniasis is the most common form of Leishmaniasis. We present the case of a 47 years- old man who came to our Department of oral and maxillo-facial surgery, complaining about a painless lesion on his lower lip. After removal of the lesion and microscopic examination, the diagnosis of Leishmaniasis was made. This clinical case illustrates that the differential diagnosis of a nodular painless lesion of the lip must include rare diagnosis like a cutaneous Leishmaniasis, especially in patient from a geographic origin which represents an area at risk for Leishmaniasis.