Streamlining and simplification of surgical stent fabrication for micro-endodontic surgery.

Surgical stents allow clinicians to undertake micro-endodontic surgical procedures with an increased level of accuracy. When planned in combination with cone-beam computed tomography (CBCT) radiographic imaging, surgical stents can help accurately determine the point of entry of the surgical drill, minimise the size of the osteotomy, ensure accurate resection of the root/s and avoid vital anatomical structures. Fabrication of surgical stents can, however, be a complex and long-drawn-out process, adding to the cost of the surgery. This case report presents a relatively easy method of fabricating a surgical guide and showcases the benefits of a planned surgical guide in managing a periapical pathology with close proximity to the mental nerve canal.

The effect of photobiomodulation on human dental pulp-derived stem cells: systematic review.

This systematic review assessed if photobiomodulation of human dental pulp tissue improved cell viability, proliferation, and/or differentiation compared with a placebo. This systematic review was conducted in line with PRISMA. PICO question was established; inclusion and exclusion criteria were established before a search had begun. A literature search was conducted through PubMed, Scopus, and Cochrane. Studies were included if published within the last 20 years in English language, or where translation was available; laser parameters were mentioned; human dental pulp tissue was studied in vitro. Studies were excluded if non-human dental pulp tissue was studied and where the study was an in vivo study. Out of the total 121 studies found, 109 were excluded. Of the twelve included studies, three full-text articles were not available despite attempts made to contact the respective authors, leaving nine studies. Four of the included studies reported the use of stem cells derived from human deciduous teeth (SHEDs), and five used those from human permanent teeth (DPSCs). Most included studies utilized InGaAlP laser with wavelengths 660 nm, and one study with 610 nm. Other types of lasers included LED InGaN, and GaAlAs. Out of all included studies, two had a moderate risk of bias, and the rest had a low risk of bias. All studies confirmed positive effects on proliferation. One study also found improved osteogenic differentiation of the stem cells derived from stem cells of deciduous teeth. After assessing SHEDs and DPSCs separately, it is found that photobiomodulation improved cell proliferation in both subgroups. Due to heterogeneity in design protocols and laser parameters, it was not possible to compare the studies together. However, this study indicated that cell viability and proliferation did improve with photobiomodulation.

Emerging therapies with potential risks of medicine-related osteonecrosis of the jaw: a review of the literature.

In the past, osteonecrosis of the jaw (ONJ) was generally reported with bisphosphonate drugs; hence, the term BRONJ (bisphosphonate-related osteonecrosis of the jaw) was initially proposed. This was followed by the term ARONJ (antiresorptive osteonecrosis of the jaw). More recently, other novel medications such as vascular endothelial growth factor (VEGF) inhibitors, tyrosine kinase inhibitors and humanised antibodies that affect osteoclastic action have been reported to initiate ONJ in several cases. For this reason, in 2014, the American Association of Oral and Maxillofacial Surgeons (AAOMS) changed the term to MRONJ - medication-related osteonecrosis of the jaw. The review primarily focuses on ONJ associated with emerging therapies for the management of bone disorders. This article sheds some light on the risk factors that predispose dental patients to the development of osteonecrosis, the mechanisms of drug therapies associated with MRONJ, and potential treatment and management regimes for MRONJ patients. The current review noted that the incidence and associated risk of MRONJ is significant with the new therapeutic agents discussed. Therefore, for optimised patient care, pharmacovigilance with the new medications is essential for dental professionals.

Efficacy of photobiomodulation on accelerating bone healing after tooth extraction: a systematic review.

Post-extraction healing of the socket may take up to 24 weeks to complete. This systematic review aims to evaluate whether photobiomodulation accelerates bone healing in those sockets. A search strategy was developed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Cochrane Library, and Scopus electronic databases were searched for in vivo studies with restrictions on the year (< 50 years old) and language (English). After applying the inclusion criteria, ten studies were selected for review. Test subjects included humans (3), rats (5), and rabbits (2), either healthy or with specified systemic condition(s). Laser parameters applied varied between studies significantly. Six studies measured bone density or bone trabeculae percentage, while remaining studies measured secondary outcome measures such as osteogenesis markers, patient's self-reported pain scores, and clinical epithelial regeneration. No side effects of photobiomodulation have been reported. Higher concentration of osteogenesis markers Ocn and Runx2 were consistently reported across studies, as well as higher percentage of bony trabeculae and bone density. Within the limitations of this review, improvement in bone repair can be found when using photobiomodulation in extraction sockets.

Oral Kaposi's sarcoma in a renal transplant patient: case report and literature review.

Malignancies, including oral Kaposi's sarcoma, may develop in transplant patients as a result of immunosuppressive therapy. Both the prevalence and the incidence of these malignancies vary. This article describes a renal transplant patient who was receiving immunosuppressive therapy and presented with oral Kaposi's sarcoma. The lesion was excised and did not recur. However, the patient died as a result of viral pneumonitis, secondary to her renal problems. The article also includes a review of the literature, with particular emphasis on oral presentation of immunosuppression-related malignancies.