Evaluation of the time-dependent osteogenic activity of glycerol incorporated magnesium oxide nanoparticles in induced calvarial defects.

Introduction: Magnesium-based biomaterials have been explored for their potential as bone healing materials, as a result of their outstanding biodegradability and biocompatibility. These characteristics make magnesium oxide nanoparticles (MgO NPs) a promising material for treating bone disorders. The purpose of this investigation is to assess the osteogenic activity of newly-developed locally administered glycerol-incorporated MgO NPs (GIMgO NPs) in rabbits' calvarial defects. Materials and methods: Characterization of GIMgO was done by X-ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR). Bilateral calvarial defects were created in eighteen New Zealand Rabbits, of which they were divided into 3 groups with time points corresponding to 2, 4, and 6 weeks postoperatively (n = 6). One defect was implanted with absorbable gel foam impregnated with GIMgO NPs while the other was implanted with gel foam soaked with glycerol (the control). The defects were assessed using histological, Micro-Computed Tomography (Micro-CT), and histometric evaluation. Results: The characterization of the GIMgO nanogel revealed the presence of MgO NPs and glycerol as well as the formation of the crystalline phase of the MgO NPs within the nanogel sample. The histological and micro-CT analysis showed time-dependent improvement of healing activity in the calvarial defects implanted with GIMgO NPs when compared to the control. Furthermore, the histometric analysis demonstrated a marked increase in the total area of new bone, connective tissue, new bone area and volume in the GIMgO NPs implanted site. Statistically, the amount of new bone formation was more significant at 6 weeks than at 2 and 4 weeks postoperatively in the calvarial defects implanted with GIMgO NPs as compared to the control. Conclusion: The locally applied GIMgO NPs demonstrated efficacy in promoting bone formation, with more significant effects observed over an extended period. These findings suggest its suitability for clinical use as a therapeutic alternative to enhance bone healing.

Osteolytic Lesion of the Maxilla in an Undiagnosed Multiple Myeloma Patient Identified Incidentally by Cone Beam Computed Tomography.

BACKGROUND Multiple myeloma is a hematological malignancy characterized by monoclonal plasma cell proliferation. Jaw lesions are found in nearly 35% of patients with symptomatic myeloma, and lesions occur in the mandible more often than in the maxilla. However, maxillary or mandibular lesions are rarely found as a primary manifestation of the disease. This report describes a case of a 65-year-old Palestinian woman with lytic lesions in the maxilla due to undiagnosed multiple myeloma identified incidentally on cone beam computed tomography (CBCT). CASE REPORT A 65-year-old Palestinian woman presented to the Oral Maxillofacial Surgery Clinic with an expansion of the maxilla which was initially thought of as an infection. CBCT imaging revealed diffuse osteolytic lesions involving multiple osseous structures. The patient was biopsied. Histopathological examination was suspicious for plasmacytic neoplasm. She was directly referred to the Hematology Department for further laboratory tests. These included complete blood count, liver function test, bone profile, protein electrophoresis, flow cytometry, and bone marrow biopsy, which were performed to confirm the diagnosis of multiple myeloma. The patient was treated with chemotherapy including zoledronic acid, dexamethasone, bortezomib, and cyclophosphamide. She went into remission for a year but unfortunately died 2 years later. CONCLUSIONS Primary myeloma of the maxilla is a rare presentation. The present report illustrates the role of CBCT imaging supported by a multidisciplinary approach to the diagnosis and management of myeloma. Consequently, it is recommended that dental practitioners be aware of radiographic features and possible oral manifestations to avoid any delay in medical intervention.

Management of internal derangement of temporomandibular joint disc displacement with reduction using two different lines of treatment / Manejo do desarranjo interno do deslocamento de disco temporomandibular com redução utilizando dois tipos diferentes de tratamento

Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases. (AU)

Objetivo: O presente estudo comparou a eficácia da Artrocentese em relação à inserção da Placa Reposicionadora Anterior (PRA) na melhoria da Amplitude de Movimento Mandibular (AMM) para pacientes que apresentam Deslocamento de Disco Anterior com Redução (DDAcR) da Articulação Temporomandibular (ATM). Método: 36 pacientes diagnosticados como DDAcR foram recrutados e divididos aleatoriamente em dois grupos. O primeiro grupo (G1) foi tratado através da Artrocentese e o segundo (G2), tratado com a PRA. Todos os pacientes foram reexaminados após seis meses. Resultados: Com exceção do movimento protrusivo, houve diferenças significativas entre os dois grupos para as mudanças percentuais das medidas de AMM pela quantidade de abertura sem dor, abertura sem assistência, abertura máxima com assistência, movimentos laterais direitos e laterais esquerdos (p < 0,05). Conclusão: Dentro do contexto do estudo atual, a PRA, não invasiva e de menor custo, proporcionou melhores resultados na melhoria da AMM no gerenciamento de casos de DDAcR (AU)

Photobiomodulation Therapy for Myofascial Pain in Temporomandibular Joint Dysfunction: A Double-Blinded Randomized Clinical Trial.

AIMS: Temporomandibular disorder (TMD) is a complex process that affects the temporomandibular joint (TMJ). The multifactorial process is of unknown etiology and has many manifestations and thus many management options. Photobiomodulation therapy has been suggested for management of TMD, despite the lack of understanding of its exact mechanism. The aim of this study is to examine the effectiveness of photobiomodulation in the treatment of myofascial type TMD. METHODS: Patients with unilateral TMJ and masticatory muscles pain during function were recruited and divided into two groups: a control group that received a sham laser treatment every 48 h for 10 days and a test group that received the same frequency of treatment to deliver a dose of 257 J per treatment and a total dose of 1285 J for the entire treatment. Pain was assessed using the visual analog scale (VAS). RESULTS: There was a significant difference in VAS scores between the test and control groups with the test group scoring lower. CONCLUSION: Photobiomodulation therapy proved to be an effective short-term therapeutic modality for myofascial TMD pain. It is non-invasive, easy to apply with no systemic side effects. Its long-term effect and its effect on different subtypes of TMD need further investigation.

Evaluation of Root and Canal Morphology of Maxillary Permanent Molars in an Egyptian Population by Cone-beam Computed Tomography.

INTRODUCTION: The purpose of this study was to evaluate the number of roots and canal morphology of maxillary permanent molars in an Egyptian population. METHODS: Six hundred fifty-seven cases were included in this study. Digitized images from cone-beam computed tomographic scanning were assessed by 2 endodontists. The number of roots and canal configuration according to Vertucci were tabulated. Age, sex, and bilateral distribution differences were calculated. RESULTS: All maxillary first molars showed 3-root configuration, whereas maxillary second molars showed 3-, 2-, and single-root configurations. For maxillary first molars, the most common Vertucci classifications for the mesiobuccal root were type II (2-1, 45.6%), type IV (2-2, 27.27%), and type I (1, 25.45%). For maxillary second molars, the most common Vertucci classifications for the mesiobuccal root were type II (2-1, 47.1%), type I (1, 42.06%), and type IV (2-2, 8.03%). The prevalence of a second mesiobuccal canal is statistically not affected by either sex, tooth position (right or left side), or age. CONCLUSIONS: Under the conditions of this study, the root canal configurations of an Egyptian population showed that the most common Vertucci classifications for the mesiobuccal root for maxillary first molars were type II (2-1), type IV (2-2), and type I (1). For maxillary second molars, the most common types were type II (2-1), type I (1), and type IV (2-2). Pre-evaluation of the endodontic case using cone-beam computed tomographic digital imaging provides better information of root canal morphology, which might improve the management and prognosis of the case.

The effectiveness of computerized anesthesia in primary mandibular molar pulpotomy: A randomized controlled trial.

OBJECTIVE: The technique of local anesthetic administration is an important consideration in the behavior guidance of a pediatric patient. The study hypothesized that there is no difference in the pain effectiveness in the experimental subjects with the use of single tooth anesthesia and the controls with the use of conventional technique (traditional inferior alveolar nerve block [IANB]).The purpose of this study was to compare the anesthesia effectiveness of traditional IANB; IANB using a computer-controlled local anesthetic delivery system (CCLAD); and intraligamental anesthesia (ILA) using CCLAD in pulpotomy of the primary mandibular second molars. METHOD AND MATERIALS: Ninety-one healthy 5- to 9-year-old children underwent pulpotomy of the mandibular second molars. They were randomly assigned into Group A (traditional IANB), Group B (IANB using CCLAD), or Group C (ILA injection using CCLAD). The effectiveness of anesthesia was measured during different steps of pulpotomy using the sounds, eyes, and motor (SEM) scale. The postoperative complications were recorded after 24 hours. RESULTS: For all five pulpotomy steps, the anesthesia effectiveness was similar among the three anesthesia techniques. Anesthesia effectiveness was not significantly different (based on SEM scores) between the three groups during clamp application, drilling of the tooth, entering the pulp, pulp extirpation, and removal of the clamp (P = .635, P = .996, P = .630, P = .945, and P = .101, respectively). There was no significant difference in postoperative complications between the three groups. CONCLUSION: The IANB anesthesia using CCLAD and periodontal ligament anesthesia using CCLAD were as effective as traditional IANB in anesthetizing the primary mandibular molars during pulpotomy.

Regenerative potential of immature permanent non-vital teeth following different dentin surface treatments.

This study evaluates the regenerative potential of immature permanent non-vital teeth following different dentin surface treatments in dogs. Periapical lesions and necrotic pulps were induced in 288 roots of 144 teeth in twelve dogs. Teeth were randomly divided into 3 equal groups according to the evaluation period. Each group was subdivided into 8 subgroups according to the treatment modalities including; blood clot, blood clot and collagen, blood clot and Ethylenediaminetetraacetic acid (EDTA), blood clot, collagen and EDTA, blood clot and Mixture Tetracycline Citric Acid and Detergent (MTAD), blood clot, collagen and MTAD, positive control and negative control. Apart from control subgroups, all infected root canals were cleaned with sodium hypochlorite solution and triple antibiotics paste before different treatment protocols. After different treatments, the root length, thickness and apical diameter were evaluated by radiographic examination. Histopathological examination was carried out to evaluate the inflammation, bone/root resorption, tissue in-growth in pulp space, new hard tissue formation and apical closure. Using EDTA solution as a surface modifier showed significantly higher levels of tissue in-growth in the pulp space after 6 weeks and 3 months. Addition of collagen as a scaffold caused significantly more bone/root resorption than the other subgroups while EDTA caused significantly lower inflammatory cell counts only after 2 weeks. Final rinse with 17% EDTA solution before blood clot induction has positive impact on tissue interaction along dentinal walls without modification of the cell type. Moreover, the use of collagen as a scaffold material and MTAD as a surface modifier did not improve the quality of the regenerative process.

A Comparative Study of the Effectiveness of Immediate Versus Delayed Photobiomodulation Therapy in Reducing the Severity of Postoperative Inflammatory Complications.

OBJECTIVE: The aim of this study was to compare the immediate versus the delayed application of photobiomodulation (PBM) therapy following odontectomy of horizontally impacted mandibular third molars, and assess which application method is more effective at reducing postoperative complications. BACKGROUND DATA: Surgical removal of horizontally impacted mandibular third molars is a common surgical procedure, usually associated with postoperative complications such as pain, swelling, and trismus. Several attempts have been made to minimize these complications. One such method is the use of PBM therapy. METHODS: Eighty patients with horizontally impacted mandibular third molars with no inferior alveolar canal approximation were recruited for this study. They were divided into two groups. The immediate group received PBM therapy immediately after surgery and on the 3rd day postoperatively. Subjects in the delayed group received PBM therapy on the 2nd and 4th days postoperatively. All subjects received 2 min of treatment using a 4 W laser beam, during which 171 J were delivered via a 2.8 cm(2) spot size. RESULTS: Clinical and statistical results showed a significant reduction in pain, trismus, and swelling in the immediate PBM therapy group compared with the delayed PBM therapy group. CONCLUSIONS: Immediate PBM therapy is more effective than delayed PBM therapy in minimizing the complications associated with mandibular third molar removal surgery.