Simple bone cyst: description of 60 cases seen at a Brazilian School of Dentistry and review of international literature

BACKGROUND: The aim of this study was to describe the relative frequency and the main demographic and clinic-radiographic features related to patients diagnosed with Simple bone cyst (SBC) in an Oral Diagnosis Service in Southeast Brazil and present a review and discussion of international literature on this topic. MATERIAL AND METHODS: SBC cases from our service encompassing the period between 1978 and 2017 were selected. In addition, a literature search was performed in the Pubmed/MEDLINE online electronic database published between 1951 and 2019. RESULTS: A total of 2,459 cystic lesions were documented in our service, thus 60 patients were diagnosed with the SBC representing 2.4% of all jaw cystic. Most of cases were asymptomatic. Multiple SBC lesions were seen in two patients (3.4%) and association with cemento-osseous dysplasia was seen in one female patient (1.7%). A total of 793 cases were enrolled in this literature review. CONCLUSIONS: The SBC is an asymptomatic lesion often discovered in routine image exams in young patients. The unilocular, well defined margin with scalloped appearance is characteristic and helps the definition of diagnosis. This review suggests a different epidemiologic trend concerning to the sex and it confirms the posterior region of mandible as the more frequent location. The conservative treatment with limited exploration and curettage remains as the gold-standard treatment

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Biomechanical behavior of three different types of internal tapered connections after cyclic and static loading tests: experimental in vitro.

BACKGROUND: In the long-term success of a dental implant, the reliability and stability of the implant-abutment interface are important. Studies of maximum force of dental implants with different loading values have been used. This study aims to evaluate the influence of the oblique cyclic loading on the maximum force supported in one-piece and two-piece abutments installed on internal tapered implants. FINDINGS: Sixty implants and sixty prosthetic abutments were divided into six groups (n = 10): G1 and G2 (two-piece abutments with 16°), G3 and G4 (two-piece abutments with 11.5°), and G5 and G6 (one-piece abutments with 11.5°). A 2-Hz cyclic loading was applied to specimens of G2, G4, and G6, with a number of cycles of 2,400,000. All specimens were inclined by 30° from the vertical axis, and a vertical loading was applied over the tapered connections (ISO 14801). Then, the maximum force was tested by applying a static compression load on the specimens of the 6 groups tested (30°) at a rate of 0.5 mm/s. Statistical analysis was performed using the Shapiro-Wilk (p > 0.05) and Levene (p = 0.789) tests to determine if the data presented homoscedasticity and the Tukey test for multiple comparisons. Tukey test showed that the maximum force supported by G1 and G2 was not affected by the cyclic load, while in G3 and G4 it decreased significantly when subjected to the cyclic load. The G5 and G6 had a significant increase in maximum force supported when subjected to cyclic load. CONCLUSIONS: Cyclic loading influenced the maximum force supported of G4 and G6 but did not influence G2.

Impact of Implant Number on Mandibular Implant-Supported Profile Prostheses: A Systematic Review.

PURPOSE: To assess studies on edentulous patients rehabilitated using mandibular implant-supported profile prostheses and analyze the impact of different numbers of implants used on the implant survival rate, peri-implant bone loss, and prosthesis survival rate. MATERIALS AND METHODS: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement and was registered on PROSPERO. The PubMed/MEDLINE database was searched for articles published before July 18, 2016. The study attempted to answer the following PICO question: In edentulous patients, do full-arch fixed prostheses supported by three implants have a satisfactory implant survival rate, marginal bone loss, and prosthesis survival rate compared with those supported by different numbers of implants? Evidence levels of each study were evaluated using the Oxford Centre for Evidence-Based Medicine (OCEBM); methodologic quality was evaluated using the Methodological Index for Nonrandomized Studies (MINORS) scale and Cochrane Risk of Bias Tool. Descriptive statistics were performed when applicable. Implant survival curves were constructed using the Kaplan-Meier method, and marginal bone loss was analyzed using the Kruskal-Wallis, Dunn's, and Mann-Whitney tests. RESULTS: This analysis included 21 published studies of 4,712 implants and 1,245 mandibular implant-supported profile prostheses in 1,245 patients. The patients were grouped by the number of implants used: group 1 (three implants) had an implant survival rate of 90%; group 2 (four implants) had a rate of 95%; and group 3 (five implants) had the lowest rate, 74%. Groups 1 and 3 had the lowest first-year bone losses (median: 0.73 and 0.70 mm, respectively), and were significantly different from group 2 (median: 1.31 mm; P < .001). CONCLUSION: Despite the limitations in the studies with low levels of evidence and the methodology of MeSH term research, it was concluded that the implant survival rate and first-year bone loss of full-arch fixed prostheses supported by three implants were satisfactory. However, the prosthesis survival rate was inferior to that of other groups, which suggests a longer follow-up of these rehabilitations.

Congenital oral synechia and ankyloblepharon filiforme adnatum: Case report and literature review.

INTRODUCTION: Congenital intraoral synechias are adhesions of intraoral structures involving soft tissue. These conditions and another anomaly called ankyloblepharon filiforme adnatum, which is partial fusion of the eyelid margins by bands of tissue, are rarely reported in the literature. The association of both anomalies of the craniomaxillofacial region is an even more unusual finding. PURPOSE: This article adds more information to the literature by reporting a case of a neonate with a rare association of bilateral synechia between the jaws, fusion of buccal mucosa to the ridges and between the tongue and palate, and ankyloblepharon filiforme adnatum in both eyes, without any other facial or systemic malformation. METHODS: A literature review of similar cases published in PUBMED/MEDLINE was conducted followed by a discussion and comparison to the new case. CONCLUSION: The rare association of these congenital defects, without the presence of syndromic symptoms, could be diagnosed and treated easily with good prognostic evolution.

Bisphosphonate treatment and dental implants: A systematic review

BACKGROUND: To analyze articles that studied patients submitted to diphosphonates therapy and who received dental implants before, during or after bisphosphonate (BP) treatment, compared to healthy patients, analyzing the increase of failure and loss of implants or bisphosphonate related osteonecrosis of the jaw (BRONJ) incidence. MATERIAL AND METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in 'PICO' format was: In patients under bisphosphonate therapy, do dental implants placement, compared to healthy patients, increase the failure and loss of implants or bisphosphonate related osteonecrosis of the jaw incidence? PubMed/MEDLINE was searched for articles published up until April 15, 2015 using a combination of MeSH terms and their Entry terms. RESULTS: The search resulted in 375 articles. After selection according to the eligibility criteria, 15 studies fulfilled were included (eight retrospective, one prospective and six case series), with a total of 1339 patients analyzed, 3748 implants placed, 152 loss of implants and 78 cases of BRONJ. CONCLUSIONS: Due to the lack of randomized clinical trials looking at this theme, further studies with longer follow-up are needed to elucidate the remaining questions. Thus, it is wise to be careful when planning dental implant surgery in patients undergoing bisphosphonate therapy because of the risk of developing BRONJ as well as occurring failure of implant. Moreover, complete systemic condition of the patient must be also taking into considering when such procedures are performed

Tratamento cirúrgico de fratura mandibular bilateral em paciente pediátrico / Surgical treatment of bilateral mandibular fracture in a pediatric patient

Fraturas mandibulares na infância são raras e seu tratamento permanece controverso. Fatores como dentição decídua, mista ou permanente e estágio de desenvolvimento ósseo devem ser considerados para escolha do tratamento, que varia desde restrição de dieta, fixação intermaxilar, odontossíntese e até fixação interna com dispositivos de titânio ou reabsorvíveis. Esse relato descreve o tratamento cirúrgico, realizado por acesso intrabucal, de fratura bilateral de mandíbula, em uma paciente de 9 anos de idade. As fraturas foram fixadas com uma miniplaca de titânio na base mandibular e odontossíntese; e, após um ano, as placas foram removidas. A paciente apresenta boa oclusão dentária e nenhum prejuízo funcional ou estético... (AU)

During childhood, mandibular fractures are rare, and their treatment remains controversial. Factors such as primary, mixed or permanent dentition and stage of bone development should be considered when deciding on the choice of the treatment, which ranges from diet restriction, intermaxillary fixation and circumdental wiring to internal fixation with titanium or resorbable devices. This case report describes the surgical treatment, using the intraoral approach, of a bilateral mandibular fracture, in a nine-year-old patient. The fractures were fixed with a titanium miniplate on the mandibular base and circumdental wiring, the plate being removed after one year. The patient shows a good dental occlusion and no aesthetic or functional injury... (AU)