Coronectomy of partially erupted lower third molars performed by an undergraduate dentistry student: a case series.

PURPOSE: The coronectomy technique is an alternative to conventional impacted tooth removal which aims to reduce the risk of damage to the inferior alveolar nerve (IAN). The technique is usually performed by senior oral surgeons or residents in training. Herein, patients were treated in a single service, in which coronectomy was performed by an undergraduate dental student on partially erupted lower third molars. METHODS: A prospective analysis was performed on 21 individuals submitted to a total of 35 coronectomies. Clinical and radiographic follow-up was performed for at least 12 months. RESULTS: Overall, healing was within normal limits, without major complications and without permanent IAN injury. However, one case showed temporary IAN paraesthesia resolved within a month and two required repetitions of coronectomy due to the remaining enamel, but with a good final result. Root migration was observed in all cases, but no other surgery was required. CONCLUSION: Coronectomy may be an important option for treating partially erupted teeth in close nerve relationships, which could also be performed by trained undergraduate dental students. This series is interesting because it can encourage oral and maxillofacial surgeons to train undergraduate students and to stimulate their attraction and passion for surgery.

Infected Cemento-Osseous Dysplasia: Analysis of 66 Cases and Literature Review.

The aim of this study was to describe a series with 66 cases of infected cemento-osseous dysplasia (COD) and to discuss the demographic distribution, clinicoradiographic features and treatment of this condition. A study looking back on the diagnoses made at a single Brazilian centre within a 28-year timeframe was performed. A literature review with searches across five databases was also conducted to identify reports on osteomyelitis/infected COD. Descriptive and statistical analyses were performed. The case series study showed a female/male ratio of 21:1. Affected individuals' mean age was 57.4 years. Mandible was the most affected site (95.5%) and florid subtype was the most frequent infected COD (62.1%). Tooth extraction was the main factor associated with the development of infection associated within a COD lesion. The literature review retrieved 30 studies reporting 46 cases of this condition. Asian women in their 40 s and 50 s were more affected. Surgery for removal/curettage of necrotic bone was acknowledged as an appropriate approach to the treatment of this infection. The clinicodemographic data of the study were similar to data collected across the literature. Clinicians, maxillofacial surgeons and oral rehabilitation providers should be alert to the diagnosis of COD, since infection is a frequent complication whose management is challenging.

Longevity, effectiveness, safety, and impact on quality of life of low-concentration hydrogen peroxides in-office bleaching: a randomized clinical trial.

OBJECTIVE: The study evaluated the longevity, effectiveness, safety, and impact on the oral health-related quality of life of in-office dental bleaching using low-concentration hydrogen peroxides. MATERIALS AND METHODS: Randomized, parallel, and double-blinded clinical trial was performed with 54 participants using 6% or 15% hydrogen peroxide (HP) in-office bleaching activated via hybrid LED/laser light. Tooth color was evaluated at baseline (T1), 1 week of bleaching (T2), 2 weeks of bleaching (T3) and 1 week (T4) and 6 months (T5) after finishing the bleaching using the Classical Vita™ scale and spectrophotometer. Tooth sensitivity and gingival irritation were measured with Visual Numeric Scale and Modified Gingival Index. The impact on quality of life was evaluated using the Oral Impact on Daily Performance. The data were analyzed using the Friedman, Mann-Whitney, and McNemar tests (p < 0.05). RESULTS: The group HP15% presented significant color change (ΔE) from T1 to T4 (p = 0.002) and T1 to T5 (p < 0.001). Parameters L, a*, and b* differed significantly at T3, T4, and T5 compared T1 for both groups. At 6-month follow-up, 57.1% of HP6 and 43.7% of HP15% participants migrated from B1 to a darker color. No significant differences were observed between the groups in tooth sensitivity, gingival irritation, or impact on quality of life. CONCLUSIONS: Both agents showed bleaching effectiveness, but HP15% presented greater color stability than HP6%, at 6-month follow-up. The agents showed low levels of tooth sensitivity, gingival irritation, and did not affect the oral health-related quality of life of the participants. CLINICAL RELEVANCE: Despite the greater presence of sensitivity during treatment compared with 6% hydrogen peroxide, 15% hydrogen peroxide demonstrated better bleaching effectiveness, and greater color stability at the end of bleaching and at 6-month follow-up. The use of 15% hydrogen peroxide presents more suitable results.

An Update on Osteomyelitis Treatment in a Pycnodysostosis Patient.

PURPOSE: The aims of the present study were to discuss the demographic distribution and clinical characteristics of patients with pycnodysostosis (PYCD) and the onset of osteomyelitis and its treatment using a literature review. The authors also report on an update of treatment of mandibular osteomyelitis in a patient with PYCD using a buccal fat pad (BFP) as a free graft. PATIENTS AND METHODS: The study was carried out in 2 steps. In the first step, an electronic search was undertaken in PubMed in March 2018, with 17 articles being included. In the second step, the authors present a case of mandibular osteomyelitis in a 30-year-old woman with PYCD treated by sequestrectomy and a BFP as a free graft (follow-up, 24 months). RESULTS: Twenty-one cases of osteomyelitis of the jaws in patients with PYCD were included. Dental extraction, mandibular fracture, and 1 case of facial trauma represented the causes of mandibular osteomyelitis. Treatments included resection associated with antibiotics and sequestrectomy alone or associated with antibiotics. CONCLUSIONS: Despite the good results of the present case, further studies using the BFP as an adjuvant for jaw osteomyelitis are necessary to elucidate its clinical efficiency and safety.

Extending Coronectomy Indications to Third Molars with Taurodontism to Prevent Paresthesia and Mandible Fracture.

Taurodontism is considered a dental anomaly responsible for a morphoanatomical change in the shape of the tooth in which the roots are reduced in size but the body of the tooth is enlarged and bulky. The aim of this paper is to present a case of a 25-year-old female patient with taurodontism of mandibular partially erupted third molars, presenting a high risk of angle fracture and paresthesia in case of their removal, treated by means of coronectomy. The postoperative period was uneventful and the patient remained in follow-up for 12 months. In conclusion, the identification of third molars with higher risk of complications related to their extractions is the key to consider conservative measures to avoid problems. Coronectomy is a relatively simple technique that should be taken into account when considering bulky, deeply located third molars with a high risk of paresthesia or mandibular fracture, even in presence of taurodontism.