In Vivo Validation of a Nanostructured Electrospun Polycaprolactone Membrane Loaded with Gentamicin and Nano-Hydroxyapatite for the Treatment of Periodontitis.

The aim of this research was to validate the use of a gentamicin (GEN) and nano-hydroxiapatite (nHAP)-loaded polycaprolactone nanostructured membrane (NM) as an innovative, highly efficient, low-cost treatment for periodontitis. We conducted an in vivo study on Wistar rats, in which we induced periodontitis by placing silk ligatures around the first right and left upper molars. The subjects were divided into three groups; the first group received no periodontal treatment, the second group received open flap debridement, and the third group received open flap debridement, together with the positioning of the GEN and nHAP-loaded nanostructured membrane as a treatment. The extent of periodontal regeneration was assessed by the periodontal pocket depth, bleeding on probing, tooth mobility, dental plaque, microbiological analysis, concentration of MMP-8 in saliva, plasma levels of CRP, and histological analysis. The results showed that using open flap debridement with the NM is more efficient, and it significantly reduces the probing depth, extent of bleeding on probing, dental mobility, bacterial plaque, and pathogenic flora. The concentrations of MMP-8 and CRP decrease. The histological analysis demonstrated that NM leads to bone regeneration. Our study indicates that gentamicin and nano-hydroxyapatite embedded in the fiber of the biodegradable membranes might be a promising therapeutic option for periodontitis treatment.

The Impact of Benign Jawbone Tumors on the Temporomandibular Joint and Occlusion in Children: A Ten-Year Follow-Up Study.

This study aimed to provide a complex analysis of the modifications in craniofacial skeleton development that may arise following the diagnosis of pediatric benign jaw tumors. A prospective study was undertaken involving 53 patients younger than 18 years of age, who presented for treatment at the Department of Maxillo-Facial Surgery, University of Medicine and Pharmacy, Cluj-Napoca, with a primary benign jaw lesion between 2012 and 2022. A total of 28 odontogenic cysts (OCs), 14 odontogenic tumors (OTs), and 11 non-OTs were identified. At follow-up, dental anomalies were identified in 26 patients, and overjet changes were found in 33 children; lateral crossbite, midline shift, and edge-to-edge bite were found in 49 cases; deep or open bite were found in 23 patients. Temporomandibular disorders (TMDs) were found in 51 children, with unilateral TMJ changes identified in 7 cases and bilateral modifications found in 44 patients. Degenerative changes in the TMJ were also diagnosed in 22 pediatric patients. Although benign lesions could be associated with dental malocclusions, a direct etiological factor could be not identified. The presence of jaw tumors or their surgical treatment could, however, be linked to a change of the occlusal relationships or the onset of a TMD.

The Value of Multiparametric Magnetic Resonance Imaging in the Preoperative Differential Diagnosis of Parotid Gland Tumors.

BACKGROUND: The aim of the present study was to determine the value of multiparametric MRI in the preoperative differential diagnosis of parotid tumors, which is essential for therapeutic strategy selection. METHODS: A three-year prospective study was conducted with 65 patients. Each patient was investigated preoperatively with multiparametric MRI and surgical excision of the tumor was performed. The preoperative imaging diagnosis was compared with the histopathological report. Several MRI parameters were analyzed, including T1 and T2 weighted image (WI), apparent diffusion coefficient (ADC), time to peak (TTP), and the time intensity curve (TIC). RESULTS: In the differential diagnosis of benign from malignant tumors, T2WI and ADC showed statistically significant differences. Multiparametric MRI had a sensitivity, specificity, and accuracy of 81.8%, 88.6% and 92.3%, respectively. All of the studied parameters (T1, T2, TIC, TTP, ADC) were significantly different in the comparison between pleomorphic adenomas and Warthin tumors. With reference to the scope of this study, the conjunction of multiparametric and conventional MRI demonstrated a sensitivity, specificity, and accuracy of 94.1%, 100%, and 97.8%, respectively. CONCLUSIONS: Morphological analysis using conventional MRI combined with diffusion-weighted imaging (DW) and dynamic contrast-enhanced (DCE) multiparametric MRI improved the preoperative differential diagnosis of parotid gland tumors.

Benign Pediatric Jawbone Lesions: A 10-Year Clinical and Radiological Pilot Study.

This study aimed at presenting a retrospective longitudinal analysis of the pediatric jaw lesions treated at the Oral and Maxillofacial Surgery Clinic in Cluj-Napoca, Romania, over a timeframe of ten years (2012 to 2022). The clinical and radiological characteristics of the jawbone lesions, the treatment outcome, and the recurrence incidence were described. All consecutive patients aged below 18 years, with histologically diagnosed odontogenic tumors (OTs), nonodontogenic tumors (non-OTs), or odontogenic cysts (OCs) were included. Age, dentition type, clinical symptoms, preoperative and postoperative radiological tests, histological diagnosis, treatment, and follow-up information one year following the diagnoses were all examined. Eighty-two cases were included. The ratio of men to women was 1.15:1, with the mandible predominating by 64.4%. Inflammatory radicular cysts predominated in 31.7% of cases. A total of 42.68% of the patients were asymptomatic. Enucleation was the most frequent surgical technique (45.1%), followed by cystectomies (28%) and marsupialization (14.6%). The overall recurrence rate was 7.3%; the most recurrent histopathological lesion was the odontogenic keratocyst. This study sheds new light on the clinical and radiological characteristics, treatment outcomes, and recurrence rate of juvenile jawbone lesions in children and adolescents. The diagnosis and treatment of jawbone lesions in children and adolescents can be enhanced with the use of epidemiological, clinical, and imagistic information.

Recovery following Orthognathic Surgery Procedures-A Pilot Study.

This study aims at evaluating and categorizing patients' objective and subjective postoperative recovery symptoms after bimaxillary orthognathic surgery assigning the healing process. The patients were monitored throughout the recovery process, and their symptoms were managed. A prospective, observational study was performed. Patients with Class II and III malocclusion (aged 18 to 35) were evaluated and monitored preoperatively, and postoperatively at 48 h, 2 weeks, 1 month, and 3 months postsurgery. A questionnaire was used to assess pain and anesthesia/hypoesthesia. The most common objective and subjective signs that were correlated with the healing process were edema, hematoma, trismus, pain, and anesthesia/hypoesthesia. Edema peaked at 48−72 h postoperatively (distance between eye's external canthus and gonion, mean difference = 4.53, between tragus and cheilion, mean difference = 7, between tragus and gnathion, mean difference = 4.65, p < 0.001); mouth opening amplitude was significantly decreased during the first two weeks postsurgery (class II, mean difference = 32.42, p = 0.006, class III, mean difference = 44.57, p < 0.001), but it steadily and considerably improved over three months. The nose tended to widen postsurgery. The most severe pain experienced by patients was of medium intensity in the mandibular body, described as pressure, and usually did not spread. Patients were most severely and persistently impacted by anesthesia/hypoesthesia.

Coronavirus (SARS-CoV-2) Pandemic: Future Challenges for Dental Practitioners.

In the context of the SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) pandemic, the medical system has been subjected to many changes. Face-to-face treatments have been suspended for a period of time. After the lockdown, dentists have to be aware of the modalities to protect themselves and their patients in order not to get infected. Dental practitioners are potentially exposed to a high degree of contamination with SARS-CoV-2 while performing dental procedures that produce aerosols. It should also be noted that the airways, namely the oral cavity and nostrils, are the access pathways for SARS-CoV-2. In order to protect themselves and their patients, they have to use full personal protective equipment. Relevant data regarding this pandemic are under evaluation and are still under test. In this article, we made a synthesis about the way in which SARS-CoV-2 spreads, how to diagnose a novel corona virus infection, what the possible treatments are, and which protective personal equipment we can use to stop its spreading.

Post-traumatic occipital psoriatic plaque complicated by extensive necrotizing fasciitis of the head and neck: a case report and literature review.

Necrotizing fasciitis (NF) is a severe infection involving the superficial fascial layers, subcutaneous cellular tissue, and possibly skin. It usually has a fulminant evolution, rapidly leading to death in the absence of early diagnosis and aggressive surgical treatment. We herein report a rare case of NF secondary to a traumatized occipital psoriatic plaque in an alcoholic 47-year-old woman and compare this case with the published literature. The NF extended to the entire scalp, right face, and posterior and lateral cervical region. Despite the initially guarded prognosis, the patient's survival emphasizes the importance of aggressive surgical treatment with wide excision of all necrotic structures without any aesthetic compromise.