Iatrogenic penetration of the mouth floor during mandibular molar extraction: A case of protracted bleeding in an emergency department and clinico-anatomical considerations.

Iatrogenic perforation of the lingual cortical plate of the mandible is uncommon but it may result in injuries to various adjacent structures such as the lingual nerve, sublingual gland, submandibular duct, deep lobe of the submandibular gland, and branches of rich anastomosing plexus supplying the floor of the mouth (FOM). The aim of this article was to highlight an unusual case of protracted postoperative bleeding that was occurred due to a FOM injury during an attempt to extract a mandibular second molar. Various anatomical considerations with clinical relevance were summarized too. Even small and superficial injuries of FOM should be not misjudged but be carefully monitored, since there is a potential risk for significant haemorrhage and hematoma formation leading to airway obstruction.

Comparative Assessment of a New Holistic-Oriented and an Old Specialty-Specific Undergraduate Curriculum in Removable Prosthodontics: A Study Based on Senior Students' Perceptions.

PURPOSE: A survey was conducted in the Dental School, Aristotle University, Thessaloniki, Greece, (i) to assess the perceptions and experiences of senior dental students, Classes of 2014 and 2015, toward the old, specialty-specific (OC) and new, holistic-oriented (NC) undergraduate curriculum, respectively, in removable prosthodontics and (ii) to identify areas of improvement in prosthodontic training. MATERIALS AND METHODS: Structural components of both curricula were collected, including the total number of (i) laboratory/lecture/clinical training hours, (ii) written examinations, (iii) mandatory clinical cases, and (iv) European Credit Transfer and Accumulation System (ECTS) credits. A 20-item closed-type questionnaire using a five-point Likert scale was distributed in two consecutive groups of seniors, Classes of 2014 (n = 54) and 2015 (n = 57); 54 OC and 57 NC senior students filled out the questionnaire. RESULTS: A greater percentage of NC students stated that (i) they felt less confident to carry out jaw relation recording and removable partial denture metal framework design and (ii) the time allocated for clinical training was less sufficient. Students of both curricula reported that the laboratory courses and lectures contributed little to their clinical performance. Implant restorations and prosthetic management of patients with craniomandibular disorders were the most popular treatment options that the respondents felt that should be incorporated in the undergraduate curriculum. CONCLUSIONS: As a general trend, students completing the revised curriculum reported more difficulties during their training and felt more insecure about their clinical competences. To enhance students' self-confidence in prosthodontics, more effective preclinical training methods, introduction of additional treatment options, and alternative educational methods should be considered.

Marginal adaptation and CAD-CAM technology: A systematic review of restorative material and fabrication techniques.

STATEMENT OF PROBLEM: The comparative assessment of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and other fabrication techniques pertaining to marginal adaptation should be documented. Limited evidence exists on the effect of restorative material on the performance of a CAD-CAM system relative to marginal adaptation. PURPOSE: The purpose of this systematic review was to investigate whether the marginal adaptation of CAD-CAM single crowns, fixed dental prostheses, and implant-retained fixed dental prostheses or their infrastructures differs from that obtained by other fabrication techniques using a similar restorative material and whether it depends on the type of restorative material. MATERIAL AND METHODS: An electronic search of English-language literature published between January 1, 2000, and June 30, 2016, was conducted of the Medline/PubMed database. RESULTS: Of the 55 included comparative studies, 28 compared CAD-CAM technology with conventional fabrication techniques, 12 contrasted CAD-CAM technology and copy milling, 4 compared CAD-CAM milling with direct metal laser sintering (DMLS), and 22 investigated the performance of a CAD-CAM system regarding marginal adaptation in restorations/infrastructures produced with different restorative materials. CONCLUSIONS: Most of the CAD-CAM restorations/infrastructures were within the clinically acceptable marginal discrepancy (MD) range. The performance of a CAD-CAM system relative to marginal adaptation is influenced by the restorative material. Compared with CAD-CAM, most of the heat-pressed lithium disilicate crowns displayed equal or smaller MD values. Slip-casting crowns exhibited similar or better marginal accuracy than those fabricated with CAD-CAM. Cobalt-chromium and titanium implant infrastructures produced using a CAD-CAM system elicited smaller MD values than zirconia. The majority of cobalt-chromium restorations/infrastructures produced by DMLS displayed better marginal accuracy than those fabricated with the casting technique. Compared with copy milling, the majority of zirconia restorations/infrastructures produced by CAD-CAM milling exhibited better marginal adaptation. No clear conclusions can be drawn about the superiority of CAD-CAM milling over the casting technique and DMLS regarding marginal adaptation.

The Historical Evolution of Dental Impression Materials.

The concept of impression making process in dentistry began in the mid 1800s. Dentists realized that the construction of a prosthetic restoration required both a detailed capture of the oral tissues along with stone cast fabrications. To accomplish these goals, impression materials were essential. Beeswax represents the first impression material, while important bechmarks during the historical evolution of dental impression materials are considered to be the introduction of dental trays in the early 1800s and the invention of the gutta-percha, thermoplastic resins and plaster of Paris. The double (corrective) impression technique, along with the functional impression concept that was established after mid 1800s, are also identified as pivotal innovations. During the 20th century, the advances in material development slowed significantly since the majority of the current impression materials had already been invented. However, the introduction of elastomeric impression materials in the field of prosthodontics that offered the advantages of accuracy and dimensional stability substantially upgraded both the impression accuracy and the quality of the final restoration. Presently, the dental practitioner has access to a variety of impression materials and should be aware of their properties, indications and limitations as well. Futhermore, while continuous attempts are being made to enhance these materials, the ideal impression material has yet to be developed. The purpose of this article was to provide a comprehensive review about the historical development of impression dental materials.

Trismus as a Clinical Manifestation of Tetanus: A Case Report.

Although the incidence of tetanus disease has radically declined in developed countries, both dental practitioners and oral and maxillofacial surgeons should be knowledgeable about its diagnosis since initial manifestations of the disease, such as trismus and dysphagia, are observed in the orofacial region. This study reports on a case of generalized tetanus diagnosed in a middle-aged man. Before the tetanus diagnosis, the patient had sought medical advice from seven different health care professionals, including a dentist and an oral and maxillofacial surgeon. The patient reported trismus and dysphagia as his main complaints. The suspicion of tetanus emerged from the patient's manifestations in conjunction with his history of trauma and his agricultural occupation. The patient underwent successful treatment including administration of muscle relaxants, antibiotics, and booster vaccination doses of tetanus toxoid as well as a tracheostomy and aided mechanical ventilation. This case report highlights the significance of taking a meticulous medical history, thoroughly performing a physical examination, and systematically assessing orofacial signs and symptoms.

Denture adhesives: a systematic review.

STATEMENT OF PROBLEM: Denture adhesives have been the objective of scientific research for over half a century. Although they are used by denture wearers worldwide, investigations of their effectiveness and biocompatibility have led to controversial conclusions. PURPOSE: The purpose of this study was to review the literature data with regard to the effectiveness and biocompatibility of denture adhesives as well as the attitudes of both patients and dental professionals toward these materials. MATERIAL AND METHODS: An electronic search of English peer-reviewed dental literature in the Medline database was conducted to evaluate the effectiveness and biocompatibility of denture adhesives. There was no limitation in publication year, so the search included all the available scientific evidence included in that particular database until March 2014. Specific inclusion criteria were used for the selection of the appropriate articles. A manual search of the citations of the obtained articles followed to extend the electronic search. RESULTS: A full text review was carried out for only 32 articles. Of the 32 articles, 21 examined the efficacy of denture adhesives in terms of retention and stability and masticatory performance, 6 evaluated the issue of the biocompatibility of denture adhesives, and 5 presented the attitudes of either professionals or patients toward these materials. CONCLUSIONS: The majority of clinical studies supported the fact that denture adhesives enhance the retention, stability, and masticatory performance of a removable prosthesis. In terms of biocompatibility, long-term in vivo studies to investigate potential harmful effects were lacking. Patients are satisfied with denture adhesives that meet their needs.

Agenesis of maxillary lateral incisors: a global overview of the clinical problem.

The agenesis of maxillary lateral incisors is a common developmental anomaly and represents a clinical problem impairing dental esthetics and function from a very young age. Several dental specialties deal with the management of this clinical problem because a multidisciplinary approach can cover the complete dental needs of patients with dental agenesis. There is controversy, however, about whether missing lateral incisor spaces should be orthodontically opened or closed using permanent canines to replace the missing teeth. The article presents a review of the existing literature about the prevalence, etiology, diagnostic evaluation, and treatment strategy of maxillary lateral incisor agenesis. Also, this article aims to present the key determinants leading to selection of space opening or closure and to report professional judgments and layperson perception concerning the available treatment alternatives. The English-language literature associated with this topic was searched via PubMed. The articles retrieved were then reviewed with an attempt to fulfill the aims of this review. Maxillary lateral incisors are one of the most common congenitally missing teeth, and to date, the origin of their agenesis has not been completely identified. Prompt diagnosis and careful evaluation of treatment determinants through a multidisciplinary approach are essential for the proper management of clinical problems. Each of the available means of rehabilitation has its own advantages, disadvantages, indications, and limitations. The configuration of the treatment plan should be devoid of clinician biases, whereas patients' realistic expectations should be taken into account.