The Causes of Dental Implant Migration into the Maxillary Sinus: A Case Series Study from 25 Years of Experience.

The use of dental implants to restore edentulous jaws has become commonplace. Usually, in the maxilla, following a tooth extraction, the height of alveolar bone decreases. This alteration in bone increases the risk of implants migrating into the sinus. In general, Caldwell-Luc and endoscopic surgery are performed to retrieve dental implants. In this case series, we collected data from 39 patients who had the complication of implant displacement within the maxillary sinus for 25 years. All the implants were removed using the Caldwell-Luc technique. Implant migration happened following functional loading, during the prosthetic procedure, due to lack of osseointegration in 3 patients, and during implant placement into the fresh socket in 3 patients. In the remaining cases, migration occurred preoperatively or postoperatively and prior to implant loading. Insufficient bone quantity is sometimes causing the implant to migrate to the maxillary sinus. In case of minimal bone height, a sinus lift before implant placement should be conducted. Retrieval of an implant pushed inside the maxillary antrum using the Caldwell Luc approach proved to be a reliable technique.

Perceptions of mandibular asymmetry among orthodontists, oral and maxillofacial surgeons, and laypersons.

Background: Facial asymmetry is one reason orthodontic patients seek treatment. This study assessed the effect of mandibular asymmetry on facial esthetics and treatment needs perceived by laypersons, orthodontists, and maxillofacial surgeons. Materials and Method: In this descriptive cross-sectional study, the frontal image of a model was captured and symmetrized from the facial midline using Adobe Photoshop software. The mandible was rotated 0°-8° with 1° intervals. Images were presented to 41 laypersons, 39 orthodontists, and 29 surgeons using an online questionnaire. The observers rated each image's esthetics with a 0-100 Visual Analog Scale and determined their treatment need by choosing one of the following three choices: No need for treatment, needs treatment, acceptable, but better to be treated. Analysis of variance for repeated measurements model. The regression method, Kruskal-Wallis analysis, was used for statistical analysis and the level of significance was set as P < 0.05. Results: The images with 0° and 1° rotation received the highest esthetic rates among all three groups, while the images with 8° rotation were the least attractive ones. Furthermore, the image esthetic ratings significantly affected their treatment need. Mandibular asymmetry diagnosis threshold was 1° for orthodontists, and 3° for both laypersons and surgeons. The treatment need threshold was 5°, 6°, and 7° for surgeons, orthodontists, and laypersons, respectively. Conclusion: The esthetics of images decreased when mandibular asymmetry increased. Treatment need was also related to increased asymmetry. Orthodontists were the most sensitive group in diagnosis, while surgeons were the most sensitive ones when it came to treatment.

Maxillofacial Fracture Types and Their Management in 3-to 18-year-old Individuals Referred to Shariati Hospital, Tehran, Iran.

Objectives: This study was performed to find the most common types of maxillofacial fractures and their management in 3 to 18-year-old individuals referred to the Department of Oral and Maxillofacial Surgery at Shariati Hospital in Tehran, during a 9-year period. Materials and Methods: This retrospective study evaluated the records of 319 patients with maxillofacial fractures between 2012-2020, ranging in age from 3 to 18 years. Data regarding the etiology and location of the fracture, age, gender, and treatment approach were retrieved from the archival records and analyzed. Results: A total of 319 patients were included in the study, out of which, 255 (79.9%) were males and 64 (20.1%) were females. Motor-vehicle accidents were the most common cause of trauma (N=124, 38.9%). We recorded 605 fractures and among them, the parasymphysis (N=131, 21.6%) was the most common site of isolated fractures. Type of treatment varied depending on the fracture type and degree of displacement of the broken segments. It consisted of open reduction and internal fixation, and closed reduction procedures, which included the use of arch bars, ivy loops, lingual splints, and circummandibular wirings. Conclusion: Analysis of the results revealed that the severity of injury increased with age. Older individuals had higher a number of fracture sites and experienced greater displacement of the broken segments.

Solitary amyloid tumor of the palate: A case report and literature review.

Amyloidosis is often caused by the abnormal extracellular accumulation of amyloid in organs and tissues. This condition, affecting the head and neck region, is typically localized, and may also involve the oral cavity, particularly the tongue and buccal mucosa. As a solitary manifestation, the localized amyloidosis occurring intraosseous is highly infrequent. In addition, localized amyloidosis has a great rate of recurrence. In this paper, a 50-year-old female patient with the chief complaint of pain in the anterior of the maxilla is reported. According to clinical examination, no significant pathologic lesion was seen. The radiographic image showed a radiolucent lesion around teeth four and five. The treatment of choice for the patient was an excisional biopsy. As amyloidosis diagnosis is clinically challenging, biopsy and histologic examination of lesions are necessary in this regard. Accordingly, it is concluded that long-term follow-up is mandatory in case of localized amyloidosis because late recurrence can occur in some cases.

Effect of Transcodent painless needles on injection pain in maxillary anterior infiltration: a split-mouth controlled randomized clinical trial.

OBJECTIVES: The present study aimed to determine the pain perceived during supraperiosteal (infiltration) injection in anterior maxillary region by Transcodent painless needle tips in comparison to the regular needle tips. MATERIAL AND METHODS: In this split-mouth controlled randomised clinical trial, 30 patients were selected as candidates for cosmetic treatment who needed infiltration injections on both sides of canine area. They were each administered 0.9 mL of Lidocaine HCl 2% with epinephrine 1:100,000 in the buccal vestibules using two types of needle tips, Transcodent painless needle tip or regular needle tip. Immediately after the injection, the pain was measured using a 100 mm visual analog scale. The level of pain was statistically analyzed in the two groups using the parametric paired t-test. A 5% significance level was considered for statically significant difference between two means. RESULTS: In accordance with the results, the patients' level of pain were estimated as 18.3 ± 10.7 mm with Transcodent painless needle tips and 43.1 ± 13.1 mm in regular needle tip (p < 0.05). CONCLUSION: The Transcodent painless needle showed considerable reduction of pain in the anterior maxillary infiltration when compared to the regular needle tips.

Mandibular sporadic Burkitt lymphoma in an adult patient: A case report and review of the literature.

Only a minor percent of lymphomas arise in the oral cavity. Although rare, dentists and clinicians should not neglect them as a possible consideration in the differential diagnosis of oral lesions.

Application of a collagen scaffold saturated with platelet-rich plasma in prevention of bisphosphonate-related osteonecrosis of the jaw in the rat animal model.

BACKGROUND: Among the myriad adverse events of drugs in the oral cavity, Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is one of the most detrimental drug reactions that have ever been known. OBJECTIVE: This study was aimed to investigate the success of applying collagen scaffold alone and platelet-rich plasma (PRP)+collagen scaffold in prevention of zoledronic acid-induced BRONJ in the rat. METHODS: A total of 17 male Wistar-rats were treated with 4 weekly doses of zoledronic acid. All rats were undergone bilateral tooth extraction of mandibular first molars and divided into three groups of scaffold + PRP + suture, scaffold + suture, and suture only. All rats were scarified and clinical, radiological, histological and histomorphomerical evaluations were made on week 8 post-treatment. The soft tissue healing, bone mineralized density (BMD), number of osteoclasts and osteoblasts, necrotic bone (NB), intensity of inflammation and new bone formation (NBF) were analyzed. RESULTS: BMD, number of osteoblasts and NBF variables proved to be statistically were higher in the treatment groups than the control group. In addition, the PRP + scaffold group showed the better results in terms of BMD, number of osteoblasts and NBF than that of the scaffold alone group. Number of osteoclasts, inflammation intensity and osteonecrosis were also significantly different in the PRP + scaffold group compared to the scaffold alone and the control groups. CONCLUSION: Application of a PRP-enriched collagen scaffold appeared to be a successful preventive treatment for BRONJ by effecting of the number of osteoblasts and osteoclasts, BMD, NBF, inflammation, and osteonecrosis.

Dental practice in the era of COVID-19: A review of literature.

Dental practitioners confront the highest risk of COVID-19 infection due to constant exposure to saliva, droplets, blood, and aerosols. Despite the suspension of routine dental care in many countries around the world, dental professionals perceive a moral duty to take part in the global fight against the pandemic. Therefore, dental professionals should be vigilant in defending against the transmission of the virus and as well as in the diagnosis of the disease through the oral manifestations of it. We conducted a literature review on publicly available data to outline updates on guidelines and studies of dental settings during the COVID-19 era. In this literature review, the categorization of the patients for dental treatments, protective precautions for the dental practice, considerations for dental drug prescription, and oral manifestations of the disease has been reviewed.

Maxillofacial gunshot injures and their therapeutic challenges: Case series.

Maxillofacial gunshot injuries require proficiency to determine a suitable treatment plan and surgical intervention. In this paper, present 4 gunshot cases. Treatment in these patients is very challenging. Moreover, post-treatment infections are a serious problem in such cases. Thus, step-by-step surgery is essential to obtain a better result in these patients.

Applying dental implant therapy in patients with oral lichen planus: a review of literature.

Lichen planus (LP) is a violent, paranormal inflammatory disease that can affect the skin or any lining of the mucous membrane. LPs are a branch of immune-mediated inflammatory disease (IMID) that collaborates with the function and structure of the immune system that are precipitated through various etiological infectious agents. Oral lichen planus (OLP) is one of the most common kinds of IMID. These traumas might limit the normal life of patients and, in some cases, can be treated spontaneously. In patients who are affected by OLP, the dental clinicians must be capable of the proper diagnosis of the disorder. Dental implants are progressively applied for the treatment of partial or complete edentulism. Implant rehabilitation in OLP patients is one of the main challenges for patients and dental clinicians. There is not enough knowledge about this condition, and also medical documents are limited. In this study, by conducting a comprehensive review of literature, we tried to collect related data around the safety and success rate of implant rehabilitation in patients who suffer from OLP disorder. There proved to be no relation between implant survival rate and OLP diseases, but it is proven that some factors such as bone quality and fracture resistance, parafunctional habits, and resection of the marginal mandible could powerfully affect it. For evaluation of the advantages and disadvantages of applying implants in patients with OLP disorders, implementation of controlled studies is required.

Noninvasive treatment for chronic sialadenitis: Case report.

This reporter expresses a patient with a history of tender neck swelling. After clinical and graphical examinations, the patient was diagnosed with submandibular sialolithiasis. Instead of invasive removal of the gland, a more conservative treatment was used. Eventually, after a 1-year-long follow-up, the patient's conditions were found to be acceptable.

Traumatic bone cyst of mandible: a case series.

BACKGROUND: A traumatic bone cyst is an uncommon nonneoplastic lesion of the jaws that is considered as a "pseudocyst" because of the lack of an epithelial lining. This lesion is particularly asymptomatic and therefore is diagnosed by routine dental radiographic examination as a unilocular radiolucency with scalloped borders, mainly in the posterior mandibular region. The exact etiopathogenesis of the lesion remains uncertain, though it is often associated with trauma. CASE PRESENTATION: We report three Persian cases of traumatic bone cyst with different clinical and radiographic features, and we present a review of the literature to further discuss diagnostic and treatment challenges. Only one of the three patients reported a history of trauma, and despite the usual signs and symptoms of the lesion, extension of the defect to the ramus, swelling of the lingual cortex, and their unusual presence in the anterior mandible were noted in these patients. CONCLUSIONS: Because features of this cyst can be varied, careful history taking and radiographic evaluation alongside the clinical signs and symptoms have a very significant role in definitive diagnosis, appropriate treatment, and accurate assessment of prognosis.

Oral lipoma: Case report and review of literature.

Lipoma is a benign neoplasm that primarily affects the middle-aged individuals and has a rare oral cavity occurrence. Given its noninvasive behavior and low recurrence rate, surgical conservative management should be regarded as the best therapeutic option. This paper highlights two patients along with their improved conditions following the treatment.