Mucogingival overgrowth in a geriatric patient.

Epulis fissuratum is a pathological condition caused by an ill-fitting denture. The mucogingival hyperplasia may be considered as a reactive condition of the oral mucosa to excessive mechanical pressure on the mucosa. Epulis fissuratum excision is a procedure usually done for prosthodontic reasons. The treatment of this benign entity is essential mainly for masticatory reasons. The use of diode laser for epulis removal without infiltrated anesthesia in a conscious geriatric patient is currently under investigation.

Dysaesthesia in the mental nerve distribution triggered by a foreign body: a case report.

INTRODUCTION: Foreign bodies' entrapments in the mandibular and submandibular regions are quite common. CASE PRESENTATION: We report an unusual case of foreign body (amalgam filling) entrapment over the mental foramen causing dysaesthesia in the distribution of the mental nerve. An interesting sign was blue discoloration of the overlaying oral mucosa which was interpreted as amalgam tattooing. CONCLUSION: Surgical removal of the foreign object eliminated the reported symptoms.

Upper-lip laser frenectomy without infiltrated anaesthesia in a paediatric patient: a case report.

Labial frenectomy is a common surgical procedure in the field of oral surgery. Labial frenectomy is a procedure usually done for orthodontic reasons. The role of laser surgery in the oral cavity is well established. The use of diode laser frenectomy without infiltrated anaesthesia is currently under investigation. Needle-less oral surgery, without infiltrated anaesthesia, is a novel situation in paediatrics with paramount importance.

Disease phobia in patients with temporomandibular joint pain assessed by the Illness Attitude Scale.

UNLABELLED: Disease phobia refers to a psychological state when the person continuously thinks that he/she is sick and improvement from the condition is impossible. Disease phobia in patients suffering from pain, secondary to temporomandibular disorders (TMDs), is usually the consequence of long-term problems; diagnosis and treatment of this group is a real challenge for healthcare professionals. AIM: The purpose of this prospective study was to objectively evaluate the role of Illness Attitude Scale (Kellner or IAS) in measuring cancerophobia and heart disease phobia in patients suffering from pain, as a consequence of TMDs. SUBJECTS AND METHODS: The cohort included 22 patients with TMDs who underwent evaluation of these phobias; pain was acute in 7 and chronic in 15. The patients were asked to complete the "Kellner" questionnaire, and this was followed by full clinical examination of the temporomandibular region. RESULTS: When measuring the correlation between the cancerophobia and heart disease phobia patients, the outcome was found significant in the total cohort, p < 0.01. Comparisons were carried out in the chronic group (n = 15) and was significant (p = 0.034 and r = 0.549); while in the acute group no significance was identified. CONCLUSION: Cancerophobia and heart disease phobia in TMD patients are factors that need to be taken in consideration when managing chronic pain in this group.

A forensic aspect of age characteristics of dentine using transversal microradiography: a case report.

BACKGROUND: Translucency of dentine is the result of occlusion of the corresponding dentinal tubules by a mineral substance which has a refractive index similar to that of the rest of the dentine. CASE PRESENTATION: This case report describes the microradiographic features of an upper cadaveric canine. Transverse microradiograph is one of the methods assessing apical dentine translucency for various dental and medical reasons. CONCLUSION: Estimation of age using teeth structures may be of primary value in forensic dentistry, especially when soft tissues are severely destructed.

Radiographic evaluation of bone regeneration after the application of plasma rich in growth factors in a lower third molar socket: a case report.

A 42-year-old Mediterranean male presented complaining of inability to sustain good oral care at the posterior aspect of the lower right jaw. The main problems were food impaction in the area and the subsequent malodor. The patient reported remarkable medical history. Clinical examination revealed local erytherma with noticeable bone defect distal to the second molar with obvious defect in the mesial wall of the third molar; the penetration depth was found to be up to 6 mm.Radiological evaluation confirmed the defect and it was attributed to the mesioangularly partially impacted lower third molar. It was decided that third molar should be extracted and concentrate of the patient's growth factors (PRGF) to be applied into the bony defect to stimulate bone regeneration and promote healing.The third molar tooth was, then, removed surgically and the PRGF, which was prepared preoperatively, was implanted in the socket. At the first postoperative day, moderate pain was the main complaint and was controlled by NSAIDs. One week postoperatively, the sutures were removed and there was good tissue healing on examination.On the fiftieth postoperative day, radiographic evaluation took place and showed noticeable enhancement of density and radio-opacity in the third molar socket area, in comparison with the baseline image. Further, clinical examination showed significant reduction of periodontal pocketing and evidence of new bone formation.In conclusion, PRGF was very successful in stimulating bone regeneration and promote healing following dental extraction.

Disease Phobia in Patients with Temporomandibular Joint Pain Assessed by the Illness Attitude Scale.

Disease phobia refers to a psychological state when the person continuously thinks that he/she is sick and improvement from the condition is impossible. Disease phobia in patients suffering from pain, secondary to temporomandibular disorders (TMDs), is usually the consequence of long-term problems; diagnosis and treatment of this group is a real challenge for healthcare professionals. AIM: The purpose of this prospective study was to objectively evaluate the role of Illness Attitude Scale (Kellner or IAS) in measuring cancerophobia and heart disease phobia in patients suffering from pain, as a consequence of TMDs. SUBJECTS AND METHODS: The cohort included 22 patients with TMDs who underwent evaluation of these phobias; pain was acute in 7 and chronic in 15. The patients were asked to complete the "Kellner" questionnaire, and this was followed by full clinical examination of the temporomandibular region. RESULTS: When measuring the correlation between the cancerophobia and heart disease phobia patients, the outcome was found significant in the total cohort, p<0.01. Comparisons were carried out in the chronic group (n=15) and was significant (p=0.034 and r=0.549); while in the acute group no significance was identified. CONCLUSION: Cancerophobia and heart disease phobia in TMD patients are factors that need to be taken in consideration when managing chronic pain in this group.

Thermal burn of palate caused by microwave heated cheese-pie: A case report.

A female patient, 36-years-old, complained of bilateral palatal pain on the anatomical area of upper second molars. The painful condition of palatal mucosa erosion was observed. Palatal erosions or ulcerations may be caused by heated food cooked in microwave ovens. We present a case of a bilateral palatal burn caused by cheese-pie. Concluding, any food containing cheese, when heated in microwave oven, may cause palatal burn if eaten immediately.

One-stage multiple root canal treatment of adjacent teeth combined with surgical apicectomies may be preferred in patients with severe anxiety under local anaesthesia: a case report.

A female patient referred to the clinic for assessment of a unilateral painful swelling formation on the left anterior maxilla. Anxiety is a psychological condition commonly seen in dental practice. When this psychological alteration affects the patient severely, any dental operation may be found difficult under local anaesthesia. We report a case of one-stage management in a patient with periapical lesion and anxiety.

Ulcerative gingival granuloma: a condition for bone biopsy.

Osteomyelitis as a medical term defining a specific type of infection may be classified in acute and chronic form. In our case an acute mandibular osteomyelitis is reported with evaluation of the clinical and histological examination. The biological course of the disease determined on that basis. The significance of this report focused on the early diagnosis and the possible need for bone biopsy.

Evaluation of the accuracy of electronic apex locators Dentaport ZX and Ray Pex 4 under clinical conditions.

AIM: The aim of the present study was to compare the accuracy of working endodontic length determination by Dentaport ZX and Ray Pex 4 under clinical conditions. MATERIAL AND METHODS: Clinical comparative evaluation of the accuracy of two electronic apex locators, Dentaport ZX and Ray-Pex 4, was carried out in 80 single-rooted teeth with vital pulp tissue planned for extraction as part of the dental treatment and after patient consent had been obtained. The normal procedure was followed, which included anesthesia, a standard endodontic access cavity, pulp removal and irrigation of the root canal with 5.25% NaOCl. The working length was estimated with Dentaport ZX for half of the selected teeth and with Ray-Pex 4 for the other half. K-files #15 were cemented at the measured working length and the teeth were extracted. The apical foramen was examined with a stereomicroscope under x15 magnification. The micrometric system of the microscope allowed precise measurement of distances. RESULTS: The comparison of the estimated working length with the actual length revealed that Dentaport ZX localized the apical foramen in 95% of the cases and the Ray Pex 4 in 92.5% with a clinically acceptable accuracy of +/- 0.5 mm. Dentaport ZX detected the foramen in 97.5% and Ray Pex 4 in 95% of the cases with an accuracy of +/- 1 mm. There was no statistically significant difference between the accuracy of the two electronic apex locators in locating the apical foramen (p < 0.05).

Adhesion of a new methacrylate resin-based sealer to human dentin.

The purpose of this study was to compare the shear bond strength of four root canal sealers: Fibrefill (a methacrylate resin sealer), Endion (a glass ionomer sealer), Topseal (an epoxy resin sealer), and CRCS (a calcium hydroxide sealer) to human root canal dentin. The dentin specimens were divided into four groups of 12 specimens each and etched with 3 ml of EDTA 17% before rinsing with NaOCl 2.5% and distilled water. Bond strength was tested using a test machine by subjecting samples to a shear load at a cross-head speed of 0.5 mm/min. The best results were observed in the Fibrefill group, in which the mean shear bond strength was 7.993 +/- 2.365 MPa. The values in the Endion (1.816 +/- 0.614 MPa) and CRCS (2.224 +/- 0.509 MPa) groups were significantly lower than in the Fibrefill and Topseal (6.235 +/- 1.428 MPa) groups. Inspection of the fractured surfaces revealed the bond failure to be mainly adhesive to dentin for Fibrefill and cohesive for Endion sealer. CRCS and Topseal sealers showed both adhesive and cohesive failures.

The influence of the smear layer on dentinal tubule penetration depth by three different root canal sealers: an in vitro study.

The effect of the smear layer on the penetration depth of three different root canal sealers into the dentinal tubules was examined in 64 recently extracted single-rooted teeth. After chemomechanical preparation, the samples were randomly divided in two equal groups. The smear layer remained intact in group A, whereas complete removal of the smear layer was performed in group B. Two roots from each group were used as controls. Ten roots from each group were obturated with laterally condensed gutta-percha points and sealers AH Plus, Apexit, and Roth 811, respectively. Examination in scanning electron microscope revealed that the smear layer obstructed all the sealers from penetrating dentinal tubules. In contrast, smear layer removal allowed the penetration of all sealers to occur to a varying depth. These findings suggest that smear layer plays an important role in sealer penetration into the dentinal tubules, as well as in the potential clinical implications.

Shear bond strength of AH-26 root canal sealer to dentine using three dentine bonding agents.

OBJECTIVE: The purpose of the study was to compare the bond strength of AH-26 root canal sealer to human root canal dentine exposed to different intracanal medications both with and without the use of three bonding agents. The materials used were AH-26 sealer, two one-bottle bonding agents (Single Bond, Bond-1) and one self-etching bonding agent (Clearfill SE Bond). METHODS: The dentine substrate was obtained from single rooted human teeth. The dentine specimens were treated either with EDTA 15% or phosphoric acid 37% to achieve the removal of smear layer. The AH-26 sealer was placed on the dentine surfaces both with and without the use of the bonding agents. Bond strength was tested using a single plane shear test assembly. RESULTS: The SBS values were (MPa): Group A (EDTA-AH-26) 3.678+/-0.853, Group B (Phosphoric acid-AH-26) 3.470+/-0.834, Group C (EDTA-Single Bond-AH-26) 4.8+/-0.865, Group D (Phosphoric acid-Single Bond-AH-26) 5.043+/-1.022, Group E (EDTA-Bond 1-AH-26) 4.939+/-0.877, Group F (Phosphoric acid-Bond 1-AH-26) 5.101+/-1.117, Group G (Clearfill SE Bond-AH-26) 6.975+/-1.694. The use of dentine bonding agents improved significantly (p<0.05) the adhesion of AH-26 sealer with the root canal dentine. However, the best results were obtained with the self-etching system. Similar results were observed from the pretreatment of dentine either with phosphoric acid 35% or EDTA 15%. CONCLUSIONS: The use of dentine bonding agents gave higher shear bond strengths of AH-26 sealer to human root canal dentine.