Undiagnosed mandibular degloving following dental trauma.

A 12-year-old girl presented to the Department of Paediatric Dentistry of the Toulouse University Hospital 10 days after a facial injury, complaining of persistent pain and halitosis. Previous examinations only reported trauma of the upper incisors. Further clinical exploration showed an 8 cm laceration of the oral mucosa in the lower labial sulcus, 1.5 cm inferior to the gingival margin and exposing the symphyseal bone. The diagnosis of mental protuberance degloving was established. The treatment consisted of debridement of the wound, removal of the necrotic tissue, multiple plane sutures and antibiotics. Complete healing of the wound with no sensory deficit was achieved. Mental degloving injuries occur when a shearing force is applied to the soft tissues overlying the chin, stripping them from the labial bone. This type of wound is rare and can go undetected if a meticulous oral examination is not performed. Early management is essential so healing is not compromised.

From Child to Adulthood, a Multidisciplinary Approach of Multiple Microdontia Associated with Hypodontia: Case Report Relating a 15 Year-Long Management and Follow-Up.

Oral rehabilitation of patients presenting multiple microdontia is a real therapeutic challenge. These alterations in size, often associated with other dental anomalies, have aesthetic and functional repercussions for patients and can lead to significant psycho-social consequences. We report here the case of an 11-year-old patient with bilateral sectorial microdontia and agenesis of teeth numbers 13 and 23. She also presented staturo-ponderal delay and a history of acute coronary syndrome with a lower coronary occlusion of unknown aetiology. At first, additive coronoplasties and an orthodontically retained interim prosthesis answered the aesthetic and functional need during childhood and adolescence. Once she reached adulthood, a multidisciplinary meeting was conducted and a treatment plan was established. The decision was made to rehabilitate the upper arch with a permanent bridge and the lower arch with indirect adhesive restorations. This solution solved the problem of the bilateral lateral infraocclusions and tooth agenesis, restoring both aesthetics and function. This paper presents 15 years of management and treatment of a patient presenting multiple microdontia associated with hypodontia. Both the multidisciplinary approach and coordination between the different medical team members was essential to maintain the existing dentition while preparing, planning, and carrying out a personalized treatment plan once maxillofacial growth was complete.

Interest of decompression in orthodontics: Case report of a keratocyst during childhood.

Keratocysts, also known as keratocystic odontogenic tumors (KCOT), make up 7% of all odontogenic cysts and develop asymptomatically in most cases. Enucleation is the benchmark treatment. However, there are surgical alternatives. Marsupialization and decompression are necessary in some cases, mainly when the KCOT is large, thus causing an increased risk of bone fracture, or if it has engulfed important elements such as the inferior alveolar nerve or teeth, consequently causing alveolar bone growth failure. The authors describe the case of a nine-year-old child treated for a large keratocyst situated in sector 4 (lower right jaw), impacting both premolars and the canine (45, 44 and 43). Surgical decompression associated with orthodontic multiband treatment were delivered to pull, and then place the three teeth in occlusion on the dental arch. With seven years hindsight since the first surgical procedure and three years since finishing orthodontic treatment, the cooperation between orthodontists and surgeons can be considered a success, from both the functional and esthetic points of view.

The role of cell surface markers and enamel matrix derivatives on human periodontal ligament mesenchymal progenitor responses in vitro.

Periodontitis is a chronic-, infectious-disease of the human periodontium that is characterized by the loss of supporting tissues surrounding the tooth such as the periodontal ligament (PDL), cementum and alveolar bone. Regeneration of the periodontium is dependent on the participation of mesenchymal stem/stromal cells (MSC) resident in the PDL. Enamel matrix derivative (EMD), an extract from immature porcine enamel rich in amelogenin protein but that also contain bone morphogenetic protein (BMP), is used to treat periodontal defects. The effects of EMD on MSC cells of the PDL are not well characterized. In this in vitro study, we identify PDL progenitor cells from multiple individuals and demonstrate that EMD stimulates them. We show that the effect of EMD on cell proliferation and migration is mediated through the amelogenin it contains, while the differentiation of these progenitor cells to cell types of mineralized tissue is mainly due to BMP signaling.

Chronic Sialadenitis revealing hepatitis C: a case report.

One 53-year-old male was referred with a history of sensitive peripheral neuropathy and Raynaud disease leading to suspect a Sjögren syndrome (SS). Labial salivary gland biopsy shown the classical features of chronic lymphocytic sialadenitis. As clinical and immunologic tests were positive, we conclude to a chronic lymphocytic sialadenitis simulating SS. Enzyme immunoassay and recombinant immunoblot were positive to HCV. Circulating HCV-RNA was detected by PCR. Liver biopsy revealed chronic persistent hepatitis. In one second biopsy, RNA was extracted. PCR amplification and southern blot hybridization for HCV-RNA were performed. After a 8-month treatment by interferon alpha, HCV-RNA was no longer detected in the serum. There was an objective improvement of the Schirmer test. The detection of HCV-RNA in the salivary glands of a Sjögren like syndrome-patient suggests that a direct infection of the salivary glands by HCV could play an important role in the pathogenesis of HCV related sialadenitis.