2011 Jan-Mar; Vol 2, No 1
Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review
J Oral Maxillofac Res 2011 (Jan-Mar);2(1):e1
Objectives: The purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement.
Material and Methods: Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies.
Results: In total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement.
Conclusions: The damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management.
Keywords: mandibular nerve; inferior alveolar nerve; mandibular canal; cranial nerve injuries; paresthesia; dental implants.
The Use of Platelet Rich Plasma, Bone Morphogenetic Protein-2 and Different Scaffolds in Oral and Maxillofacial Surgery - Literature Review in Comparison with Own Clinical Experience
J Oral Maxillofac Res 2011 (Jan-Mar);2(1):e2
Objectives: The purpose of this article was to review and critically assess the use of platelet rich plasma, recombinant human bone morphogenetic protein-2 and different scaffolds (i.e. tricalciumphosphate, polycaprolactone, demineralized bone matrix and anorganic bovine bone mineral) in oral and maxillofacial surgery comparing the relevant literature and own clinical experience.
Material and Methods: A literature review was conducted using MEDLINE, MEDPILOT and COCHRANE DATABASE OF SYSTEMATIC REVIEWS. It concentrated on manuscripts and overviews published in the last five years (2006-2010). The key terms employed were platelet rich plasma, bone morphogenetic proteins and their combinations with the above mentioned scaffolds. The results of clinical studies and animal trials were especially emphasized. The statements from the literature were compared with authors’ own clinical data.
Results: New publications and overviews demonstrate the advantages of platelet rich plasma in bone regeneration. The results from the literature review were discussed and compared with the publications detailing authors’ own experiences.
Conclusions: A favourable outcome concerning newly grown bone was achieved combining platelet rich plasma in addition to optimal matrices with or without recombinant human bone morphogenetic protein-2, depending on the clinical case. As a consequence, the paradigm shift from transplantation of autogenous bone to bone tissue engineering appears promising.
Keywords: platelet-rich plasma; growth factors; bone morphogenetic protein 2; tissue engineering; bone regeneration; bone replacement materials.
Therapeutic Efficacy of Subgingivally Delivered Doxycycline Hyclate as an Adjunct to Non-surgical Treatment of Chronic Periodontitis
J Oral Maxillofac Res 2011 (Jan-Mar);2(1):e3
Objectives: Locally used doxycycline has been shown to concentrate in crevicular fluid and demonstrates a wide spectrum of activity against the periodontal pathogens. The aim of the present clinical study was to evaluate the efficacy of doxycyline hyclate 10% as an adjunct to scaling and root planing in the treatment of chronic periodontitis.
Material and Methods: 60 systemically healthy, chronic periodontitis patients were included in the study. Randomized clinical trial was performed over the 6 month period. Test group was treated by scaling and root planing followed by local delivery of doxycycline hyclate 10%, while the control group was treated by scaling and root planing along with placebo.
Results: Significantly greater (P < 0.001) reduction in the mean probing pocket depth was demonstrated in the test group (3.03 ± 0.92 mm) when compared with the control group (2.3 ± 0.65 mm). When the differences in clinical attachment level gain for the test group (2.0 ± 0.64 mm) versus control group (1.13 ± 1.07 mm) were analyzed by Student's unpaired t-test, test group showed statistically greater clinical attachment level gain (0.87 ± 0.22 mm, P < 0.001).
Conclusions: From the analysis of the results it can be concluded that the use of doxycyline hyclate 10% as an adjunct to scaling and root planing provides more favourable and statistically significant (P < 0.001) reductions in probing pocket depth and gains in clinical attachment level compared to scaling and root planing alone.
Keywords: doxycycline hyclate; periodontal diseases; chronic periodontitis; periodontium; periodontal pocket.
Myoepithelioma of the Soft Palate: a Case Report Giving Special Attention to the Differential Diagnosis
J Oral Maxillofac Res 2011 (Jan-Mar);2(1):e4
Background: Myoepitheliomas are rare tumours that may generally arise from the minor or major salivary glands. The differential diagnosis of this tumour should be performed along with several benign and malignant soft tissue neoplasms. The present case report describes an asymptomatic mass that arose in the soft palate of 42 year old black woman with duration of the six months.
Methods: An incisional biopsy of soft palate lesion was carried out and submitted for histological evaluation under the clinical hypothesis of salivary gland tumour. To confirm the myoepithelial nature of neoplastic cells the immunohistochemical reactions for smooth-muscle actin, cytokeratins and S100 were performed.
Results: The histological examination revealed the presence of tumour originating from a minor salivary gland and covered by a stratified squamous oral epithelium. The tumour cells were arranged in order to form a myxoid pattern and, individually, small and/or medium spindle-shaped cells with predominantly round or ovoid nuclei, as well as epithelioid and plasmocytoid cells were noted. The stroma was myxomatous and no ductal or syringomatous epithelial structures were observed. Following the histological and immunohistochemical diagnosis of myoepithelioma, the lesion was surgically removed. After the surgery, a follow-up of one year showed no signs and symptoms of reccurrence.
Conclusions: The myoepithelioma should be carefully distinguished from the other soft tissue tumours, especially those arising from salivary glands, such as pleomorphic adenoma and adenoid-cystic carcinoma.
Keywords: myoepithelioma; soft tissue neoplasms; differential diagnosis; palate; minor salivary glands; salivary gland diseases.
Contact Allergic Cheilitis Secondary to Latex Gloves: a Case Report
J Oral Maxillofac Res 2011 (Jan-Mar);2(1):e5
Background: The purpose of this report is to present a rare case of allergic chelitis secondary to latex in an elderly diabetic patient. There are very few reported cases of allergic cheilitis in literature. Most of the reported cases of allergic chelitis were secondary to cosmetics, tooth pastes or impression materials. Few cases of rubber dam induced allergic cheilitis and stomatitis reported.
Methods: Since the patient was diabetic on insulin therapy and belonged to the elderly age group, utmost caution was observed while performing diagnostic tests and treatment procedures. The use test was performed to detect the allergen (latex) because of short contact time to the skin surface.
Results: The patient was followed-up for a period of eight months, complete healing of the lesions was witnessed. The patient has not reported of any lesions later.
Conclusions: Appropriate diagnostic test and interdisciplinary approach in consultation with medical specialists would be ideal for the management of allergic cheilitis especially in diabetic elderly patients.
Keywords: cheilitis; allergic contact dermatitis; latex hypersensitivity; elderly; dental care for aged; diabetic complications.