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.
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
Karl-Heinz Schuckert, Stefan Jopp, Magdalena Osadnik
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.
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.
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.
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.