2010 Oct-Dec; Vol 1, No 4
The Effect of Locally Delivered Doxycycline in the Treatment of Chronic Periodontitis. A Clinical and Microbiological Cohort Study
J Oral Maxillofac Res 2010 (Oct-Dec);1(4):e1
Objectives: To evaluate the efficacy of locally delivered doxycycline as an adjunct to non-surgical treatment with the use of an ultrasonic device compared to scaling and root planing using hand instruments, by means of clinical and microbiological criteria.
Material and Methods: Thirty three patients with chronic periodontitis participated in this cohort study and were divided into two groups. Patients in control group received scaling and root planing using hand instruments, whereas patients in control group received ultrasonic debridement and 8.8% doxycycline gel was applied after initial therapy and at 3 months at preselected sites. Clinical recordings concerning probing pocket depth, clinical attachment level, plaque index and gingival bleeding index were performed at baseline, 3 and 6 months after baseline. Subgingival samples were analysed using the "checkerboard" DNA-DNA hybridisation technique for Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola.
Results: Both treatments resulted in significant improvement in all clinical recordings. Six months after the treatment a statistically significant decrease was observed for Porphyromonas gingivalis in both of groups and Treponema denticola in the control group (P < 0.05). No inter-group differences were observed (P < 0.05).
Conclusions: Both treatment modalities provided comparable clinical and microbiological results in the treatment of chronic periodontitis.
Keywords: chronic periodontitis; doxycycline; root scaling; root planing; debridement; cohort studies.
Mouthwash Use in General Population: Results from Adult Dental Health Survey in Grampian, Scotland
J Oral Maxillofac Res 2010 (Oct-Dec);1(4):e2
Objectives: The purpose of this study was to determine the pattern of mouthwash use and to investigate the associated factors in general population.
Material and Methods: An Adult Dental Health Survey was conducted on 3,022 residents of Grampian region of Scotland (adjusted participation rate 58.2%). Participants received a questionnaire consisting of questions on oral health and behavioural factors.
Results: The majority of participants (38.1%) have never used mouthwash, 17.5%
used mouthwash less than once a month, 19.4% used mouthwash once every
few days and 25.1% used mouthwash daily.
Prevalence of use decreased with age (P < 0.001). Woman were more likely to use mouthwash than men (P = 0.004). Mouthwash use decreased with decrease in the level of deprivation (P < 0.001). Never-smokers were less likely to use mouthwash (40.3%) compared to smokers (53.1%) or those who stopped smoking (46.5%) (P < 0.001). Mouthwash was used by smaller proportion of people drinking alcohol on daily basis (36.6%), than by abstainers (42.2%) (P = 0.012).
There was a positive relationship between flossing or brushing pattern and mouthwash use (P < 0.001). There was statistically significant relationship between mouthwash use and reasons for the last dental visit (P = 0.009).
When compared to healthy individuals, mouthwash was used by higher proportion of people reporting that they had gum disease (P = 0.001), ulcers (P = 0.001), oral infections or swelling (P = 0.002) or other problems (P = 0.025).
Conclusions: Mouthwash use in general population is associated with socio-demographic, health and behavioural factors.
Keywords: mouthwashes; oral hygiene; dental plaque; epidemiology; dental health survey; population groups.
Granular Cell Ameloblastoma: an Unusual Histological Subtype Report and Review of Literature
J Oral Maxillofac Res 2010 (Oct-Dec);1(4):e3
Background: Granular cell ameloblastoma is a rare histological subtype of ameloblastoma accounting for less than 5% of the total. The characteristic microscopic features of granular cells are attributed to the increased presence of lysosomes in the cytoplasm of the tumour cells.
Methods: A case of bone expansion in the mandible of 65 year old patient was examined on the basis of the clinical examination, radiographic imaging and microscopic features. A complete surgical removal was performed.
Results: The radiographic imaging characteristics were consistent with a locally aggressive jaw lesion. Histological examination of the tumour revealed typical features of granular cell ameloblastoma. The specimen margins were free of tumour and the postoperative course was uneventful. No evidence of recurrence was noticed during a 1.5 years follow-up period.
Conclusions: The rarity of the granular cell ameloblastoma subtype and the possibility of confusion with other odontogenic and non-odontogenic lesions with a granular cell component require an understanding of the salient features of this locally aggressive neoplasm. A literature review is provided focusing on emerging molecular parameters in the pathogenesis of these tumours and the differential diagnosis of oral lesions featuring granular cells.
Keywords: jaw neoplasms; ameloblastoma; odontogenic tumor; lysosomes.
Osteochondroma of the Temporomandibular Joint Treated by Means of Condylectomy and Immediate Reconstruction with a Total Stock Prosthesis
J Oral Maxillofac Res 2010 (Oct-Dec);1(4):e4
Background: Osteochondromas are one of the most common benign tumours of bone, but they are rare in the craniofacial region. These condylar tumours have been variably treated, including resection through local excision or condylectomy with or without reconstruction.
Methods: A case of osteochondroma of the mandibular condyle and cranial base arising concurrently in the 76 years old patient was presented. The surgical excision of the skull base lesion and condylectomy with immediate reconstruction of temporomandibular joint was applied.
Results: Based on the history, clinical examination and radiographic findings, osteochondroma of the skull base was diagnosed, with a concurrent lesion of the condylar process. Treatment methods for this patient included excision of the skull base tumour and condylectomy with immediate temporomandibular joint reconstruction using appropriately sized stock total temporomandibular joint prosthesis. At the 24 month follow-up, patient was free of pain and her maximal incisal opening was maintained, with no radiographic evidence of tumour recurrence or failure of the device.
Conclusions: Temporomandibular joint stock total replacement prosthesis became a good option to reconstruct both the fossa and the condyle in a one-stage surgery, due to the fact that both the condylar/mandibular and the fossa implants were stable in situ from the moment of fixation, with a good outcome at 24 month follow-up, with no loosening of the screws nor failure of the device.
Keywords: osteochondroma; mandibular neoplasms; mandibular condyle; temporomandibular joint; joint prosthesis implantation.
Lateral Periodontal Cyst: a Case Report and Literature Review
J Oral Maxillofac Res 2010 (Oct-Dec);1(4):e5
Background: The lateral periodontal cyst is considered a developmental odontogenic cyst with unusual occurrence. In most cases it is preliminary diagnosed as a radiographic finding, presenting as well circumscribed or as a round or teardrop-shaped radiolucent area. Due to its location it can easily be misdiagnosed as a lesion of endodontic origin. Final diagnosis should be based on histopatological examination. The purpose of this paper is to report a classic case of lateral periodontal cyst located in the anterior region of mandible and to review the relevant literature which describes the clinical, radiological and histopathological features of lateral periodontal cysts.
Methods: A 50 years female patient complained of an asymptomatic gingival swelling in the region between the left mandibular lateral incisor and canine. Radiographic examination revealed a well circumscribed radiolucency with approximately 0.5 cm diameter with a radiopaque margin between the roots of the left mandibular lateral incisor and canine. The adjacent teeth had vital pulp.
Results: A total enucleation of the lesion was performed, and intraoperative examination showed a single lesion with no communication between the cyst's cavity and the oral environment. Histological examination revealed that the lesion was "lateral periodontal cyst of developmental origin". There was no recurrence or complications for 24 months follow-up.
Conclusions: The lateral periodontal cyst can be considered in the differential diagnosis when a radioloucent lesion appears adjacent to the roots of vital teeth. The treatment of choice is surgical removal and subsequent histological evaluation to confirm the diagnosis. Relapses are infrequent.
Keywords: apical periodontal cyst; radicular cyst; odontogenic cysts; jaw cysts.