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Oral cavity is one of the manifestations that results from Human Immunodeficiency Virus (HIV) infection. Some of these lesions are suggestive whilst others are specific. However, the oral candidiasis that was observed during HIV infection is specific in terms of its severity and resistance to the usual treatment. Therefore, it is important for all practitioners to know it well in order to be able to make the diagnosis and propose an adequate treatment. During HIV infection, 95% of HIV-positive people have one or more lesions in the oral cavity during their illness. Moreover, oral candidiasis is classified among these lesions. We will describe the different types of candidiasis and their treatment.

Aims: The principal goal of the following case report is to shed light on the importance of thorough clinical, radiological and histological examinations in order to exhibit a final diagnosis of solitary bone cyst, as well as the importance of the surgical treatment for a better outcome. Presentation of case: A case of solitary cyst was identified accidentally in the mandibular right premolars’ region of an asymptomatic 14-year-old male patient post orthodontic consultation. Panoramic radiograph revealed a well-circumscribed, unilocular, radiolucent area giving a typical scalloped appearance between the roots of the involved teeth, that is, 43–44 (Federation Dentaire Internationale). The lesion was asymptomatic and no cervical lymphadenopathy was detected. Discussion: Solitary bone cysts are infrequent mandibular cavities lacking epithelial coating and that are most commonly found in the posterior region of the lower jaw. They exhibit multiple names such as traumatic bone cyst, hemorrhagic bone cyst, extravasation cyst, progressive bone cavity and single chamber bone cyst. Solitary bone cysts are usually asymptomatic but may cause bone deformities, teeth displacement as well as pathological fractures of the affected region. Solitary bone cyst, also found in other skeletal locations, is often suspected after epidemiologic and radiologic test results and confirmed at surgery. Conclusion: In solitary bone cysts cases, undoubtedly, the determinant factor is surgical exploration of the lesion, although its clinical characteristics and scientific literature descriptions must be borne in mind as well as the fact that histological and radiographic characteristics are important to sustain accurate diagnosis. Since etiology of these cysts is unknown to the present date, it can only be intuited according to personal characteristics of each patient. The most accepted theory suggested a traumatic origin for these lesions. Nevertheless, when trauma is discarded as etiologic factor, the most accepted theory would be related to calcium metabolism alterations associated to the overall condition of our patient.

In 2017, the World Health Organization classified the odontogenic keratocyst as a developmental odontogenic cyst. The posterior parts of the mandible, especially the angle and the ramus, are the most involved sites. Due to their high recurrence rate, keratocysts are managed surgically with careful complete excision. Additionally, chemical solutions such as Carnoy's solution, modified Carnoy's solution, and 5-Fluorouracil have been associated with surgical treatment. Diode lasers generate diverse wavelengths that have photothermal and photochemical special properties and could have some effects on the lining epithelium remnants of the cyst. In this paper, we discuss a case of mandibular recurrent odontogenic keratocyst treated with 5-Fluorouracil topical application after enucleation and diode laser application with 18 years follow-up and teeth replacement with dental implant. 5-Fluorouracil and diode laser have been found to be very effective in the treatment of keratocysts.

A dentigerous cyst is an epithelial-lined odontogenic cyst formed by an accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla and the most involved teeth are maxillary canines and maxillary third molar. Dentigerous cysts often displace the related tooth into an ectopic position. In the maxilla when the cyst expands into the sinus, usually causes total or partial occupation of the sinus cavity and can extend to the nose. We report a rare case of a 24-year-old female with bilateral maxillary third molars inside the maxillary sinuses attached to a dentigerous cyst and treated with a minimally invasive endoscopic surgery through the middle meatal meatotomy.

Aims: The main goal of the following case report was to shed the light on the importance of thorough clinical, radiological and histological examinations in order to elaborate a final diagnosis of asymptomatic dentigerous cysts detected in unusual locations. Presentation of Case: A case of dentigerous cyst was identified accidentally in the maxillary left premolar region of an asymptomatic 14-year-old female post an orthodontic consultation. Histological examination of the tissue specimens following enucleation confirmed the diagnosis of a dentigerous cyst. Discussion: Dentigerous cysts are the second most common odontogenic cysts after radicular cysts. They involve impacted, un-erupted, permanent, supernumerary, odontomas and rarely deciduous teeth. Dentigerous cysts are usually painless but may cause facial swelling and delayed tooth eruption. Extensive maxillary involvement and childhood presentation are rare. Radio-graphic and histological examinations should be done to confirm the diagnosis of a dentigerous cyst. Conclusion: In our case, we showed the presence of a maxillary premolar dentigerous cyst that was removed by enucleation. The presence of dentigerous cyst is not always associated with a syndrome and its removal is very important to avoid future complications.

Is to measure the peripheral and internal gap at the implant-abutment interface of an implant system connected to its original or compatible non-original abutments. Twenty implants were assembled with four different types of abutments having the same conical internal interface. All abutments were considered compatible with Tx Astra Tech Implant SystemTM. Four groups were created and each group of five implants was connected to a different abutment; Ti DesignTM abutments (group A), DualTM abutments (group B), Natea plusTM abutments (group C) and ImplanetTM abutments (group D). The peripheral gaps between implant and abutment were observed in three points facing the flat surface of the abutment. The implant-abutment assemblies were then embedded in resin and grinded in the mesio-distal direction of the scalloped abutment margin using a diamond disk at very low speed and under water-cooling. The inner aspect of the implant abutment interface was observed in three different points, on the coronal border of the connection, in the middle area and on the apical border of the implant-abutment interface. The mean gap width was 0.543 ± 0.09 μm for group A and, respectively, 0.708 ± 0.1232 μm, 0.726 ± 0.0891 μm and 0.818 ± 0.0851 μm for groups B, C and D. When comparing group, A to B and C, a highly significant difference in numbers was obvious while an even higher variation was observed with group D. External and internal fit of components is better when using original components.

Mesenchymal stem cells, being characterized by high self-renewal capacity and multi-lineage differentiation potential, are widely used in regenerative medicine especially for repair of bone defects in patients with poor bone regenerative capacity. In this study, we aimed to compare the osteogenic potential of human maxillary schneiderian sinus membrane (hMSSM)-derived stem cells versus permanent teeth dental pulp stem cells (DPSCs). Both cells types were cultivated in osteogenic and non-osteogenic inductive media. Alkaline phosphatase (ALP) activity assay and quantitative real-time PCR analysis were carried out to assess osteogenic differentiation. We showed that ALP activity and osteoblastic markers transcription levels were more striking in hMSSM-derived stem cells than DPSCs. Our results highlight hMSSM-derived stem cells as a recommended stem cell type for usage during bone tissue regenerative therapy.

The extraction of retained and completely impacted third molars is one of the most common surgical procedures performed by dental practitioners with low rates of complications. The accidental displacement during the surgeries of the maxillary third molar into adjacent anatomical spaces is one of the most critical problems that can arise. The most common sites of migration during surgical interventions are the infratemporal fossa, the pterygomandibular space, the maxillary sinus, the buccal space, and the lateral pharyngeal space. In this paper, two cases in which a maxillary third molar accidentally was displaced into the buccal space are presented, the retrieval of the tooth via intra-oral approach is explained, and the anatomical spaces implications are discussed.

Different materials can be used in filling the extraction socket to achieve an alveolar ridge preservation. The present study compared the wound healing potential and pain management efficacy of the collagen and the xenograft bovine bone, covered by a cellulose mesh, inserted into the socket of extracted teeth. Thirteen patients were willingly chosen to enter our split-mouth study. It was a clinical trial of crossover design with a minimum of two teeth to be extracted for each patient. Randomly, one of the alveolar sockets was filled with collagen material as Collaplug®, and the second alveolar socket was filled with xenograft bovine bone substitute Bio-Oss® and covered with a cellulose mesh Surgicel®. Post-extraction follow-up was observed at day 3, 7 and 14, and each participant was told to document his/her pain experience in our prepared Numerical Rating Scale (NRS) document for 7 consecutive days. Clinically, the differential wound closure potential between the two groups was significant in the buccolingual (P = 0.045) but not significant in the mesiodistal (P = 0.204) mouth areas. The pain expressed as rated in the NRS was higher in the case of the Bio-Oss®, but there was no significant difference upon comparing the two procedures for 7 consecutive days (P = 0.397) except on day 5 (P = 0.004). Collagen appears to support faster wound healing rate, higher potential influence on socket healing and decreased pain perception than xenograft bovine bone.

Regenerative endodontics is a biologically based treatment designed for immature permanent teeth with necrotic pulp to replace dentin and root structures, as well as dental pulp cells. This procedure has become a part of novel modality in endodontics therapeutic manner, and it is considered as an alternative to apexification. In the last decade, numerous case reports, which describe this procedure, have been published. This therapeutic approach succeeded due to its lower financial cost and ease of performance. Although the clinical protocol of this procedure is not standardized and the effects of irrigants and medicaments on dental stem cells fate remain somewhat ambiguous, however when successful, it is an improvement of endodontics treatment protocols which leads to continued root development, increased dentinal wall thickness, and apical closure of immature teeth. To ensure a successful regenerative procedure, it is essential to investigate the appropriate disinfection protocols and the use of biocompatible molecules in order to control the release of growth factors and the differentiation of stem cells. This is the first review in the literature to summarize the present knowledge regarding the effect of intracanal irrigants and medicaments on the dental derived stem cells fate in regenerative endodontic procedures., info:eu-repo/semantics/published

Injectable dermal fillers are widely used for facial rejuvenation; they help reshape the facial contours by treating volume loss due to aging changes. Facial fillers may become infected following a dental infection. In this report, we present a case of a 44-year-old female patient who presented with a swelling in her upper right buccal region following dental treatment of her second maxillary right premolar. After a thorough history, clinical, and radiological examinations, the diagnosis of infected dermal filler was made. The lesion was treated by association of two antibiotics (ciprofloxacin IM and clindamycin tablets 300 mg), and a complete healing was observed two months after the end of the dental treatments.

PURPOSE To evaluate retrospectively at 10 years the marginal bone levels around implants located in healed ridges or in extraction sockets and loaded immediately with provisional crowns fixed in prefabricated abutments. MATERIALS AND METHODS Forty-two implants were placed in 36 patients needing single tooth replacement. Implants were inserted either in healed ridges (group 1) or in extraction sockets (group 2) and loaded immediately with prefabricated abutments. Two implants were lost during the healing period from group 2. The bone level around the implant shoulder was calculated mesially and distally on each implant using intraoral radiographs after crown cementation and 1, 3, 5, and 10 years following loading. RESULTS On the 10-year follow-up report, 36 implants were available for the clinical and radiologic evaluation. Besides the two implants lost during the osseointegration period, no implant loss was documented over the 5- to 10-year observation period. The average bone loss after implant and crown cementation was 0.266 ± 0.176 mm for 1 year, 0.194 ± 0.172 mm for 5 years, and 0.198 ± 0.165 mm for 10 years in healed ridges and 0.267 ± 0.161 mm for 1 year, 0.213 ± 0.185 mm for 5 years, and 0.287 ± 0.194 mm for 10 years in extraction sockets. Three crowns (in group 1) and one crown (in group 2) were replaced for esthetic reasons. CONCLUSION The outcome of this study revealed that in both groups, the responses of marginal bone were similar. Immediate placement of the definitive prefabricated abutment in an immediate loading protocol appears to conserve marginal bone around the implant neck.

Accidental implant displacement into the maxillary sinuses and accompanying complications are well documented in the literature. Two surgical approaches have been suggested to remove the displaced implants and to handle the related complications: an intraoral approach and the nasal endoscopy. The intraoral approach is preferred in cases of absence of local infection, ostium obstruction, and oroantral communication needing to be closed. The nasal approach, besides retrieval of displaced implants, allows the treatment of any associated pathology and reestablishment of the mucociliary clearance as well as the natural ventilation through the ostium. This article reports two clinical cases of implant displacement in the maxillary sinus treated with a nasal endoscopy through the middle meatal meatotomy. This article reports two clinical cases of implant displacement in the maxillary sinus treated with a nasal endoscopy through the middle meatal meatotomy. Implants accidentally displaced can be avoided by a proper exploration of the preoperative x-ray, selecting an appropriate treatment plan, and esteeming the surgical skills. The most appropriate approach to handle these complications is close cooperation between oral surgeons and otolaryngologists.

Aim This paper aims to present an alveolar ridge preservation technique, using an autologous punch formed of hard and soft tissues harvested from the tuberosity area. Materials and methods Ten residual sockets in the anterior maxilla were filled with a punch of hard and soft tissues harvested from the tuberosity area. Clinical and radiographical data were collected at the surgical extraction time 0 (T0) and 5 months during implant placement (T1), from clinical and radiological measurements using cone-beam computed tomography scans and periapical radiographs. Core biopsy was harvested during implant placement for histological and histomorphometrical analysis. Results Clinically, the alveolar ridge presented a mean width of 10.3 mm before extraction which decreased to 8.85 mm at T1, where the mean horizontal loss is 1.45 mm (standard deviation [SD] 1.03 mm). The initial ridge mean height was 11.25 mm and increased to 12.85 mm after 5 months, where the mean vertical gain is 1.6 mm (SD 0.65 mm). The radiological evaluation shows a reduction in the horizontal dimension with a mean of 1 mm; however, the sockets show stability in the vertical dimensions. Histology showed a new lamellar bone formation with some areas of woven bone. Histomorphometric analysis showed that the percentage of new bone formed was 42.44 ± 5.54% and 48.62 ± 8.66% of the connective tissue and 8.94 ± 5.28% of the residual autogenous bone. Conclusion At T1, the extraction sockets showed significantly lower vertical and horizontal bone changes, compared to T0. The described preservation punch technique resulted in greater stability in the horizontal and vertical dimensions after 5 months. Clinical significance Clinical and radiological results show that the punch of hard and soft tissue graft reduces hard and soft tissue dimensional alteration after tooth extraction. In addition, using autogenous bone showed histological new bone formation.

Background. Novel treatments for bone defects, particularly in patients with poor regenerative capacity, are based on bone tissue engineering strategies which include mesenchymal stem cells (MSCs), bioactive factors, and convenient scaffold supports. Objective. In this study, we aimed at comparing the potential for different scaffolds to induce osteogenic differentiation of human maxillary Schneiderian sinus membrane- (hMSSM-) derived cells. Methods. hMSSM-derived cells were seeded on gelatin, collagen, or Hydroxyapatite β-Tricalcium phosphate-Fibrin (Haβ-TCP-Fibrin) scaffolds. Cell viability was determined using an MTT assay. Alizarin red staining method, Alkaline phosphatase (ALP) activity assay, and quantitative real-time PCR analysis were performed to assess hMSSM-derived cells osteogenic differentiation. Results. Cell viability, calcium deposition, ALP activity, and osteoblastic markers transcription levels were most striking in gelatin scaffold-embedded hMSSM-derived cells. Conclusion. Our findings suggest a promising potential for gelatin-hMSSM-derived cell construct for treating bone defects.

Odontogenic cysts are usually treated by enucleation (cystectomy). Limited cysts (less than 5 cm) are usually managed by primary excision (total cystectomy), whereas larger ones (exceeding 5 cm) are often decompressed or marsupialized. Because it consists only of opening a much smaller surgical window, decompression is regarded as a more conservative method of treatment: this method associates the creation of an opening (window) into the cystic cavity with the suturing of a decompressing device (plastic tube or stent) at the periphery of the cyst. Apart from releasing intraluminal pressure in the pathological cavity, this procedure helps the lesion to progressively decrease in volume “with a gradual increase in bone apposition” and preserves pulp vitality and periodontal integrity of the adjacent teeth. We are reporting a case of a mandibular radicular cyst that was treated by decompression, followed by enucleation, bone reconstruction, and restoration with two osseointegrated dental implants. The cystic cavity progressively decreased in volume and increased in bone density.

Fibrous dysplasia is a developmental disorder of the bone that originates from a genetic defect disturbing the osteogenesis leading to the replacement of normal bone with the excess proliferation of fibrous tissue. It can be associated with hyperpigmentation of the skin and endocrine disorders. Fibrous dysplasia can manifest in a monostotic form affecting one bone or in a polyostotic form involving several bones. Approximately 30% of monostotic forms are observed in the maxilla and the mandible. It frequently appears in the posterior region and is usually unilateral. It is found in teenagers and could become static after adulthood. Patients can present with swelling, facial asymmetry, pain, or numbness on the affected side. Treatment modalities vary between conservative surgical treatment, radical surgical approach, and medical treatment based on bisphosphonates. Here, we present a case of a monostotic form of fibrous dysplasia affecting the posterior left region of the mandible in a 9-year-old male complaining of gradually increased swelling on the left mandibular side of one-year duration. The diagnosis of fibrous dysplasia is established based on clinical, radiographical, and histopathological features. Conservative surgery is implemented with surgical shaving and reencountering of the bone excess to reduce the facial asymmetry. Recurrence is reported 10 years later and is also treated with a localized osteoplasty and remodeling of the bone contours. Five years later, the lesion remains stable. In conclusion, a conservative approach should be adopted as the first line of treatment for young patients suffering from monostotic fibrous dysplasia.

Small bone defects can heal spontaneously through the bone modeling process due to their physiological environmental conditions. The bone modeling cycle preserves the reliability of the skeleton through the well-adjusted activities of its fundamental cell. Stem cells are a source of pluripotent cells with a capacity to differentiate into any tissue in the existence of a suitable medium. The concept of bone engineering is based on stem cells that can differentiate into bone cells. Mesenchymal stromal cells have been evaluated in bone tissue engineering due to their capacity to differentiate in osteoblasts. They can be isolated from bone marrow and from several adults oral and dental tissues such as permanent or deciduous teeth dental pulp, periodontal ligament, apical dental papilla, dental follicle precursor cells usually isolated from the follicle surrounding the third molar, gingival tissue, periosteum-derived cells, dental alveolar socket, and maxillary sinus Schneiderian membrane-derived cells. Therefore, a suitable animal model is a crucial step, as preclinical trials, to study the outcomes of mesenchymal cells on the healing of bone defects. We will discuss, through this paper, the use of mesenchymal stem cells obtained from several oral tissues mixed with different types of scaffolds tested in different animal models for bone tissue engineering. We will explore and link the comparisons between human and animal models and emphasized the factors that we need to take into consideration when choosing animals. The pig is considered as the animal of choice when testing large size and multiple defects for bone tissue engineering.

BACKGROUND: Classifications of impaction based on panoramic radiographs such as the ones of Pell and Gregory and Winter are essential to allow a better understanding of third molar position regarding depth and bone coverage of the impacted tooth and to evaluate the difficulties of the surgical procedures. The aim of the study was to classify upper and lower third molars teeth in a sample of a Lebanese population and compare the data to results from other studies. MATERIALS AND METHODS: Digital panoramic radiographs of 71 patients with a total of 181 wisdom teeth from patients that had been subjected for third molars extraction, from November 2016 to November 2018, were collected and analyzed. The mean age was 26.25 years. All third molars were categorized according to Pell and Gregory by using A, B, C scores for depth in upper and lower third molars, and angulations were classified according to Winter’s classification. Nonparametric normality tests evaluating age group and gender distribution were conducted by utilizing the Chi-square test for age distribution and the binomial and Kruskal–Wallis tests for gender. RESULTS: In the Pell and Gregory classification, the lower third molars showed type B impaction as the most frequent with 66.1% for the right side and 60.3% for the left side; the maxillary third molars both showed the type C impaction as the most frequent with 63.3% for the right side and 59.2% for the left side. According to the Winter classification, lower third molars showed mesio-angulation as the most frequent angle of impaction with 41.1% for right mandibular side and 46.5% for mandibular left side; As for the maxillary third molars, the disto-angulation was the most frequent angulation seen in both maxillary right and left side teeth 53.3% and 43.2%. CONCLUSIONS: Comparison of our results with other populations has shown similarities in certain criteria like angulation and relation to ramus, but most results varied. Thus, the current study can be taken as a baseline for further studies.

Objective Dental pulp stem cells (DPSCs) and stem cells from human exfoliated deciduous teeth (SHED) are types of human dental tissue-derived mesenchymal stem cells (MSCs) that have emerged as an interesting and promising source of stem cells in the field of tissue engineering. The aim of this work is to isolate stem cells from DPSCs and SHED, cultivate them in vitro and compare their odontogenic differentiation potential. Methods DPSCs and SHED were extracted from molars, premolars and canines of six healthy subjects aged 5–29 years. The cells were characterized, using flow cytometry, for mesenchymal stem cell surface markers. MTT colorimetric assay was applied to assess cell viability. Alizarin red staining, alkaline phosphatase (ALP) activity, quantitative real-time PCR (qRT-PCR) and western blot were carried out to determine DPSCs and SHED osteogenic/odontogenic differentiation. Results DPSCs express higher STRO-1 and CD44 levels compared to SHED. Moreover, the cells differentiate and acquire columnar shape with a level of calcium deposition and mineralization that is the same between DPSCs and SHED. ALP activity, ALP, COLI, DMP-1, DSPP, OC, and RUNX2 (osteogenic/odontogenic differentiation markers) expression levels were higher in DPSCs. Conclusions DPSCs and SHED express MSCs markers. Although both cell types had calcium deposits, DPSCs presented a higher ALP activity level. In addition, DPSCs showed higher levels of osteogenic and odontogenic differentiation markers such as COLI, DSPP, OC, RUNX2, and DMP-1. These results suggest that DPSCs are closer to the phenotype of odontoblasts than SHED and may improve the efficacy of human dental tissue-derived mesenchymal stem cells therapeutic protocols. ‘Clinical significance’ DPSCs are closer than t SHED to the phenotype of odontoblasts. This would be helpful to enable better therapeutic decisions when applying MSCs-based therapy in the field of dentistry.

Non Hodgkin’s Lymphoma (NHL) of the oral cavity is rare. When it occurs, one should be suspicious of infection with the Human Immunodeficiency Virus (HIV).NHL is the second most common malignancy associated with the Acquired immunodeficiency Syndrome (AIDS).This report describes the occurence of a maxillary NHL as a primary clinical manifestation of HIV infection., Le lymphome non hodgkinien de la cavité orale est rare. Lorsqu’il survient il convient de suspecter une infection par le virus de l’immunodéficience humaine (HIV).Le lymphome non hodgkinien est, par ordre de fréquence, la seconde manifestation de malignité associée à un syndrome d’immunodéficience acquise (SIDA).Ce rapport décrit la survenue dans le maxillaire supérieur d’un lymphome non hodgkinien comme première manifestation clinique d’une infection par le HIV.

Cytokines are proteins secreted by diverse types of immune and non-immune cells and play a role in the communication between the immune and nervous systems. Cytokines include lymphokines, monokines, chemokines, interleukins, interferons, colony stimulating factors, and growth factors. They can be both pro- and anti-inflammatory and have autocrine, paracrine, and endocrine activities. These proteins are involved in initiation and persistence of pain, and the progress of hyperalgesia and allodynia, upon stimulating nociceptive sensory neurons, and inducing central sensitization. The objective of this review is to discuss several types of pro- and anti-inflammatory mediators and their relation with inflammatory pain in masticatory muscles.

Purpose The effect of masticatory loads on the retention of overdenture attachments is poorly documented. The aim of this in vitro study is to assess the effect of simulated mastication on the retentive properties and dimensions of Locator inserts. Materials and methods 30 specimens simulating nonanatomic edentulous flat ridges with two implant replicas each were fabricated. Overdenture units were connected to the implants with Locator attachments and 3 types of inserts: transparent (Group T; n = 10 pairs), pink (Group P; n = 10 pairs), and blue (Group B; n = 10 pairs). The overdenture units were subjected to simulated bi-axial masticatory loads of 68.6 N. Locator retention was assessed using axial dislodging forces at baseline (T0) and following 100,000 (T1) and 200,000 (T2) masticatory cycles. The inner diameter of the insert (XY) and the diameter of the central core (AB) were measured under stereomicroscope at T0 and T2. Retention changes and dimensional variations of the inserts were statistically analyzed. Results The 3 groups showed significantly different retentions with the highest values recorded for group T followed by group P, and finally group B at T0, T1, and T2. Groups T and P were not affected by loading while group B showed a significant mean retention loss from T0 to T1. XY and AB were significantly different between the 3 color-coded inserts at baseline and at T2. No correlation could be established between retention changes and dimensional variations of the 3 types of inserts. Conclusions Within the limitations of this in vitro study, simulated mastication seems to significantly affect the extra-light blue Locator inserts but not the more-retentive ones. The transparent and pink inserts may require less frequent replacements and could therefore be recommended under clinical conditions.

Objectives: Cone-Beam Computed Tomography (CBCT) produces vital information required for the accurate and prudent placement of dental implants. Lack of standardization between CBCT machines may result in unsafe patient exposure to harmful radiation; higher doses are not necessarily associated with improved image quality. Aim: The study aimed to assess the influence of low- and high-dose milliamperage settings on CBCT images for objective and subjective implant planning. Methods: Two dry skulls (4 hemi-maxillary segments of the maxilla and 4 hemi-maxillary segments of the mandible) were scanned under low (2 mA) and high (6.3 mA) dosage settings using a CBCT (Carestream CS 9300). Cross-sectional slices of both image qualities were evaluated by five expert clinicians, for image quality for implant planning and objective bone measurements. Results: There were no significant differences in bone measurements taken on high or low dose images (p > 0.05). In qualitative image assessments, assessment and image quality for almost all observers were independent of each other. For planning posterior mandibular implant placement, increased dosage improved concordance and kappa values between low and high dose images. Conclusion: Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient intra-rater reliability for qualitative assessment; therefore dose reduction can be achieved without compromising diagnostic decision- making.

Objectives: bone substitutes used in oral surgery include allografts, xenografts and synthetic materials that are frequently used to compensate bone loss or to reinforce repaired bone by encouraging new bone ingrowth into the defect site. The aim of this study was to evaluate a number ofphysical and chemical properties in a variety of allografts biomaterials used in oral surgery and to compare them with those of autogenous bone. Materials and methods: autogenous bone andfive different allograft biomaterials were studied by high-resolution X-ray diffractometry, atomic absorption spectrometry, laser diffraction, and checked for their chemical composition, calcium release concentration, crystallinity and granulation size. Results: the highest calcium release concentration was 24.94 mg/gforPuros® and the lowest one was 4.05 mg/gfor OsteoSponge® compared to 20.15 mg/g to natural bone. The range ofparticles size, in term of median size D50, varied between 394.24 pm for DIZG Spongiosa® and 902.41 pm for OsteoSponge®, compared to 282.1 pm for natural bone. Bone and Puros® displayed a hexagonal shape as bone except and OsteoSponge® which showed a triclinic shape and all the rest showed monoclinic shape. Conclusion: a bone substitute of choice depends largely on its clinical application that is associated to its biological and mechanical performance. These morphological differences between biomaterials greatly influence their in-vivo behavior of biomaterials. Significant differences were detected in terms of calcium concentration, particles size, and crystallinity.

The broad clinical applications of Mesenchymal Stem Cells (MSCs) in the regenerative medicine field is attributed to their ability to self-renew and differentiate into multiple cellular lineages. Nowadays, MSCs can be derived from a variety of adult and fetal tissues including bone marrow, adipose tissue, umbilical cord and placenta. The difficulties associated with the isolation of MSCs from certain tissues such as bone marrow promoted the search for alternative tissues which are easily accessible. Oral derived MSCs include dental pulp stem cells (DPSCs), dental follicle progenitor cells (DFPC), and periodontal ligament stem cells (PDLSC). Being abundant and easily accessible, oral derived MSCs represent an interesting alternative MSC type to be employed in regenerative medicine. Human periapical cyst-mesenchymal stem cells (hPCy-MSCs) correspond to a newly discovered and characterized MSC subtype. Interestingly, hPCy-MSCs are collected from periapical cysts, which are a biological waste, without any influence on the other healthy tissues in oral cavity. hPCy-MSCs exhibit cell surface marker profile similar to that of other oral derived MSCs, show high proliferative potency, and possess the potential to differentiate into different cell types such as osteoblasts, adipocytes and neurons-like cells. hPCy-MSCs, therefore, represent a novel promising MSCs type to be applied in regenerative medicine domain. In this review, we will compare the different types of dental derived MSCs, we will highlight the isolation technique, the characteristics, and the therapeutic potential of hPCy-MSCs.

The aim of this article is to describe a large mandibular cyst treated with decompression followed by surgical enucleation. Furthermore, we described the utility of cyst volume measurements by using a 3D reconstruction on Cone Beam Computed Tomography (CBCT). The dentigerous cyst is the most common cyst type of epithelial origin, arising from remnants of odontogenic epithelium, asymptomatic and associated with the crown of an unerupted or partially or completely impacted tooth. However, after a long duration and extension of the cyst volume it may provoke significant bone resorption, cortical expansion, tooth displacement and the vitality of neighboring teeth may be affected. The regular treatment of this lesion is enucleation and extraction of the involved tooth. Marsupialization and decompression are proposed when the volume of the cyst is well developed to release the cystic pressure and allow the bone cavity to progressively decrease in volume with the gradual apposition of bone. This report presents a large dentigerous cyst related to impacted mandibular third molar of a 21-year-old male patient. The cyst was treated successfully by decompression and later by surgical enucleation with surgical extraction of the related molar. In conclusion, the combination of decompression and surgical approach showed on the three-dimensional CBCT investigation a significant correlation between the treatment and volume reduction of the cyst. The clinical case described allows us to observe bone formation after decompression and surgical enucleation was performed with less risk on vital anatomic elements.

Objective. Repairing bone defects, especially in older individuals with limited regenerative capacity, is still a big challenge. The use of biomimetic materials that can enhance the restoration of bone structure represents a promising clinical approach. In this study, we evaluated ectopic bone formation after the transplantation of human maxillary Schneiderian sinus membrane- (hMSSM-) derived cells embedded within various scaffolds in the femur of pigs. Methods. The scaffolds used were collagen, gelatin, and hydroxyapatite/tricalcium phosphate (HA/βTCP) where fibrin/thrombin was used as a control. Histological analysis was performed for the new bone formation. Quantitative real-time PCR (qRT-PCR) and immunohistochemistry (IHC) were used to assess mRNA and protein levels of specific osteoblastic markers, respectively. Results. Histological analysis showed that the three scaffolds we used can support new bone formation with a more pronounced effect observed in the case of the gelatin scaffold. In addition, mRNA levels of the different tested osteoblastic markers Runt-Related Transcription Factor 2 (RUNX-2), osteonectin (ON), osteocalcin (OCN), osteopontin (OPN), alkaline phosphatase (ALP), and type 1 collagen (COL1) were higher, after 2 and 4 weeks, in cell-embedded scaffolds than in control cells seeded within the fibrin/thrombin scaffold. Moreover, there was a very clear and differential expression of RUNX-2, OCN, and vimentin in osteocytes, osteoblasts, hMSSM-derived cells, and bone matrix. Interestingly, the osteogenic markers were more abundant, at both time points, in cell-embedded gelatin scaffold than in other scaffolds (collagen, HA/βTCP, fibrin/thrombin). Conclusions. These results hold promise for the development of successful bone regeneration techniques using different scaffolds embedded with hMSSM-derived cells. This trial is registered with NCT02676921.

The aim of our study is to prove and validate the existence of an osteogenic progenitor cell population within the human maxillary Schneiderian sinus membrane (hMSSM) and to demonstrate their potential for bone formation. Ten hMSSM samples of approximately 2 × 2 cm were obtained during a surgical nasal approach for treatment of chronic rhinosinusitis and were retained for this study. The derived cells were isolated, cultured, and assayed at passage 3 for their osteogenic potential using the expression of Alkaline phosphatase, alizarin red and Von Kossa staining, flow cytometry, and quantitative real-time polymerase chain reaction. hMSSM-derived cells were isolated, showed homogenous spindle-shaped fibroblast-like morphology, characteristic of mesenchymal progenitor cells (MPCs), and demonstrated very high expression of MPC markers such as STRO-1, CD44, CD90, CD105, and CD73 in all tested passages. In addition, von Kossa and Alizarin red staining showed significant mineralization, a typical feature of osteoblasts. Moreover, alkaline phosphatase (ALP) activity was significantly increased at days 7, 14, 21, and 28 of culture in hMSSM-derived cells grown in osteogenic medium, in comparison to controls. Furthermore, osteogenic differentiation significantly upregulated the transcriptional expression of osteogenic markers such as ALP, Runt-related transcription factor 2 (Runx-2), bone morphogenetic protein (BMP)-2, osteocalcin (OCN), osteonectin (ON), and osteopontin (OPN), confirming that hMSSM-derived cells are of osteoprogenitor origin. Finally, hMSSM-derived cells were also capable of producing OPN proteins upon culturing in an osteogenic medium. Our data showed that hMSSM holds mesenchymal osteoprogenitor cells capable of differentiating to the osteogenic lineage. hMSSM contains potentially multipotent postnatal stem cells providing a promising clinical application in preimplant and implant therapy.

Sjogren's syndrome is a chronic autoimmune disorder characterized by lymphocytic infiltration, and consequently hypofunction of lacrimal and salivary glands. The loss of salivary function induces oral dryness (xerostomia). This review focuses on methods for determining salivary gland function including clinical signs, salivary flow rate measurements (sialometry), analysis of salivary composition (sialochemistry), histopathological and radiologic examinations, and other recent advanced techniques.

Introduction Use of compatible abutments may increase micromovements between the abutments, and the inner part of the implant may increase the stress on marginal bone level. Also micromovement will change the volume of the inner space of the implant–abutment complex. The resulting pumping effect can transport even initially immobile microorganisms from the exterior to the interior and vice versa. Objectives The purpose of the study was to evaluate the mechanical comportment of OsseoSpeed™ Tx implants connected with original and compatible abutments in vitro under simulated clinical loading conditions. Materials and methods A total of 15 OsseoSpeed™ TX implants (4×11 mm) were used and divided into three groups (n = 5). Three types of abutments were used in the study; group I: Five original Ti Design™ abutments, group II: Five Natea™ abutments, and group III: Implanet™ abutments. Abutments used in groups II and III were all compatible with Astra Tech Implant System™. Implants were embedded into resin. Simulating the human masticatory cycle, the axial force vector was increased up to a defined maximum (25, 50, 75, 100, 125, 150, 175, and 200 N) and inclined 30° to the implant axis. A radiograph amplifier was used to convert the X-ray projection into a picture. The visual evaluation of the frames and the provided X-ray videos were evaluated for an existing microgap in width and length between the implant and the abutment. Results An initial width gap was observed in groups II and III in four of the five samples with an average of 6.5 and 5 μm respectively. When the axial forces reach 75 N, only groups II and III demonstrated a gap width of 5.2 ± 3.63 and 4.8 ± 3.03 μm, and a gap length of 5.2 ± 3.63 and 94 ± 125.3 μm respectively. At 200 N, group I showed a gap width of 8.4 ± 1.67 μm and a gap length of 187.6 ± 43.6 μm, while groups II and III showed a gap width of 12.4 ± 3.29 and 22.8 ± 5.76 μm, and a gap length of 387.2 ± 84.36 and 641.2 ± 122.6 μm respectively. Conclusion Within the limitations of this study and under the parameters used and from the resulting data collected, we can presume that the use of compatible components leads to significant micromovement when compared with the use of original ones. Clinical significance The use of compatible prosthetic components with original implants showed significant micromovements when compared with the use of abutment and implant from the same manufacturer. Clinically, the micromovements when associated with leakage leads to bone loss around the neck of the implant and later to peri-implantitis. How to cite this article Berberi A, Maroun D, Kanj W, Amine EZ, Philippe A. Micromovement Evaluation of Original and Compatible Abutments at the Implant–abutment Interface. J Contemp Dent Pract 2016;17(11):907-913.

The effect of masticatory loads on the retention of overdenture attachments is poorly documented. The aim of this in vitro study is to assess the effect of simulated mastication on the retentive properties and dimensions of Locator inserts.30 specimens simulating nonanatomic edentulous flat ridges with two implant replicas each were fabricated. Overdenture units were connected to the implants with Locator attachments and 3 types of inserts: transparent (Group T; n = 10 pairs), pink (Group P; n = 10 pairs), and blue (Group B; n = 10 pairs). The overdenture units were subjected to simulated bi-axial masticatory loads of 68.6 N. Locator retention was assessed using axial dislodging forces at baseline (T0) and following 100,000 (T1) and 200,000 (T2) masticatory cycles. The inner diameter of the insert (XY) and the diameter of the central core (AB) were measured under stereomicroscope at T0 and T2. Retention changes and dimensional variations of the inserts were statistically analyzed.The 3 groups showed significantly different retentions with the highest values recorded for group T followed by group P, and finally group B at T0, T1, and T2. Groups T and P were not affected by loading while group B showed a significant mean retention loss from T0 to T1. XY and AB were significantly different between the 3 color-coded inserts at baseline and at T2. No correlation could be established between retention changes and dimensional variations of the 3 types of inserts.Within the limitations of this in vitro study, simulated mastication seems to significantly affect the extra-light blue Locator inserts but not the more-retentive ones. The transparent and pink inserts may require less frequent replacements and could therefore be recommended under clinical conditions.

Aim: The aim of the study was to evaluate oral manifestations of HIV /AIDS patients and to correlate their occurrence with plasma levels of CD4+, CD8+ counts and CD4/CD8 ratio. Study Design: A descriptive cross-sectional study. Place and Duration: Odontology Unit, St-Antoine Hospital, a twoyear study. Methodology: In a descriptive cross-sectional study, 50 patients infected with human immunodeficiency virus (HIV) were assessed. The relationships between oral lesions and CD4+, CD8+ cell counts and CD4/CD8 ratio were evaluated. Results: The mean CD4+ counts and CD8+ counts were 167.12 cells/mm 3 and 979.66 cells/mm 3 and the mean CD4/CD8 ratio were 0.25. All patients displayed at least one oral manifestation. The most common identified oral lesion was pseudomembranous candidiasis, accounting for 76% Original Research Article Berberi et al.; BJMMR, 6(9): 859-866, 2015; Article no.BJMMR.2015.261 860 (38/50) followed by periodontal disease 34% (17/50), herpetic lesions, and hairy leukoplakia 10% for each (5/50), gingivitis 8% (4/50), oral ulceration 8% (4/50), Kaposi’s sarcoma 6% (3/50), and Non-Hodgkin lymphoma 2% (1/50). Conclusion: The CD4+ count was decreasing and the presence of oral lesions were increasing in this study. No relation was found between the presence of oral lesions and CD4/CD8 ratio. Progression to AIDS was characterized by increased prevalence of some oral lesions such as candidiasis, hairy leukoplakia and Kaposi’s sarcoma. The clinical appearance of oral lesions was more pronounced when CD4+ count was low.

PURPOSE The aim of this study was to clinically, radiologically, and histologically evaluate a sinus augmentation technique using a resorbable collagen sponge to maintain space between the Schneiderian membrane and the residual crestal bone. MATERIALS AND METHODS Patients with partially edentulous maxillae were clinically and radiographically evaluated for implant placement. A total of 10 consecutive patients with the bone height for implant placement (

BACKGROUND: Differences in CBCT units and the lack of standardization result in exposure to radiation doses beyond what is required for diagnostic purposes, especially when planning the surgical placement of dental implants. AIM: To assess the influence of low- and high-dose milliamperage settings on CBCT images for objective and subjective implant planning among senior specialists (5 years of experience) and juniors (fresh graduates). MATERIALS AND METHODS: Two dry skulls (4 hemi-maxillary segments of the maxilla and 4 hemi-maxillary segments of the mandible) were scanned under low (2 mA) and high (6.3 mA) dosage settings using the Carestream CS 9300 machine. Cross-sectional slices of both image qualities were evaluated by the 5 seniors and the 5 juniors for subjective image utility for implant planning and for objective linear bone measurements. RESULTS: There were no significant differences in bone measurements taken on high- or low-dose images by all seniors and by the majority of juniors (p > 0.05). In qualitative image assessments, there was independence between assessment and image quality for almost all observers. For planning posterior mandibular implant placement, increased dosage improved concordance and kappa values between low- and high-dose images for senior observers (from K = 0.287 at low dose to K = 0.718 at high does) but not for juniors (K = 0.661 and K = 0.509 for low and high dose, respectively). CONCLUSION: Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient concordance for qualitative assessment. Judicious optimization of milliamperage settings based on individual diagnostic requirements can result in significant dose reduction without compromising diagnostic decision-making.

Purpose Limited information is currently available relative to the effect of masticatory loads on the retentive properties of Locator attachments. The aims of this in vitro study were to assess and compare the effect of simulated mastication on the retention of white, pink, and blue Locator inserts for overdentures retained by 2 implants. Materials and Methods Thirty specimens simulating a nonanatomic edentulous flat ridge with two implants and an overdenture were divided into 3 groups according to the color of the fitted insert: transparent clear group (n = 10), pink group (n = 10), and blue group (n = 10). Retention forces were measured in an axial direction initially and after 100,000 cycles of simulated masticatory loads. One-way ANOVA followed by Tukey's post hoc tests were used to compare retention values and percentage retention loss between the 3 groups with significance set at p = 0.05. Results The 3 groups presented significant differences in retention at baseline (9.95 ± 1.91 N, 15.43 ± 4.08 N, and 41.73 ± 9.29 N for the blue, pink, and clear groups, respectively) and after simulated mastication (6.37 ± 2.64 N, 14.00 ± 3.89 N, 38.20 ± 5.11 N for the blue, pink, and clear groups, respectively). Within the same group, cyclic loading did not significantly affect retention in the clear and pink groups, while the blue inserts showed a significant retention loss (-37%) after loading. Conclusions The results suggest that short-term simulated mastication affects the extra-light blue inserts but not the more-retentive inserts.