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Background: Oral surgery involves the diagnosis and surgical treatment of diseases affecting the soft and hard tissues of the oral cavity and encompasses a wide range of surgical interventions. The aim of this investigation was to study the characteristics and age-related diagnoses of these oral surgeries, as well as to describe the surgical procedures performed in a pediatric oral and maxillofacial surgery service. Methods : A descriptive, retrospective, observational, and relational study was conducted on children and adolescents aged from 0 to 22 years who were treated in a pediatric oral and maxillofacial surgery service at a children's hospital. Results: We analyzed 1311 surgical interventions (51.4% were on boys and 48.6% on girls), consisting of 24.8% soft tissue surgeries, 65.9% bone and dental tissue surgeries, and 9.3% mixed tissue surgeries. The most common pathologies were tooth eruption disorders (65.9%), followed by ankyloglossia (20.5%). The most frequent treatment was wisdom teeth extraction (31.3%). A statistically significant association ( p < 0.05) was found between surgical treatments and variables such as age, sex, tissue type, and biopsy. Conclusions: This study enhances our understanding of pediatric oral surgery, emphasizing that the most common pathology is altered tooth eruption, while the most frequent surgical intervention is the extraction of wisdom teeth at different stages of development.

Following surgery, healing within the oral cavity occurs in a hostile environment, and proper oral care and hygiene are required to accelerate recovery. The aim of the current study is to investigate and compare the bioreactivity characteristics of mouthwashes based on either chlorhexidine (CHX) or a novel bone bioactive liquid (BBL) in terms of oral healing within seven days application post-surgery. A randomized, double blind clinical trial was conducted in 81 patients, wherein the mouthwashes were applied twice a day for a period of 7 days. The visual analog scale (VAS) protocol was applied to determine pain index scores. Early wound healing index (EHI) score was determined for evaluating oral cavity healing progress. No adverse effects were observed using the mouthwashes, but CHX application resulted in stained teeth. Applications of both CHX and BBL were sufficient to reduce pain over a period of 7 days. However, the BBL group demonstrated a statistically significant reduction in VAS scores starting on day 4. The EHI scores were significantly higher in the BBL group compared with the CHX group, independent of tooth location. No differences in either VAS or EHI scores due to gender were observed. Compared with the commercially available CHX mouthwash, application of the BBL mouthwash reduced pain and accelerated oral cavity healing to a greater extent, suggesting it effectively improves the oral cavity microenvironment at the wound site in mediating soft tissue regeneration.

Liver diseases are major causes of morbidity and mortality. Dental pulp pluripotent-like stem cells (DPPSCs) are of a considerable promise in tissue engineering and regenerative medicine as a new source of tissue-specific cells; therefore, this study is aimed at demonstrating their ability to generate functional hepatocyte-like cells in vitro . Cells were differentiated on a collagen scaffold in serum-free media supplemented with growth factors and cytokines to recapitulate liver development. At day 5, the differentiated DPPSC cells expressed the endodermal markers FOXA1 and FOXA2. Then, the cells were derived into the hepatic lineage generating hepatocyte-like cells. In addition to the associated morphological changes, the cells expressed the hepatic genes HNF6 and AFP. The terminally differentiated hepatocyte-like cells expressed the liver functional proteins albumin and CYP3A4. In this study, we report an efficient serum-free protocol to differentiate DPPSCs into functional hepatocyte-like cells. Our approach promotes the use of DPPSCs as a new source of adult stem cells for prospective use in liver regenerative medicine., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Carlos Gil-Recio et al.)

Background: Bioactive chemical surface modifications improve the wettability and osseointegration properties of titanium implants in both animals and humans. The objective of this animal study was to investigate and compare the bioreactivity characteristics of titanium implants (BLT) pre-treated with a novel bone bioactive liquid (BBL) and the commercially available BLT-SLA active., Methods: Forty BLT-SLA titanium implants were placed in in four foxhound dogs. Animals were divided into two groups (n = 20): test (BLT-SLA pre-treated with BBL) and control (BLT-SLA active) implants. The implants were inserted in the post extraction sockets. After 8 and 12 weeks, the animals were sacrificed, and mandibles were extracted, containing the implants and the surrounding soft and hard tissues. Bone-to-implant contact (BIC), inter-thread bone area percentage (ITBA), soft tissue, and crestal bone loss were evaluated by histology and histomorphometry., Results: All animals were healthy with no implant loss or inflammation symptoms. All implants were clinically and histologically osseo-integrated. Relative to control groups, test implants demonstrated a significant 1.5- and 1.7-fold increase in BIC and ITBA values, respectively, at both assessment intervals. Crestal bone loss was also significantly reduced in the test group, as compared with controls, at week 8 in both the buccal crests (0.47 ± 0.32 vs 0.98 ± 0.51 mm, p < 0.05) and lingual crests (0.39* ± 0.3 vs. 0.89 ± 0.41 mm, p < 0.05). At week 12, a pronounced crestal bone loss improvement was observed in the test group (buccal, 0.41 ± 0.29 mm and lingual, 0.54 ± 0.23 mm). Tissue thickness showed comparable values at both the buccal and lingual regions and was significantly improved in the studied groups (0.82-0.92 mm vs. 33-48 mm in the control group)., Conclusions: Relative to the commercially available BLT-SLA active implants, BLT-SLA pre-treated with BBL showed improved histological and histomorphometric characteristics indicating a reduced titanium surface roughness and improved wettability, promoting healing and soft and hard tissue regeneration at the implant site.

Aim: The enamel defects of Molar-Incisor Hypomineralisation (MIH) share clinical characteristics with hypomineralised second primary molars (HSPM) and hypomineralised primary canines (HPC). The main objective of this study is to determine the prevalence of these entities in a population of patients in a hospital dentistry service. The secondary objectives are to know the number and distribution of lesions, classify them according to their degree of severity and to know which dental surfaces are most affected., Methods: A cross-sectional and observational prevalence study was carried out over a 32-day period, guided by the diagnostic criteria of the European Academy of Paediatric Dentistry (EAPD) together with the descriptive study of the lesions. Healthy patients between 30-42 months and who had all erupted teeth were included., Results: Out of a total of 153 patients, 29 presented HSPM (18.95%) and 17 HPC (11.11%). Check-ups were made on 116 second primary molars (SPM) and 116 primary canines (PC), obtaining 81 HSPM (69.82%) and 31 HPC (26.72%). The lesions observed were mild in 60 molars (74.07%) and in 27 canines (87.09%). As for the 405 surfaces checked, 168 showed HSPM (41.48%) and 43 HPC (10.61%)., Conclusions: The prevalence of HSPM and HPC varies depending on the population studied. It was observed that SPM were affected more often than PC, with the occlusal and buccal surfaces being the most affected, and the majority of the lesions presenting a low degree of severity.

Aim: Oral and maxillofacial development is influenced by the lingual frenulum and also affects breathing, occlusion, sucking, swallowing, speech, among others. Ankyloglossia in the newborn may result in breastfeeding difficulties: maternal nipple pain and/or erosion or mastitis, poor weight gain and excessively long breastfeeds. The main objective of this work is to study the prevalence of ankyloglossia in newborns with breastfeeding difficulties., Materials and Methods: This is a transversal descriptive study of 302 patients, between 0 and 6 months, who attended the hospital as a result of breastfeeding difficulties. All patients with sucking problems and ankyloglossia were included in this study and followed the multidisciplinary treatment protocol made up of the services of Breastfeeding, Speech Therapy and Orofacial Rehabilitation and Oral and Maxillofacial Surgery., Results: 1,102 newborns were seen at the paediatric service of Hospital de Nens, Barcelona (Spain) during 2 years; 302 had breastfeeding difficulties and of these, 171 were diagnosed with ankyloglossia (60 girls and 111 boys). Coryllos Grade 3 ankyloglossia was the most prevalent (59.6%) type; 85 infants (49.7%) were exclusively breastfed and 26 (50.35%) were mixed fed (formula and breastfeeding). Only 43 patients had a family history of tongue-tie (25.1%)., Conclusion: Ankyloglossia linked to breastfeeding difficulties must be treated by a multidisciplinary team. We have found a high prevalence of the condition since the population studied are newborns with sucking problems. If a frenotomy is necessary, we recommend stimulating suction with myofunctional therapy before and after surgery to avoid scar retraction.

The problems of suction in newborns give rise to multiple consequences for both the mother and the newborn. The objective of this paper is to present a case of ankyloglossia ("tongue-tie") and the suction problems that were treated by a multidisciplinary team. The subject is a 17-day-old male patient, with ankyloglossia and suction problems during breastfeeding (pain in the breastfeeding mother, poor weight gain, and long breastfeeds). The patient followed the circuit established in our centre between the services of Oral and Maxillofacial Surgery and Breastfeeding and Speech Therapy and Orofacial Rehabilitation (CELERE). The evolution following the breastfeeding sessions, the myofunctional stimulation, and the lingual frenotomy was very favourable, thereby solving the suction problems that the newborn presented. All our patients receive breastfeeding sessions and myofunctional therapy as treatment. We know that a frenotomy is not always necessary and we believe that the stimulation of sucking before and after the surgical intervention is important in order to improve the final result.

Background: Partial ankyloglossia is a limitation which restricts the possibility of protrusion and elevation of the tip of the tongue due to the shortness of either the lingual frenulum or the genioglossus muscles or both. The principal objective of this paper is to present our protocol of action for the treatment of ankyloglossia. The specific objectives are to study patients with ankyloglossia treated by the Service of Maxillofacial Surgery and the Service of Speech Therapy of our pediatric Hospital, describe the diagnostic procedures, the pre-surgical intervention, the surgical technique undertaken and the post-surgical rehabilitation taking into account the level of collaboration of the patients, and finally, describe the surgical complications and the referral of patients., Material and Methods: This is a descriptive study of healthy patients, without any diagnosis of syndrome, ranging between 4 and 14 years that have been surgically treated and rehabilitated post-surgery within a period of 2 years., Results: 101 frenectomies and lingual plasties have been performed and patients have been treated following the protocol of action that we hereby present. After the surgical intervention, the degree of ankyloglossia has been improved, considering correction in 29 (28%) of the patients (95% CI: 20%, 38%), reaching, with the post-surgical orofacial rehabilitation, a correction of 97 (96%) of the participants (95% CI: 90%, 98%)., Conclusions: The chosen surgical technique for moderate-severe ankyloglossia in our centre is the frenectomy and lingual plasty. The myofunctional training begins one week before the surgical intervention so that the patients learn the exercises without pain.

Aim: The main objective was to study supernumerary teeth diagnosed during the routine checkups at the Paediatric Dentistry Service of Hospital de Nens, Barcelona (Spain), for four months., Materials and Methods: A transversal, descriptive study, was performed in 1,960 patients, aged 1 to 17 years, visited during routine oral checkups. An intraoral exploration (with intraoral mirror and probe) was performed to all patients, and subjects older than 5 years also underwent panoramic x-ray examination., Results: A total of 33 patients showed supernumerary teeth (1.68%), 22 boys and 11 girls. A total of 10 patients (8 boys/2 girls) had supernumerary teeth in the temporary dentition, 20 patients (12 boys/8 girls) in the permanent dentition and 3 patients (2 boys/1girls) in both temporary and permanent dentition. A total of 46 supernumerary teeth were diagnosed., Conclusion: Any alteration in the number of teeth in patients younger than 5 years are difficult to diagnose, as x-rays are usually not taken. We believe that starting at 5 years old, a radiological exploration (panoramic x-ray) has to be carried out as a complement to the clinical examination.

Objectives: The aim of this study was to evaluate the effect of two different designs, tapered vs cylindrical, on the primary stability of implants placed with an immediate loading protocol in edentulous mandibles to support fixed prostheses within occlusal contacts during the first 48 h., Material and Methods: Tapered and cylindrical implants were placed in a split-mouth study using the same implant protocol in ten patients with edentulous jaws. A total of 20 tapered implants (test group) and 20 cylindrical implants (control group) were placed. All implants were loaded immediately with provisional fixed prostheses during the healing period before the final restoration. The implants were evaluated at the implant placement by analyzing the insertion torque values (ITVs) and the resonance frequency analysis (RFA) and after the healing period of three months, the success of those implants and the marginal bone loss were evaluated., Results: Two cylindrical implants were mobile within the same patient and no tapered implants failed, resulting in implant survival rates of 90% and 100%, respectively after three months. The ITVs were statistically significantly different (P = 0.0210) for the tapered implants than for the cylindrical implants. However, no statistically significant differences in RFA values were found (P = 0.6063) when comparing the implant designs and the primary stability measured with implant stability quotient (ISQ) values. The control group resulted in a mean bone loss after three months of 0.91 mm while the test group resulted 0.42 mm., Conclusion: The tapered implant achieved greater primary stability values measured with ITVs and less marginal bone loss than the cylindrical implants., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Intraosseous arteriovenous malformations (AVMs) in the head and neck region are uncommon. There are several types and they can have a wide range of clinical presentations. Depending on the blood flow through the AVM, the treatment may be challenging for the attending team and may lead to life-threatening hemorrhages. A clinical case report is presented. A 9-year-old girl, seen for gingival bleeding during oral hygiene, was found to have a high-flow AVM located within and around the mandible. Two-stage treatment consisted of intra-arterial embolization followed by intraoral injection of a sclerosing agent 8 weeks later. At the 8-year follow-up, imaging study showed no evidence of recurrent lesion inside or outside the bone. The final outcome is a correct occlusion with a symmetric facial result. This case shows that conservative treatment may be the first treatment option mostly in children. Arteriography and transcortical injection were enough to control the AVM.

Objectives: The purpose was to assess thermal changes and drill wear in bovine bone tissue with the use of twisted stainless steel and zirconia-based drills, during implant site preparation., Methods: A total of 100 implant site preparations were performed on bovine ribs using a surgical unit linked to a testing device, in order to standardize/simulate implant drilling procedures. Bone temperature variations and drilling force were recorded when drilling at a depth of 8 and 10 mm. A constant irrigation of 50 ml/min. (21±1°C) and drilling speed of 800 r.p.m. were used. Scanning electron microscopy analysis was preformed prior and after drilling., Results: Mean temperature increase with both drills at 8 mm was 0.9°C and at 10 mm was 2°C (P<0.0001). Statistical significant higher bone temperatures were obtained with stainless steel drill (1.6°C), when comparing with the ceramic drill (1.3°C) (P<0.05). Temperature increase was correlated with higher number of perforations (P<0.05) and drilling load applied. There was no significant association between drilling force applied and temperature increase by either drill or at either depth. No severe signs of wear of either drill were detected after 50 uses., Conclusions: Drill material and design, number of uses, depth and drilling load applied appear to influence bone temperature variations during implant site preparation. Drilling depth was a predominant factor in bone temperature increase. Both drills can be used up to 50 times without producing harmful temperatures to bone tissue or severe signs of wear and deformation., (© 2011 The Authors. Journal compilation © 2011 John Wiley & Sons A/S.)

Objectives: The aim of this article is to review the current state of immediate implants, with their pros and contras, and the clinical indications and contraindications., Material and Methods: An exhaustive literature search has been carried out in the COCHRANE library and MEDLINE electronic databases from 2004 to November 2009. Randomized clinical trials and clinical trials focused on single implants placed in fresh extraction sockets were included and compared. A meta-analysis could not be performed due to heterogeneity of the data., Results: Twenty studies out of 135 articles from the initial search were finally included, which summed up a total of 1139 immediate implants with at least a 12-month follow-up. Our results have been compared with other current available papers in the literature reviewed that obtained similar outcomes., Discussion: Immediate implants have predictable results with several advantages over delayed implant placement. However, technical complications have been described regarding this technique. Also, biomaterials may be needed when the jumping distance is greater than 1mm or any bone defect is present., Conclusions: Few studies report on success rates rather than survival rates in the literature reviewed. Short-term clinical results were described and results were comparable to those obtained with delayed implant placement. Further long-term, randomized clinical trials are needed to give scientific evidence on the benefits of immediate implants over delayed implant placement.

The use of autogenous grafts is still considered in bone regeneration surgeries. However, the bone cell viability of such grafts after being harvested from donor sites remains a matter of debate. The aim of the present study is to evaluate particulated and block bone cell viability, in terms of presence or absence of apoptosis and necrosis, obtained from different maxillary intra-oral harvesting methods: bone scraper, rotary carbide burs and piezoelectric device. Five healthy patients were enrolled in the study. The patients required sinus augmentation by lateral window approach. The bone was harvested by the bone scraper, piezoelectric device and rotary surgical instrument. The samples were processed with the Annexin V/FITC (fluorescein isothiocyanate stain) kit and were analyzed by means of Fluoresence-Activated Cell Sorted (FACS) technique. Within the limitations of this pilot study, the results indicated that autogenous bone chips collected from the three harvesting methods presented a large percentage of apoptotic cells, although large scale production of necrotic cells was not detected. In summary, although rotary surgical instrument and piezoelectric devices are frequently used instruments for oral osteotomy, fresh autogenous bone chips collected from them did not present a viable bone cell source.

Potent stem/progenitor cells have been isolated from normal human dental pulps, termed dental pulp stem cells (DPSCs). However, no study has described the presence of stem cell populations in human dental pulp from the third molar with embryonic phenotypes. The dental pulp tissue was cultured in media with the presence of LIF, EGF, and PDGF. In the present study, we describe a new population of pluripotent stem cells that were isolated from dental pulp (DPPSC). These cells are SSEA-4(+), Oct4(+), Nanog(+), FLK-1(+), HNF3beta(+), Nestin(+), Sox2(+), Lin28(+), c-Myc(+), CD13(+), CD105(+), CD3(-), CD45(-), CD90(low), CD29(+), CD73(low), STRO-1(low) and CD146(-). We have investigated by SEM analysis and q-RT-PCR the capacity of DPPSCs to 3D differentiate in vitro using the Cell Carrier 3D glass scaffold into tissues that have similar characteristics to embryonic mesoderm and endoderm layers. These data would support the use of these cells, which are derived from an easily accessible source and can be used in future regeneration protocols for many tissue types that differentiate from the three embryonic layers.

Various techniques are described in the literature, either by crestal or lateral approach. Sinus augmentation has a high percentage of success, but presents a number of intraoperative and postoperative complications. The most frequent complication is the Schneiderian membrane perforation with a percentage of perforations between 11% and 56% according to authors. The aim of this study is to describe another membrane approach technique for the sinus lateral wall osteotomy that minimizes the risk of Schneiderian membrane perforation. We present a case of a 50 year old patient attended the University Dental Clinic (UDC) of International University of Catalonia for implant and crown treatment due to the loss of a right maxillary first molar. To insert an implant in position 1.6 a computerized tomography (CT) was requested to determine with greater accuracy the quantity of residual crestal bone. It showed a height of 5 mm and width of 8 mm. The lateral osteotomy was performed with a (SLA KIT®-Neobiotech) trephine mounted in the same implant handpiece with which the field for the implant and the implant itself were prepared. It can be concluded that in the case described, the use of trephine drills of the SLA system mounted in a handpiece allows better access to lateral approach due to its perpendicular position relative to the sinus wall minimizing the membrane perforation risk.

Aims: This study aims to relate bone density in Hounsfield units (Hu) with the primary implant stability measured by insertion torque (Ncm) and resonance frequency analysis (ISQ)., Materials and Methods: Ten patients were included in this study. A total of 54 implant sites were provided from 10 computerized tomography scans. The computerized tomography scan was used for the preoperative evaluation of bone density for each patient. The bone mean density around planned implants was determined with Physioplanet TM software. Bone quality according resistance to drilling, insertion torque and resonance frequency measurements were recorded., Results: A statistically significant relationship was observed between bone quality density and location with ISQ values., Conclusions: This research demonstrates a strong relationship between the bone density values from computerized tomography and the location in the maxillaries. A correlation exists between bone quality, according to the Lekholm & Zarb classification, and Hu computerized tomography values. The primary implant stability measured with resonance frequency analysis depends on bone density values, bone quality and implant location.

Unlabelled: Unerupted supernumerary teeth, depending on the morphology, number and distribution can give rise to various alterations in the eruption and development of those permanent teeth to which they are related., Objectives: We aimed to make an epidemiological and descriptive study of the clinical characteristics of patients in Barcelona, their surgical treatment and how said treatment was hindered., Materials and Methods: A descriptive study including 113 supernumerary teeth from 79 healthy pediatric patients between 5 and 19 years of age, which underwent surgery in our hospital during a 2 year period (May 2005 / May 2007), taking into account the variables of personal data, gender, age, location, number, morphology, position-axis, radiological study, surgical treatment, related pathologies, and surgical complications., Results: Male patients (51) were more frequently affected than female (28) patients mainly within the central incisors-mesiodens (53.16%), in which the unique form (68.52%) predominates in conoid morphology (69.62%). Surgical treatment was done by palatal/lingual extraction (49.37%), with few surgical complications (only 1 case of post-surgical bleeding)., Conclusion: Incidence in supernumerary teeth is higher among male patients (ratio M:F of 1.82:1). They are most frequently located in the maxilla (82%), specifically, in the premaxilla (77%). Most cases presented only one supernumerary tooth (68.5%) and, in multiple cases, the premolar region is predominant. The conoid shape is the commonest morphology (69.62%). Surgical extraction, was done by palatal/lingual in 49.37% of the cases, as opposed to the vestibular approach in 45.57%.

A case of polymorphous low-grade adenocarcinoma arising in the right nasal cavity of a male patient with previous history of kidney transplantation is reported. The tumor contained extensive areas of undifferentiated carcinoma, probably arising from the low-grade component. This combination of findings has not been previously reported in this variety of salivary gland tumor.