The occurrence of unicystic ameloblastoma has been studied in 20 patients presenting with unilocular cystic lesions whose clinical, radiographic and gross features were those on non-neoplastic cysts. In the majority of these, the lesion mimicked dentigerous cyst. The rate of recurrence for this group of lesions as determined by long term follow-up observation available for the majority of patients was distinctly lower than that associated with multicystic character of the lesion throughout its course, is indicative of a much less aggressive variety of neoplasm. The adequacy of simple enucleation as a modality of treatment in the majority of patients with this type of lesion is suggested. It was not possible to answer the question whether or not the ameloblastoma began in antecedent non-neoplastic cyst.

Unicystic ameloblastoma, a prognostically distinct entity

Tumours of the salivary glands are unusual in the dog, with an overall incidence reported as 0.2%. This chapter looks at clinical approach; management; prognosis.

Tumours of the salivary glands

After removal of a dental implant or extraction of a tooth in the upper jaw, the closure of an oroantral fistula (OAF) or oroantral communication (OAC) can be a difficult problem confronting the dentist and surgeon working in the oral and maxillofacial region Oroantral communication (OAC) acts as a pathological pathway for bacteria and can cause infection of the antrum, which further obstructs the healing process as it is an unnatural communication between the oral cavity and the maxillary sinus There are different ways to perform the surgical closure of the OAC The decision-making in closure of oroantral communication and fistula is influenced by many factors Consequently, it requires a combination of knowledge, experience, and information gathering Previous narrative research has focused on assessments and comparisons of various surgical techniques for the closure of OAC/OAF Thus, the decision-making process has not yet been described comprehensively The present study aims to illustrate all the factors that have to be considered in the management of OACs and OAFs that determine optimal treatment

/pdf/decision-making-in-closure-of-oroantral-communication-and-193njq2gs6.pdf

Decision-making in closure of oroantral communication and fistula

Background
An oro-antral communication is an unnatural opening between the oral cavity and maxillary sinus. When it fails to close spontaneously, it remains patent and is epithelialized to develop into an oro-antral fistula. Various surgical and non-surgical techniques have been used for treating the condition. Surgical procedures include flaps, grafts and other techniques like re-implantation of third molars. Non-surgical techniques include allogenic materials and xenografts.

Objectives
To assess the effectiveness and safety of various interventions for the treatment of oro-antral communications and fistulae due to dental procedures.

Search methods
We searched the Cochrane Oral Health Group's Trials Register (whole database, to 3 July 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 6), MEDLINE via OVID (1946 to 3 July 2015), EMBASE via OVID (1980 to 3 July 2015), US National Institutes of Health Trials Registry (http://clinicaltrials.gov) (whole database, to 3 July 2015) and the World Health Organization (WHO) International Clinical Trials Registry Platform (http://www.who.int/ictrp/en/) (whole database, to 3 July 2015). We also searched the reference lists of included and excluded trials for any randomised controlled trials (RCTs).

Selection criteria
We included RCTs evaluating any intervention for treating oro-antral communications or oro-antral fistulae due to dental procedures. We excluded quasi-RCTs and cross-over trials. We excluded studies on participants who had oro-antral communications, fistulae or both related to Caldwell-Luc procedure or surgical excision of tumours.

Data collection and analysis
Two review authors independently selected trials. Two review authors assessed trial risk of bias and extracted data independently. We estimated risk ratios (RR) for dichotomous data, with 95% confidence intervals (CI). We assessed the overall quality of the evidence using the GRADE approach.

Main results
We included only one study in this review, which compared two surgical interventions: pedicled buccal fat pad flap and buccal flap for the treatment of oro-antral communications. The study involved 20 participants. The risk of bias was unclear. The relevant outcome reported in this trial was successful (complete) closure of oro-antral communication.

The quality of the evidence for the primary outcome was very low. The study did not find evidence of a difference between interventions for the successful (complete) closure of an oro-antral communication (RR 1.00, 95% Cl 0.83 to 1.20) one month after the surgery. All oro-antral communications in both groups were successfully closed so there were no adverse effects due to treatment failure.

We did not find trials evaluating any other intervention for treating oro-antral communications or fistulae due to dental procedures.

Authors' conclusions
We found very low quality evidence from a single small study that compared pedicled buccal fat pad and buccal flap. The evidence was insufficient to judge whether there is a difference in the effectiveness of these interventions as all oro-antral communications in the study were successfully closed by one month after surgery. Large, well-conducted RCTs investigating different interventions for the treatment of oro-antral communications and fistulae caused by dental procedures are needed to inform clinical practice.

Interventions for treating oro‐antral communications and fistulae due to dental procedures

The present invention is directed to a reinforced absorbable hemostat comprising at least one hemostatic agent in a single layer of nonwoven synthetic fabric having a mixture of compressed fiber staples of a polyglycolide/polylactide copolymer and a polydioxanone.

Reinforced absorbable synthetic matrix for hemostatic applications

Radicular cysts are the most frequent bone lessions which appears in childhood. Their appearance is in connection with gangrenous teeth of permanent dentition. Folicular cysts are somewhat rare bone lessions but their appearance is in connection with impacted teeth of permanent dentition. Because of that they appear a little bit later, i.e. when they begin to sprout out. In this work has been given an interesting case report of enucleated radicular cyst caused by gangrenous second lower deciduous molar. All clinical indicators have shown follicular cyst, but microscopic finding gave completely different results. The rule that definitive diagnosis of lesion's character should be made only after approved histopathology analysis. .

A radicular cyst in lower deciduous molar

Introduction: The process of wound healing after tooth extraction has been studied in several animal species under normal and experimental conditions that might interfere with the healing. Chronology of wound healing after tooth extraction (molars and incisors), which consists in several phases, has been examined by histological, radiological, immunohistochemistry, stereology (bone volumetry), and densitometry methods and by using of micro-camera to determine the volume fraction of histological components. The aim of this study is to analyse the process of healing of normal extraction wound and to determine the period of time it takes for the postextraction wound to completely heal. Material and method: The research is based on the literature available in electronic databases Pubmed/Medline, Kobson, Googlescholar. The total of 22 papers which follow the normal course of healing were found; 7 papers met the criteria regarding the complete description of the healing process in the socket after tooth extraction in rats. Results: On the second day after the extraction wound starts with forming epithelium. The first sign of bone tissue has appeared four days after the extraction as subperiostal osteogenesis. On fourth and fifth day, in some fibroblasts differentiation in osteoblasts has already begun. On the fifth day the delicate trabecules of young bone attached to the walls of the socket in its basal part can be seen, and the signs of ossification are clearly indicated by a darker shadow in the central part of the apical third of the socket present in the x ray. The end of the epitelization is on the eighth day, when the lamina dura was slightly less pronounced, while the lower parts of the socket have a pronounced X-ray shadow. In most of the specimens, the socket has been completely filled with reticular bone on day 14. The socket has been filled with young bone after 20 days. Presence of lamelar bone can be seen 60th day after extraction. Remodelation of aveolar ridges lasts until 112th day. Conclusion: The healing of normal extraction wounds in rats begins with the appearance of the epithelium of the second postoperative day, and the end of the epitelization is on the eighth day . Formation of bone begins on the fourth day after the exodontia. The intense bone formation lasts until the twentieth postoperative day when the young r bone fills the socket. Lamellar bone is present on 60th days after extraction. Application of bone morfogenetic protein, low power laser and polarized light had no expected effect on the healing of the extraction wound in experimental rats.

/pdf/healing-of-extraction-wounds-in-an-experimental-model-of-rat-5alw8vv7p5.pdf

Healing of extraction wounds in an experimental model of rat

Background/Aim. Ropivacaine is a relatively new longacting local anesthetic.
 The aim of this study was to compare the postoperative analgesic effect of
 topical anesthetics ropivacaine 0.75% and lidocaine 2% with adrenaline in
 the postoperative treatment of periapical lesions in the maxilla. Methods.
 The study was conducted on 60 subjects, divided into two groups. The
 study-group received 0.75% ropivacaine without a vasoconstrictor, while the
 control group was treated with 2% lidocaine with adrenaline (1 : 80.000).
 Block anesthesia for n. infraorbitalis was used and local anesthetics were
 applied also on the palatine side for the end branches of n. nasopalatinus.
 The following parameters were observed: time elapsed from the application of
 an anesthetic until the first occurrence of pain after the surgery and first
 intake of an analgesic, the intensity of initial pain, pain intensity 6 h
 after the application of anesthetics and the total number of analgesics
 taken within 24 h after the completion of surgery. Results. The pain
 appeared statistically significantly earlier in the patients who had been
 given lidocaine with adrenaline (p < 0.001), while statistically
 significantly higher mean values of initial postoperative pain (p < 0.05)
 and pain intensity 6 h after the intervention (p < 0.01) were also
 registered in the same group of patients. In the period of 24 h upon the
 intervention, the study-group patients were taking less analgesics as
 compared to the control-group subjects (46.6% vs 73.3%), who were given
 analgesics earlier, although no statistically significant differences were
 observed related to the number of analgesic doses taken. Conclusion. The
 results of our study indicate a better postoperative analgesic effect of
 ropivacaine as compared to lidocaine with adrenaline.

/pdf/assessment-of-ropivacaine-postoperative-analgesic-effect-oeix6a2gp9.pdf

Assessment of ropivacaine postoperative analgesic effect after periapical maxillary incisors surgery

Summary The term necrotizing fasciitis (NF) was first used by Wilson in 1952, who described this rare, however, progressive infection that primarily affects the fascia and subcutaneous tissues. Necrotizing fasciitis may affect any part of the body; however, it usually appears on the extremities. The most common microorganisms isolated in NF are Staphylococcus aureus, group A Streptococci, and Escherichia Coli. We are presenting the case of a sixty-seven-year old woman, who was admitted for the perforation of painful edema of the left cheek. Clinical examination of the anterior two-thirds of the left cheek revealed a defect of the full thickness of the skin, 3×4 cm in size. During the patient’s hospitalization she was treated by parenterally administered broad-spectrum antibiotics, necrotomy, fasciotomy of the cheek and the extraction of the remaining roots in the 3rd and 4th quadrant. Necrotic fasciitis is a rare, rapidly progressive infection of soft tissues, which, if untimely diagnosed and treated, may be life-threatening. The prognosis of treatment depends on the early recognition of the disease. It is treated with aggressive surgical debridement followed by antibiotic therapy.

/pdf/necrotizing-fasciitis-of-the-cheek-a-case-report-3wx5i8kc5p.pdf

Necrotizing Fasciitis of the Cheek: A Case Report

Introduction Mucoepidermoid carcinoma, compared to other tumors of salivary glands, occurs in 5–10% of cases. Histopathologically, it is divided into a well differentiated tumor that is of low-grade of malignancy, and a medium and poorly differentiated tumor of high grade of malignancy. Central mucoepidermoid carcinoma (CMEC) of the mandible was firstly described by Lepp in 1936, on a 66-year-old female patient. CMEC is characterized by atypical clinical image and radiological manifestation. Case outline A 55-year-old female patient was examined at the Clinic of Dentistry in Nis, Serbia, with anamnestic data regarding the presence of painless swelling in the right side of the mandible. Considering the histopathological results and presence of enlarged lymph nodes, right hemimandibulectomy and tumour excision from pterygomandibular space followed by supraomohyoid neck dissection was done. In due course, postoperative radiotherapy was applied (60 Gy) Conclusion CMEC represents a rare tumor, characterized by local tissue destruction and ability to metastasize. Initial biopsy represented the key in preoperative planing. Radical excision with neck lymph node dissection followed by postoperative radiotherapy in our case represent a successful method of treating CMEC of the mandible.

/pdf/central-mucoepidermoid-carcinoma-of-the-mandible-a-case-3eoiqq10vf.pdf

Central mucoepidermoid carcinoma of the mandible – A case report.

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