Basic properties and types of zirconia: An overview

This paper describes types and characteristics of zirconia materials in relation to their applications in dentistry. The zirconia material typically used today by most manufacturers is a tetragonal polycrystalline zirconia, partially stabilized with yttrium oxide. The mechanical properties of zirconia have been extensively investigated in the scientific literature and zirconia clearly measures up to any other equivalent manufactured material. The biocompatibility of zirconia has also been extensively evaluated and no local or systemic adverse reactions or cytotoxic effects have been found in relation to it. However, ceramic bonding, ageing, light transmission and manufacturing processes are all factors that need to be further evaluated in order to guide the successful use of zirconia as a prosthetic restorative material. Milling zirconia to full-contour might be an alternative to traditionally veneered restorations. A potential adhesion mechanism appears to be the combination of air abrasion with aluminum oxide particles (silanated or not), followed by sintering with materials containing special reactive monomers. Changes in zirconia properties before and after the sintering process have also been investigated. It was found that after sintering, surface roughness was greater, and micro hardness was slightly reduced; however, accurate precision of fit was not affected by the sintering process. Currently, zirconia restorations are manufactured by either soft or hard-milling processes, with the manufacturer of each claiming advantages over the other. Chipping of the veneering porcelain is reported as a common problem and has been labeled as its main clinical setback. As zirconia has demonstrated good mechanical and biological performance, future technology is attempting to improve esthetics and minimize veneer fracture, aiming to create confidence in the dental community towards this all-ceramic system. Milling zirconia to full-contour might be an alternative to traditionally veneered restorations. Finally, implications are drawn for manufacturing, machining, and widespread use of these materials.

Salivary gland disorders: A comprehensive review

Salivary glands are complex in nature. They could be either tubulo acinar, merocrine or exocrine glands secreting mainly saliva. Salivary gland is one of the main soft tissue structures in the maxillofacial area. Saliva is a clear, slightly acidic muco serous fluid that coats the teeth, mucosa and thereby helps to create and maintain a healthy environment in the oral cavity. Salivary glands may be affected by a number of diseases: local and systemic and the prevalence of salivary gland diseases depend on various etiological factors. The glands may be infected by viral, bacterial, rarely fungal or its ductal obstruction which may cause painful swelling or obstruction, affecting their functions. The salivary gland may also be affected by a various benign and malignant tumours. This review article briefly describes about the various salivary gland disorders, diagnostic techniques and their management including the recent advances and the future perspective.

Dental pulp stem cells: Novel cell-based and cell-free therapy for peripheral nerve repair

The regeneration of peripheral nerves comprises complicated steps involving a set of cellular and molecular events in distal nerve stumps with axonal sprouting and remyelination. Stem cell isolation and expansion for peripheral nerve repair (PNR) can be achieved using a wide diversity of prenatal and adult tissues, such as bone marrow or brain tissues. The ability to obtain stem cells for cell-based therapy (CBT) is limited due to donor site morbidity and the invasive nature of the harvesting process. Dental pulp stem cells (DPSCs) can be relatively and simply isolated from the dental pulps of permanent teeth, extracted for surgical or orthodontic reasons. DPSCs are of neural crest origin with an outstanding ability to differentiate into multiple cell lineages. They have better potential to differentiate into neural and glial cells than other stem cell sources through the expression and secretion of certain markers and a range of neurotropic factors; thus, they should be considered a good choice for PNR using CBT. In addition, these cells have paracrine effects through the secretion of neurotrophic growth factors and extracellular vesicles, which can enhance axonal growth and remyelination by decreasing the number of dying cells and activating local inhabitant stem cell populations, thereby revitalizing dormant or blocked cells, modulating the immune system and regulating inflammatory responses. The use of DPSC-derived secretomes holds great promise for controllable and manageable therapy for peripheral nerve injury. In this review, up-to-date information about the neurotrophic and neurogenic properties of DPSCs and their secretomes is provided.

Effects of energy and sports drinks on tooth structures and restorative materials

Sports and energy drinks are consumed by more people than ever. Sports and energy drinks may enhance physical resistance, stimulate metabolism, prevent rehydration and replace electrolytes during high activity efforts. However, these drinks often have a low pH and are acidic, which can erode enamel and dentin, and increase dentine hypersensitivity. In addition to the adverse effects of sports and energy drinks on tooth structures, they often have the potential to damage restorative materials. These drinks often contain artificial colors which have potential to discolor resin composite materials and glass ionomers. The acidic nature of these drinks could also lead to a degradation, increase in wear, and roughening of the surface of the restorative materials. Many of the negative consequences of sport and energy drinks can be related to their over-consumption among children and teenagers. Patients should be advised to have a healthy diet, and consume soft and energy drinks in moderation, to avoid any negative dental or health consequences. The over-consumption of sports and energy drinks which are high in sugar and have the lowest pH are most likely to cause avoidable dental problems.

Oral lichenplanus: Etiology, pathogenesis, diagnosis, and management

Oral Lichen planus (OLP) is a common chronic mucocutaneous disorder with an immune mediated pathogenesis. Its appearance may vary from presence of keratotic to erythematous areas. Etiology of OLP is unknown, but it is thought to be the result of an autoimmune process with an unknown predisposing factor. Oral lichen planus is a complex and poorly understood clinical condition with periods of remissions and exacerbations. Management of the OLP is diversified with few lesions requiring treatment for years and few others are mild, requiring no treatment.

Non-surgical periodontal therapy: An update on current evidence

Periodontal disease is an inflammatory condition that involves a complex interaction between pathogenic bacteria, environmental and acquired factors and host related factors. Till recently periodontal treatment was directed primarily towards reduction of bacterial load by subgingival debridement of root surfaces and modification of environmental risk factors. The current paradigm of periodontal disease stresses greater role of host-mediated inflammatory response in tissue destruction characteristic of periodontal disease. Various therapeutic modalities have been developed adjuvant to mechanical periodontal therapy. The use of laser and photodynamic therapy show great promise but their effectiveness has still not been conclusively proven. Chemotherapeutic agents, either systemic and local antimicrobials or host modulating drugs, played pivotal role in better and more predictable management of periodontal disease. The present review focuses on the best available evidence, for the current management of the chronic periodontal patients, gathered from systematic reviews and meta-analysis of mechanical non surgical periodontal therapy (NSPT) (subgingival debridement, laser therapy and photodynamic therapy) and the adjunctive chemotherapeutic approaches such as systematic and local antibiotics and antiseptics, subgingival pocket irrigation and host modulation therapies. The review also attempts to briefly introduce future developments in some of these modalities. At the end, the review summarizes the analysis of the current evidence that suggests that thorough subgingival debridement remains the mainstay of NSPT and that adjunct use of chemotherapeutic agents may offer better management of clinical parameters in periodontitis patients.

Risk aspects of dental restoratives: From amalgam to tooth-colored materials

Dental materials’ choice of patients has considerably changed. Whereas cast gold and amalgam have been the predominant biomaterials for decades, today tooth-colored materials like resin-based composites and ceramics are more and more successful. However, are we going to replace a good but biologically questionable material (amalgam) with an equal material (resin composite) being more esthetic but also biologically questionable For amalgam, long-term clinical studies reported some significant hints that in single cases amalgam may be a health hazard for patients, finally Norway banned amalgam completely. The main advantage of a resin-based composite over amalgam is its tooth-like appearance and more or less absence of extensive preparation rules. For many years it was believed that resin-based composites may cause pulpal injury. However, pulpal injury associated with the use of resin-based composites is not correlated with their cytotoxic properties. Nevertheless, resin-based composites and other dental materials require rigorous safety evaluation and continuous monitoring to prevent adverse events similar like with amalgam. Because of non-biocompatible pulp responses to resin-based composites and amalgam, they should not be placed in direct contact with the dental pulp. The less dentin remaining in the floor of preparations between resin-based composites or other dental materials is more likely to cause pulpitis. Percentage of patients and dental practitioners who display allergic reactions is between 0.7% and 2%. The release of cytotoxic monomers from resin-based materials is highest after polymerization and much lower after 1 wk. Substances released from resin-based composites have been shown to be toxic in cytotoxicity tests. Nevertheless, in vitro cytotoxicity assays have shown that amalgam has greater toxic effects than resin-based composites, sometime 100-700-fold higher. Altogether, the risk of side-effects is low, but not zero, especially for dental personnel.

Diagnostic aids in detection of oral cancer: An update

Oral cancer is the sixth most common malignancy with almost 500000 new cases reported worldwide annually. The diagnosis of oral cancer at an early stage has a good prognosis as the survival rate is high (around 80%). However, the majority of oral cancer cases are diagnosed at a later stage with a considerably poor 5-year survival rate of 50% according to World Health Organization statistics. Thus, an effective management strategy for oral cancer will depend on its early identification and intervention which would pave the way for superior prognosis. Despite the obvious advantage of earlier diagnosis of oral cancer, no approach has yet proven to be a reliably successful in diagnosis of oral cancer at an early stage. Currently; the primary line of screening of oral cancer is performed by visual inspection, which is a subjective examination. Among the screening tests or diagnostic aids now available for oral cancer, few (toluidine blue, brush biopsy, salivary and serum bio-markers) have been utilised and studied for many years while others have recently become commercially available. The authors in the present article review all the modalities of screening aids used in oral cancer detection and provide an update on the latest screening tools used in oral cancer detection.

Host-derived biomarkers in gingival crevicular fluid for complementary diagnosis of apical periodontitis

Apical periodontitis (AP) develops as a result of the host’s immune inflammatory response to pulpal infection of the dental root canals that leads to the generation of an apical lesion of endodontic origin (ALEO) and potentially to systemic metabolic alterations. Misdiagnosed ALEO is not infrequent due to the lack of diagnostic tools to differentiate apical lesions of different natures. Despite the conservative endodontic treatment shows a high success rate, there are refractory cases that can not be identified early enough during follow up. This evidences the need to develop complementary diagnostic tools, such as oral fluid biomarker analysis. Gingival crevicular fluid (GCF) is a serum transudate that becomes an exudate under inflammatory conditions, carrying molecules from local periodontal tissues and general circulation than can be harvested non-invasively. We aimed to review the available literature analyzing GCF composition in AP patients to evaluate whether GCF has any potential for complementary diagnosis. To the date, only few studies addressing changes of GCF components in AP are available. Most studies support GCF modifications in specific components in AP-affected teeth, suggesting that it might reflect periapical inflammation. GCF has potential for diagnostic tool, treatment follow-up and eventually to assess systemic comprise.

Angina bullosa hemorrhagica an enigmatic oral disease

Angina bullosa hemorrhagica (ABH) is an enigmatic oral disorder described for the first time by Badham in 1967 to define blisters with a hematic content in the oral cavity and oropharynx unrelated to any hematological, dermatological or systemic disease. The ABH is an uncommon disease of the oral cavity distinctively affecting adults, with the highest incidence over the 5^th decade of life. This process is considered nowadays to have a multifactorial etiopathogenesis, where mild oral traumatisms can trigger the blisters in susceptible individuals. Certain association on the onset of the lesion with the chronic use of inhaled steroids and, more controversially, with triggering systemic disorders, such as, diabetes or hypertension has been described. Characteristically, the ABH blisters are acute and are located on the lining mucosa, more frequently on the soft palate. Usually, the lesions are solitary and rupture easily, resulting in a superficial ulceration that heals quickly without scarring. The histopathological analysis shows a subepithelial blister containing blood and direct immunofluorescence on the epithelium is negative. The differential diagnosis should consider all oral vesiculo-bullous disorders with hematic content, including mucocutaneos, hematological or cystic pathology. The diagnosis of ABH is clearly clinical, although the biopsy might be helpful on atypical or abnormally recurrent cases. The general prognosis of ABH is good and the treatment is symptomatic.

Evaluation of factors affecting the success rate of orthodontic mini-implants by survival analysis

AIM: To investigate the success rate of mini-implants and its characteristics and risk factors by survival analyses.

METHODS: Three hundred and ninety-four mini-implants of the same type were placed by a single clinician. Age, gender, treatment duration, time of failure, side and jaw of implantation and the soft tissue at placement site were recorded. Odds ratio, survival curves, and Cox proportional hazard model were applied to evaluate the factors influencing the mini-implants’ success rate.

RESULTS: The cumulative success rate was 88.1%. The maxilla had a significantly higher success rate than that of the mandible (91.7% vs 83.7%, respectively, P = 0.019). Placement of mini-implants in the attached gingiva (AG) showed a higher success rate than that of the mucogingival junction (MGJ) and mucous membrane (MM) (AG, 94.3%; MGJ, 85.8%; MM, 79.4%; P < 0.001). Significant association was found between the jaw and the gingival tissue type (P < 0.001). There were no significant differences between maxilla and mandible when compared within each placement site.

CONCLUSION: The gingival tissue type had the most significant effect on the success rate of the mini-implant with higher success rate in the attached gingiva.

Effects of low intensity laser irradiation phototherapy on dental pulp constructs

AIM: To investigate low intensity laser irradiation phototherapy (LILIP) on the proliferation, mineralization and degradation of dental pulp constructs.

METHODS: Stem cells from human exfoliated deciduous teeth (SHED) were grown to confluence and seeded on collagen scaffolds to create dental pulp constructs. LILIP was delivered to the dental pulp constructs using an 830 nm GaAIAs laser at an output power of 20 mW. The LILIP energy density was 0.4, 0.8, 1.2, and 2.4 J/cm². After 8 d, the cell proliferation and degradation within the dental pulp constructs were measured using histologic criteria. After 28 d, the effect of LILIP on SHED mineralization was assessed by von Kossa staining.

RESULTS: SHED proliferation within the dental pulp constructs varied after exposure to the 0.4, 0.8, 1.2, and 2.4 J/cm² LILIP energy densities (P < 0.05). The maximum proliferation of SHED in nutrient deficient media was 218% after exposure to a 1.2 J/cm² LILIP energy density. SHED grown in nutrient deficient media after exposure to a 0.4, 0.8, and 1.2 J/cm² LILIP energy density, proliferated by 167-218% compared to the untreated (non-LILIP) control group (P < 0.05). SHED exposed to a 0.4, 0.8, and 1.2 J/cm² LILIP energy density, and grown in optimal nutritional conditions and proliferated by 147%-164% compared to the untreated (non-LILIP) control group (P < 0.05). The exposure of SHED to the highest LILIP energy density (2.4 J/cm²) caused a reduction of the cell proliferation of up to 73% of the untreated (non-LILIP) control (P < 0.05). The amount of mineral produced by SHED increased over time up to 28 d (P < 0.05). The 0.8 and 1.2 J/cm² LILIP energy densities were the most effective at stimulating the increased the mineralization of the SHED from 150%-700% compared to untreated (non-LILIP) control over 28 d (P < 0.05). The degradation of dental pulp constructs was affected by LILIP (P < 0.05). The dental pulp constructs grown in optimal nutritional conditions exposed to a 0.8 J/cm² or 1.2 J/cm² LILIP energy density had 13% to 16% more degradation than the untreated (non-LILIP) control groups (P < 0.05). The other LILIP energy densities caused a 1% degradation of dental pulp constructs in optimal nutritional conditions (P > 0.05).

CONCLUSION: LILIP can enhance or reduce SHED proliferation, degradation and mineralization within dental pulp constructs. LILIP could promote the healing and regeneration of dental tissues.

Dental stem cells: Progress and perspectives

Dental pulp stem cells (DPSCs) are thought to contribute to reparative dentin formation, and that they may correspond to heterogenous populations of precursor cells or represent distinct differentiation stages along the odontoblastic lineage. DPSCs share many similarities with mesenchymal stem cells of the bone marrow (BMSCs). It appears that the distribution of tissue stem cells is not random and, within the dental pulp, there are potentially several distinct niches of stem/progenitor cells. In addition to DPSCs, other dental stem cell populations have been isolated. As for DPSCs, further studies are still needed to evaluate their potential of differentiation and their regenerative activity. Up today, (1) the formal demonstration that pulpal resident stem cells are actually the reparative dentin-forming cells recruited in response to injury is still lacking; and (2) the origin, localization and precise identity of odontogenic stem cells remain largely unknown. Dental clonal cell lines may represent valuable tool to answer some fontamental questions concerning the dental stem cell biology. Altogether, the presence of dental cell populations displaying stem cell properties has opened new paths for considering regenerative therapies. This might be a prerequisite to design alternative strategies for capping and endodontic treatment, using stem cells.

Impact of different types of herpesviral infections in the oral cavity

The herpesviruses are ubiquitous, doubled-stranded DNA viruses that can reactivate under conditions such as immunosuppressive therapy, acquired immunodeficiency syndrome, malnutrition, and immunosenescence. There are eight types of herpesviruses: Human herpesvirus simplex (HSV) type I (HSV-1) and HSV type II (HSV-2), varicella-zoster virus (VZV), epstein-Barr virus (EBV), cytomegalovirus, human herpesvirus (HHV)-6, HHV-7, and HHV-8 or Kaposi’s sarcoma herpesvirus. Some of these viruses can infect the oral cavity, leading to different types of lesions. Specifically, labial herpes (HSV-1 and less frequently HSV-2), zoster (VZV), infectious mononucleosis and oral hairy leukoplakia (EBV), and Kaposi’s Sarcoma (HHV-8) are the most common viruses infecting the oral cavity. Some of these viruses can act in synergy with other herpesviruses or as distinct infectious agents. Other herpesviruses may have indirect effects in periodontal disease. The diagnosis is frequently based on signs and symptoms and depends on the experience of the examiner. Cytopathologic and/or histopathologic examination as well as immunological methods such as ELISA could help to elucidate cases. In addition, molecular techniques which can be sensitive and specific have been reported in the literature. These methods require low amounts of sample and could offer results faster than other traditional methods.

Oral lichenoid lesion: A review of the literature

The oral lichenoid lesion (OLL) is response that occurs on the oral mucosa. The OLL include allergic response to the dental materials, drugs, and on graft-vs-host disease (GVHD). OLL to dental material happen when restorative materials, most commonly amalgam, are in direct contact with the mucosa in sensitized individuals. Medications that produce OLL are oral hypoglycemic agents, angiotensin-converting enzyme inhibitors, and nonsteroidal anti-inflammatory agents. GVHD is a complication in bone marrow transplantation and OLL is a common lesion observed in this disease especially in chronic GVHD. The clinical and histological aspects of OLL are similar to oral lichen planus and turn it difficult to make a differential diagnosis. The purpose of this paper is review about OLL related to the dental materials, drug use and GVHD.

Minireview of the clinical efficacy of platelet-rich plasma, platelet-rich fibrin and blood-clot revascularization for the regeneration of immature permanent teeth

The aim of this mini-review was to investigate and compare the clinical efficacy of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), vs blood clot revascularization (BCR) for the regeneration of immature permanent teeth. The clinical efficacy of PRP, PRF, and BCR to regenerate 90 immature permanent teeth after one year, were compared for their ability to accomplish apical closure, a periapical lesion healing response, root lengthening, and dentinal wall thickening. The 90 cases were published in three different articles. The mean success rate for apical closure after one year was: PRP (89.2%) PRF (80%), and BCR (75.6%). The mean success rate for root lengthening after one year was: BCR (88.9%), PRP (68.2%), and PRF (65%). The periapical lesion healing response was 100% for BCR and 100% for PRP. Dentinal wall thickening was 100% for BCR, and 100% for PRP. All the PRP, PRF, and BCR treatments appeared to be effective. The published clinical results for PRP, PRF, and BCR indicate that these treatments are effective for the regeneration of immature permanent teeth.

Relationship between periodontitis and cardiovascular diseases: A literature review

Periodontitis and cardiovascular disease have a complex etiology and genetics and share some common risk factors (i.e., smoking, age, diabetes, etc.). In recent years, the relationship between periodontal disease and cardiovascular disease has been investigated extensively. This research mostly focused on the fact that periodontitis is an independent risk factor for cardiovascular disease. Our aim in this article is to investigate the etiological relationship between periodontal disease and cardiovascular disease and the mechanisms involved in this association. According to the current literature, it is concluded that there is a strong relationship between these chronic disorders.

Platelet preparations in dentistry: How? Why? Where? When?

The aim of this article is to review the outcomes of platelet preparations in dentistry. A structured electronic search discovered 348 articles, which described the use of autologous platelet concentrates with a relevance to clinical dentistry. Among these articles, 220 articles investigated platelet rich plasma, 99 investigated platelet rich fibrin, 22 investigated plasma rich in growth factors and 7 investigated the use of concentrated growth factors. Several studies reported beneficial treament outcomes in terms of enhanced bone and soft tissue regeneration.

Klippel-feil: A syndrome in the occipital-cervical spine field and its dentofacial manifestations

Klippel-Feil syndrome (KFS) is defined by congenital cervical vertebral spine fusion and is seen with a wide spectrum of dental manifestations and craniofacial profiles. Previous studies on lateral cephalograms have documented an association between fusion of the cervical vertebrae and deviations in the craniofacial profile in non-syndromic patients with severe malocclusion. To our knowledge, no previous studies have described the craniofacial profile including the cranial base of KFS patients on lateral cephalograms. Therefore KFS and its craniofacial and dental manifestations were described according to existing literature and additionally the craniofacial profile and cranial base was analysed on lateral cephalograms of two patients with KFS. According to the literature the dental manifestations of KFS-patients included oligodontia, overjet, cross bite, open bite and deep bite. The craniofacial profile was clinically described as reduced lower facial height, midfacial hypoplasia, and mandibular prognathia. The analyses of the two lateral cephalograms showed increased mandibular inclination, increased vertical jaw-relationship, increased jaw angle and maxillary retrognathia. The cranial base was normal in both cases. The sagittal jaw relationship and mandibular prognathia varied between the two cases. The literature review and the analyses of the two lateral cephalograms have shown that deviations in the occipital and cervical spine field as KFS were associated with deviations in the teeth and craniofacial profile.

Treatment of mouth and jaw diseases with intralesional steroid injection

Many lesions of the oral region are treated with surgical methods such as curettage and resection. Chemotherapy and radiation therapy with or without surgical intervention can be used as an adjunct in some cases. Intralesional steroid injection is a conservative procedure which is already used in various regions of the body and joints. This technique is used also for a number of mouth and jaw lesions. Localized langerhans cell histiocytosis, central giant cell granuloma, oral submucous fibrosis, oral lichen planus, lichen sclerosus of the oral mucosa, lymphatic malformations and orofacial granulomatosis can be considered among these diseases. The purpose of this review is to investigate the effects of intralesional steroid injections in the treatment of oral diseases.

Concepts and challenges of alveolar ridge preservation and augmentation

The loss of the post-extraction alveolar ridge vertical and horizontal volume constitutes an irreversible process and presents a considerable impact on the prosthetic rehabilitation, particularly when implant-supported. Therefore, alveolar ridge resorption has become a challenge in contemporary clinical dentistry and alveolar ridge preservation and augmentation are an interesting therapeutic approach. The employment of biomaterials, as a therapeutic alternative to preserve bone in height and volume, has been frequently studied over the years, due to its conceptual attractiveness and its simple technique. The purpose of this paper is to review and discuss current methods to optimize the alveolar bone repair while maintaining its horizontal and vertical dimensions. This paper is based on scientific studies published in English including systematic reviews and also animal and human studies that were searched using the keywords “alveolar ridge preservation,”“bone substitute”, “biomaterials”, “bone graft” and “grafting”. Either autogenous bone as xenogenic and alloplastic materials, platelet rich plasma and use of membrane are alternatives. It becomes fundamental to understand that alveolar bone loss is still a clinical challenge and alveolar ridge preservation techniques can minimize, but not completely, eliminate the resorption process. The goal of alveolar ridge preservation and augmentation is to use a combination of bone or biomaterials to create bone which is sufficient for dental implant placement. Freeze-dried bone is generally recognized as giving more predictable treatment outcomes than synthetic materials or platelet rich plasma, and membranes must always be used to separate hard and soft tissues to promote optimal tissue healing.

Tooth agenesis and craniofacial morphology in pre-orthodontic children with and without morphological deviations in the upper cervical spine

AIM: To analyze differences in prevalence and pattern of tooth agenesis and craniofacial morphology between non syndromic children with tooth agenesis with and without upper cervical spine morphological deviations and to analyze associations between craniofacial morphology and tooth agenesis in the two groups together.

METHODS: One hundred and twenty-six pre-orthodontic children with tooth agenesis were divided into two groups with (19 children, mean age 11.9) and without (107 children, mean age 11.4) upper spine morphological deviations. Visual assessment of upper spine morphology and measurements of craniofacial morphology were performed on lateral cephalograms. Tooth agenesis was evaluated from orthopantomograms.

RESULTS: No significant differences in tooth agenesis and craniofacial morphology were found between children with and without upper spine morphological deviations (2.2 ± 1.6 vs 1.94 ± 1.2, P > 0.05) but a tendency to a different tooth agenesis pattern were seen in children with morphological deviations in the upper spine. In the total group tooth agenesis was associated with the cranial base angle (n-s-ba, r = 0.23, P < 0.01), jaw angle (ML/RLar, r = 0.19, P < 0.05), mandibular inclination (NSL/ML, r = -0.21, P < 0.05), mandibular prognathia (s-n-pg, r = 0.25, P < 0.01), sagittal jaw relationship (ss-n-pg, r = -0.23, P < 0.5), overjet (r = -0.23, P < 0.05) and overbite (r = -0.25, P < 0.01).

CONCLUSION: Etiology of tooth agenesis in children with upper spine morphological deviations was discussed. The results may be valuable for the early diagnosis and treatment planning of non syndromic children with tooth agenesis.

Autism spectrum disorder: Review of literature and dental management

With an increase in the number of cases of autism spectrum disorder (ASD), dental professionals need to be aware of the different techniques required to ensure safe dental treatments for affected patients. The concerns and preferences of the parents and the medical and dental history of each patient should be considered. The aim of this article was to provide a comprehensive update on the medical and dental health of patients with ASD. A detailed search of the electronic database PubMed/Medline/Lilacs was performed for the terms “Autism”, “Autistic”, “Autism Spectrum Disorder”, “ASD”, “Dentistry” and “Dentist”, in the period between 2006 and 2017. Systemic reviews, research articles, and literature reviews were included. Expert opinions, case series, and case reports were excluded from the search. A detailed family-centered approach based on the preferences and concerns of parents is an important foundation for appropriate individualized dental treatment of patients with ASD. In addition, the knowledge of disruptive behaviors and patient´s challenges may guide dental practitioners in improving treatment planning, oral management, and the overall oral health of patients with ASD.

Soft tissue aneurysmal bone cyst of the mandible: Report of a case

We report the case of a 17-year-old boy with a soft tissue aneurysmal bone cyst (STABC) located in the posterior aspect of the right mandible. Conventional radiography revealed no positive findings. On the computed tomography scan, the lesion appeared to have a non-uniform intralesional density. Magnetic resonance imaging revealed an abnormal soft tissue masses with cystic component in the superficial part of right mandibular body and angle with intact cortex. Following histopathological examination, fibro-histiocytic proliferation, blood-filled spaces and multinucleated giant cells were seen and the lesion was diagnosed as a STABC. The mass together with underlying bone and periosteum on its periphery was surgically resected under general anesthesia. Thirty-six months after surgery the patient was assessed at outpatient clinic and found no sign of recurrence This may be only the first reported case of the mandible in the English literature of this extremely rare benign tumor occurring in soft tissue.

Diagnostic imaging: Morphological and eruptive disturbances in the permanent teeth

This paper reviewed the literature on newer three-dimensional imaging techniques and their applications in diagnosis and treatment planning of various dental anomalies. Developmental anomalies can occur during any of the developmental stages and are manifested clinically after the tooth is fully formed. These dental anomalies may involve a single tooth, a group of teeth, or the entire dentition. Two-dimensional diagnostic imaging, including periapical, occlusal, panoramic, or cephalometric radiographs are essential in localization and management of morphological and eruptive disorders. However, due to their inherent limitations such as insufficient precision because of unusual projection errors and lack of information about spatial relationships, these methods are considered unreliable. Thus, the use of newer image acquisition techniques that allow comprehensive three dimensional imaging and visualization of dental abnormalities is highly recommended for making a confirmatory diagnosis. The significance of accurate endodontic, surgical and orthodontic treatment planning in dental abnormalities cannot be overstated as it pertains to critical anatomic landmarks such as proximity to adjacent teeth or the mandibular canal. The precise information on spatial relationships provided by multiplanar imaging helps the dental surgeon to establish more accurate diagnosis, management strategies and also increases the patient safety. This review highlights the use of high-end diagnostic imaging modalities in diagnosis of the various morphologic and eruptive dental abnormalities.