Laparoscopic lymph node biopsy in the diagnosis of lymphoma. Indications and results

Spontaneous Recession Repair after Orthodontic Treatment: Case Report with the Use of Digital Approach for Quantification of Soft Tissue Changes

The article presents a case of spontaneous recession repair in a male patient with Class II malocclusion, division 1, after orthodontic treatment with aligners. The difference in digital recession depth was measured before and at the end of treatment by means of automatic intraoral scans superimposition within adapted software while using "Cross section" and "Measuring" instruments. Digital analysis of intraoral scans obtained before and at the end of treatment has revealed that recessions within the area of teeth 1.5, 1.4, 1.3, 1.2, 1.1, 2.1, 2.2, 2.3, 2.4, and 2.5 have improved, and recession depth reduced by 0.73 ± 0.08 mm, 1.02 ± 0.09 mm, 1.86 ± 0.13 mm, 0.72 ± 0.09 mm, 0.73 ± 0.04 mm, 0.67 ± 0.06 mm, 0.66 ± 0.07 mm, 1.50 ± 0.12 mm, 1.10 ± 0.05 mm, and 0.45 ± 0.04 mm, appropriately. The present case report emphasizes that orthodontic correction of altered tooth position (angulation, inclination, and rotation) under certain clinical conditions may be considered as an effective method for soft tissue contour optimization in cases when pre-treatment tooth position could be interpreted as a causative factor or associated with diagnosed recession. The following outcomes could be related, but not limited to creeping attachment mechanism, bone-housing centering effects, optimization of occlusal load distribution with ruling out peak zones of strain accumulation, and mucogingival stress leveling. Due to the authors' knowledge, the present case report is the first one where the signs of spontaneous recession repair after orthodontic treatment were evidenced with the intraoral scans and quantified by the specifically implemented digital analysis approach.

Effect of orthodontic retraction force on thick and thin gingival biotypes in different grades of gingival recession and alveolar bone quality: A finite element analysis

INTRODUCTION

To evaluate the effect of orthodontic retraction force on thick and thin gingival biotypes of anterior teeth having grade I and II gingival recession with D1 and D2 alveolar bone densities by assessing the displacement of teeth and deformation in gingival tissue, along with evaluating the amount of equivalent stress on teeth and gingiva in finite element model.

MATERIALS AND METHOD

Based on cone-beam computed tomography datasets, eight models (LC01-LC08) of maxilla with appliance assembly were created. A retraction load of 150 gm was applied on each model during the finite element analysis (FEA), and then values of teeth displacement, gingival deformation, and von Mises stress were evaluated.

RESULT

All the models with D1 bone density (LC01-04) were showing gingival deformation, whereas models with D2 bone quality (LC05-08) give no significant outcome. The amount of von Mises stress for teeth and gingival tissue in each model was the same for both central and lateral incisors.

CONCLUSION

All the models having D1 bone quality showed greater gingival deformation after applying retraction force, whereas in models with D2 bone density, deformation was not significant. Changes in gingival tissue are brought about by orthodontic treatment, which also helps to correct the periodontal defects; however, bone density plays a significant role in improving gingival recession.

Laparoscopic dissection of the hepatic node: The trans lesser omentum approach

BACKGROUND

Diagnosis of lympho-proliferative diseases is sometimes challenging. Excisional lymph node biopsy is the standard of care. Five percent of the patients will present with abdominal or retroperitoneal lymphadenopathy alone. Advancements in endoscopic techniques allow for access to fine needle biopsy in complicated areas, but this often does not meet the standard guidelines for diagnosis.

AIM

To investigate the results of laparoscopic excisional biopsy of the hepatic node (LEBHN) through a trans lesser omentum approach.

METHODS

Data of all patients undergoing LEBHN were collected retrospectively from patients’ electronic charts over a period of 1 year. Data collected included age, gender, suspected disease, number of previous biopsies and biopsy method, surgical approach, intraoperative complications, operative time, post-operative complications, mortality, and final diagnosis.

RESULTS

Six patients were operated in this technique during the time frame of the study, 66.6% (n = 4) were females, and median age was 55 years (range: 25-72 years). We present no conversions from laparoscopy to laparotomy, and mean operating time was 51.2 min. Mean length of hospital stay was 1 d, and morbidity and mortality were nil. Most importantly, this technique offered definite diagnosis and appropriate treatment in all patients. Final diagnosis included two patients with lymphoma (Hodgkin and Follicular), two patients with sarcoidosis, and two patients with reactive lymph nodes with no evidence of malignancy.

CONCLUSION

In conclusion, this technique seems to be feasible and safe and may offer a simple approach for a definite diagnosis for what seems to be a complicated anatomical area.

Orthodontic management of a dental anomaly pattern (DAP) including mandibular canine transmigration: A case report: A challenging treatment but worth it!

Orthodontic technology has advanced to the point where management of cases with multiple dental anomalies should be within an orthodontist's daily armamentarium. A patient with bilateral agenesis of lower second premolars, delayed development, and transmigration of a mandibular canine was treated with the aid of hemisection, indirect/closed exposure, application of continuous force, targeted delivery, and strict attention to keeping the roots as much in bone as possible. This was accomplished without implants or flattening the facial profile, yet with excellent periodontal status and a fully functioning occlusion.

Can corticotomy (with or without bone grafting) expand the limits of safe orthodontic therapy?

Purpose

To assess whether concomitant particulate bone grafting makes a difference in the ability to safely orthodontically reposition teeth outside the bony envelope after corticotomy.

Material and methods

Retrospective analysis of patients who underwent corticotomy as part of their orthodontic therapy for treatment of severe crowding. Patients were divided as: a) Group 1: corticotomy with bone grafting, and, b) Group 2: corticotomy without bone grafting. CT scan examinations were performed before and at the end of the treatment. Measurements of bone and tooth positions were obtained and differences between pre- and post-treatment values were calculated.

Results

The study sample included 20 adult patients between the ages of 25 to 58 years. A total of 144 teeth were orthodontically repositioned outside their native bony envelope after corticotomy. Average follow-up was 9 months. Teeth that were repositioned after corticotomy and bone grafting maintained the alveolar bone volume around them while corticotomy without bone grafting was not successful in maintaining bone thickness around teeth that were moved outside the alveolar housing.

Conclusions

Corticotomy in combination with guided bone regeneration has the potential to increase the scope of conventional orthodontic treatment by allowing for expansive movements beyond the traditional limits.

Gingival recession: its causes and types, and the importance of orthodontic treatment

Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature.

Vestibulo-Oral inclination of maxillary and mandibular canines and bicuspids - a CBCT investigation

BACKGROUND

The aim of this retrospective study was to measure tooth and crowns axes of canines, first and second bicuspids of orthodontically untreated subjects with near normal occlusion to: 1. Define norms and reveal potential gender differences and 2. Discuss implications of the findings for orthodontics.

METHODS

The CBCT-datasets of 167 patients, 56 males (mean age 28.63 years ± 11.99 years) and 111 females (mean age 29.72 years ± 11.47 years) were used. Tooth- and crown axes were measured for right and left sides. Normal distribution was evaluated with the Kolmogorov-Smirnov-test. For gender comparison independent t-Tests and for comparison of right and left sides a paired t-Test were used for normally distributed data. For data not following normal distribution for gender comparison the Mann-Whitney-U-Test was used and for data comparing the two sides the Wilcoxon signed rank test was applied. The level of statistical significance was set at p ≤ 0.05.

RESULTS

Measurement of tooth axes revealed buccal inclination for both genders with maximum values for maxillary and mandibular canines. Statistical significant differences were only found for maxillary canines (P = 0.025) and lower second bicuspids (P = 0.016) respectively. Values for crown axes revealed oral inclination for both genders with maximum values for maxillary first bicuspids and in the mandible for first and second bicuspids. No statistical significant differences were found between the genders apart from asymmetry for crown axes for the upper first bicuspids for males (P = 0.006) and females (P < 0.001).

CONCLUSIONS

Our study reveals that irrespective of gender, oral inclination of the crowns of canines and premolars is the norm. The values of the most commonly used bracket prescriptions coincide with the average values found in our investigation. For esthetic reasons modifications of torque values can be considered.