Journal of Clinical and Experimental Dentistry. 2023. Vol. 15, no. 7

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    9-year follow-up of uncommon cleft palate in Aarskog-Scott syndrome
    (2023) Aranha, Andreza-Maria-Fábio; Veiga, Kadyja; Stefanini, Maria-Angélica-Liesenberg; de Barros, Yolanda-Benedita-Abadia-Martins; Guedes, Orlando-Aguirre
    Aarskog-Scott syndrome (AAS) is characterized by different facial, skeletal and genital anomalies and may have oral manifestations. A 7-year-old boy was referred to the University General Hospital for treatment of speech difficulties and frequent regurgitation. Characteristics such as a triangle-shaped face, hypertelorism, low-set ears, flattened nose, shawl scrotum and partial syndactylia on hands and feet were observed. Based on these clinical features, the child was diagnosed with AAS. Upon intraoral examination, maxillary atresia and an incomplete cleft palate were observed. The mixed dentition was characterized by extensive coronary destruction of primary teeth and caries lesions on permanent teeth. Here, the case of a 9-year follow-up of this child with uncommon AAS associated with cleft palate is reported. The child was referred to a multidisciplinary team for planning and carrying out the treatment. In the follow-up visit after 9 years from the beginning of the treatment, the child showed greater sociability, with significant improvement in spontaneous speech and pronunciation of phonemes. However, the patient continues until now with articulation and spontaneous speech training. The correction of class II malocclusion, better dental alignment and canine extrusion were achieved. At the moment, the patient uses a nighttime extraoral device, and the treatment continues for dental alignment and prevention of tooth decay. The presence of cleft palate could be coincidental with AAS and may aggravate the prognosis, requiring careful patient monitoring by a multiprofessional team.
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    Vertical preparation: a new technique for analogical and digital impressions
    (2023) Castelo Baz, Pablo; Freire-Álvarez-Blázquez, María; Pereira Lores, Patricia; Álvarez Nóvoa, Pablo; Dablanca Blanco, Ana Belén; Miguéns Vila, Ramón; Martín Biedma, Benjamín
    The BOPT technique (Biologically Oriented Preparation Technique) was proposed by Loi et al. (1) and has become a popular form of vertical preparation for complete crowns with promising results. In this procedure, the clinician can operate on the gingival tissue during preparation and modify its structure in thickness and height by adding modifications on the provisional restoration. However, one of the main challenges in this technique is the transference of information about the gingival tissue to the laboratory technician, who will place the margin of the restoration randomly in a space determined by two marks on the working cast.The technique proposed enables the accurate transmission of the exact point where the margin of the restoration needs to be placed. Furthermore, it facilitates the recording of conventional impression materials and intraoral scanners due to the compression of polytetrafluoroethylene (PTFE) tape into the sulcus, which allows to arrest bleeding or intracrevicular liquid and is easily registered irrespective of the method of impression used.
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    Hamular bursitis as a cause of orofacial pain. A case report
    (2023) Prats-Sisquella, Blanca; Peeva, Nikol A.; Jorba-García, Adrià; Escuin Henar, Tomás; Figueiredo, Rui; Bara Casaus, Javier
    Pterygoid hamular bursitis is an infrequent cause of orofacial pain due to a hypertrophic pterygoid hamulus. The pain is often referred to the pharynx, temporomandibular region and facial zone, and requires a differential diagnosis with other craniofacial entities. This paper describes a patient with pterygoid hamular bursitis that presented pain of neuropathic characteristics in the left retromolar region, associated with odynophagia and temporomandibular joint disorders. Based on the clinical and radiological findings, a surgical resection of the pterygoid hamulus was decided. After the surgical procedure the patient still reported symptoms so additional specific treatments such as peripheral nerve block and infiltration were performed. Four months later, the patient developed a squamous cell carcinoma on the left margin of the tongue, which was surgically treated. At present (thirty months follow-up), the patient has no pain or signs of tumor relapse.
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    Mast cell expression in oral submucous fibrosis: a systematic review and metanalysis
    (2023) Gharote, Harshkant P.; Bhowate, Rahul
    Background: Oral submucous fibrosis (OSMF) is a chronic disorder associated with reduced mouth opening, burning sensation and listed as potentially malignant disorder. The role of mast cells in initiation and progression of this condition has been debated in last few years. It is imperative to understand the definitive role of mast cells and subsequently identify a possible cost-efficient treatment modality for OSMF. This review aimed to study the role of mast cells in OSMF by framing a research question that assessed the mast cell count (MCC), their degranulation and immunohistochemical analyses. We performed a comprehensive search of PubMed, EBSCOhost and general Google search that conceded 26 studies from which 15 articles were finalized for the review. The individual study syntheses revealed increased MCC in OSMF as compared to controls. Also, there was decreased MCC with the progression of OSMF. However, the metanalysis showed high level of heterogeneity as three studies out of eight studies found reduced MCC in disease when compared with controls. There is definite increase in mast cell in OSMF although the cell count falls with the advancement of OSMF. This increases the scope for further research to identify exact mechanism by which mast cells contribute to fibrosis and conduct the drug trials that can inhibit the mechanism.
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    HPV infection in oral cancer, our experience: prevalence, clinical implications, and current vaccination program in Spain
    (2023) Aragón Niño, Íñigo; Cuesta-Urquía, Carolina; González Martín-Moro, Javier; Morán Soto, M. J.; Pozo Kreilinger, José Juan; Pampín Martínez, Marta María; Castillo Pardo de Vera, José Luis del; Cebrián Carretero, José Luis
    Oral cancer is the 11th most common type of cancer in the world, with established major risk factors as tobacco and alcohol, and recently included high-risk human papillomavirus types 16 and 18. HPV types 16 and 18 are the etiologic agents of cervical cancers and a proportion of oropharyngeal cancers. However, the picture of HPV and the clinical implications of oral cancers are not clear with most reports combining oral cancer data with head and neck cancers. It has been confirmed as a favorable prognostic factor in oropharyngeal cancer. However, the prognostic value of HPV in oral squamous cell carcinoma is still unclear.The main objective of this article is to present the evidence encountered following a bibliographical review of recent publications specifically related to oral cancer and its differences from oropharyngeal cancer. The secondary goals are to present the findings of a five-year retrospective observational study of the prevalence of HPV infection in oral cancer patients treated by the Oral and Maxillofacial Surgery Department at La Paz University Hospital (Madrid, Spain), and finally, we to evaluate and compare our country’s HPV prevention program in comparison to other European countries.According to the review of the literature, HPV positive oral squamous cell carcinoma is associated with significantly decreased overall survival and distant control. Bibliographic review suggest HPV infection can be used as a negative prognostic factor in oral squamous cell carcinoma.As regards diagnostic testing for HPV, it should be extended to as many cases of oral cavity squamous cell carcinoma as possible, especially in those with risk factors. The current vaccination program in Spain does not have adequate coverage and is significantly under the level of other European Union countries; it should be expanded and catch-up strategies should be included.
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    Systematic review of the oral manifestations produced by the SARS-CoV-2 vaccine
    (2023) López Carriches, Carmen; Santana-Torres, Tomás; Taheri, Ricardo Bahram; Leco Berrocal, María Isabel
    To combat the coronavirus pandemic different vaccines have been developed. However, diverse adverse effects have been reported due to their use, including oral manifestations. Our objective is to review the existing bibliography to analyze what complications these vaccines have caused in the oral cavity.A bibliographic search was conducted by two independent reviewers (TS and CL), in parallel in 6 electronic databases (PubMed, Scopus, Cochrane, Google Scholar, LILACS, BioMed Central). A total of 22 articles were analyzed.The most frequent adverse effect was oral lichen planus, with a higher prevalence in women and after the Pfizer mRNA BNT162b2 vaccine.These complications are minor and resolve with treatment, so the benefit of the use of vaccines outweigh the potential risks associated with these.
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    Oral hyperpigmentation as an adverse effect of highly active antiretroviral therapy in HIV patients: a systematic review and pooled prevalence
    (2023) Radithia, Desiana; Subarnbhesaj, Ajiravudh; Ayuningtyas, Nurina-Febriyanti; Bakti, Reiska-Kumala; Mahdani, Fatma-Yasmin; Pratiwi, Aulya-Setyo; Ayunnisa, Naqiya; Putri, Salsabila-Fitriana; Pramitha, Selviana-Rizky
    Human Immunodeficiency Virus (HIV) infects patients via CD4+ cells which are later be destroyed subsequently causing the deteriotation of immune system. HIV generally manifests in the oral cavity as the first indicating sign and a marker of disease progression. HAART medications are used to reduce the incidence of oral manifestations, however it can also generate adverse effects in the oral cavity including oral hyperpigmentation. This review aimed to estimate the prevalence of oral hyperpigmentation which affect individual quality of life as a side effect of HAART.This systematic review applied Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2020. Literature search was performed in ScienceDirect, PubMed, and Scopus by combining terms such as highly active antiretroviral therapy, oral manifestation, epidemiology or prevalence published between January 1998 to March 2022.Of 108 articles, eleven articles were included for systematic review and meta-analysis. The pooled prevalence of oral hyperpigmentation in HAART patients was 25% (95% CI: 11%, 38%; I2: 99%). Subgroup analysis based on geographical location showed varied result may be due to the type and duration of HAART used in study population. The most widely used type of ARV was from the NRTI group (n=7) and the study with the shortest duration showed the lowest oral hyperpigmentation prevalence (n=7).There is an increased prevalence of oral hyperpigmentation by the use of HAART. Future study should investigate the correlation between HAART duration and the degree of oral hyperpigmentation.
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    A randomised trial of the bone formation after maxillary sinus floor augmentation with bovine hydroxyapatite (Cerabone®) and Photobiomodulation: histomorphometric and immunohistochemical analysis
    (2023) Klassmann, Fabio-André; Ervolino, Edilson; Klüppel, Leandro Eduardo; Theodoro, Letícia H.; Mulinari-Santos, Gabriel; Garcia, Valdir G.
    The use of non-autogenous biomaterial to increase bone height in the maxillary sinus has been shown to be effective, but the results are still inconclusive.Eight participants were selected and included in the research. After surgical access with osteotomy on the lateral wall of both maxillary sinuses, these were filled with Cerabone®. Then, by blind randomization, they received one of the following treatments: Filling with Cerabone® (Control group); treatment with Photobiomodulation (PBM), filling with Cerabone® and treatment with low-power laser (PBM group). Biopsies were obtained 30 days after the surgery, using a 2.8 mm internal diameter trephine bur. Qualitative and quantitative histological analyzes were performed and immunohistochemical analyzes of osteocalcin (OCN) and tartrate-resistant acid phosphatase (TRAP) were performed with scores for each of the biological events.The Cerabone® biomaterial demonstrated a high degree of biocompatibility. New bone formation was observed in both groups. In the PBM group, there was greater bone formation and newly formed tissue in an advanced state of bone maturation. The immunostaining of OCN was greater at 30 days in the PBM group than in the control. There was no significant difference in TRAP immunostaining at 30 days between the groups.Low-power laser-mediated by PBM promoted greater bone formation; the newly formed tissue showed a more advanced state of bone maturation in maxillary sinuses filled with Cerabone® biomaterial and treatment with PBM, within the 30-day evaluation period.
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    Effect of fibrin-rich plasma and collagen sponge on healing of the palatal mucosa
    (2023) Alvarez-Medina, Rocío; Guerrero, Maria Eugenia; Córdova-Limaylla, Nancy E.; López-Llamosas, Luis E.; Huamani-Echaccaya, José-Luis; Palomino-Zorrilla, Jerson J.; Rosas-Díaz, José C.
    The purpose was to evaluate the variation in thickness and early healing of the donor area of the palate with the placement of a collagen sponge and the use of fibrin-rich plasma (L-PRF).Thirty patients who required mucogingival surgery treatment were selected and distributed into 2 groups. After obtaining the free palate graft, L-PRF was placed in Group A, and a collagen sponge was placed in Group B. The healing process of the palate was evaluated at 24 hours and 7, 14, 21 and 28 days postsurgery. The thickness of the donor area (palate) was evaluated using an acrylic splint. These measurements were made before and 4 months after surgery.In the collagen sponge group, less gain of the palatal mucosa was observed, with a mean difference of 0.1 ± 0.8 mm (CI: −0.341–0.518) (p=0.691), whereas in the fibrin-rich plasma group, a mean difference of 0.0 ± 0.5 mm (CI: −0.229–0.229) (p=0.934) was found; however, when comparing the gain of the palatal mucosa in both groups, no significant difference was observed (p=0.932). The healing index at 24 hours indicated the presence of clots, on Day 28 vascularisation and total epithelialisation (100.0%), and finally, the collagen sponge group on Day 14 presented 93.3% partial vascularisation of connective tissue and 33.3% L-PRF (p=0.001).There was no statistically significant difference in the thickness of the palatal mucosa after the use of L-PRF and the collagen sponge.
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    Segmental resection vs. partial resection on treating solid multicystic ameloblastomas of the jaws – recurrence rates: a systematic review and meta-analysis
    (2023) Netto, Rafael; Peralta-Mamani, Mariela; de Freitas Filho, Silas-Antonio-Juvencio; Moura, Ludimila-Lemes; Rubira, Cassia Maria Fischer; Rubira Bullen, Izabel Regina Fischer
    The aim of the present study was to compare the recurrence rates of solid multicystic ameloblastomas after segmental resection or marginal resection.PubMed, ScienceDirect, Web of Science, Scopus, Embase were searched for studies published up to July 2022. The gray literature was also searched. Meta-analysis was performed using OpenMeta Software, p< 0.05 considered significant.Among the search, 8 studies met all eligibility criteria. The group that underwent marginal resection was 1.1 times more likely to present recurrence of the lesion compared to the group that underwent segmental resection. There was no statistically significant difference between the two groups (segmental resection and marginal resection) in all eight studies regarding reducing ND (95% Confidence interval, 0.339 – 3.705; heterogeneity: Q value= 3.105; I2= 0%).The results showed that there was no statistically significant difference between segmental and marginal resection for the treatment of solid multicystic ameloblastomas; however, prospective studies with more rigorous methodological procedures are needed to better compare the surgical techniques.
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    Antibacterial Effect of Miswak herbal toothpaste Compared to Fluoride Toothpaste in High Caries Risk Patients: randomized Clinical Trial
    (2023) Shaalan, Omar; El-Rashidy, Aiah
    Modern toothbrushes origin can be traced to plant-derived chewing sticks, which were documented to be used Babylonians as early as 3500 BC. Chewing sticks are routinely used for cleaning teeth in Asia, Africa, South America, and the Middle East. The aim of the current study was to evaluate the antibacterial effect of miswak herbal toothpaste compared to fluoride toothpaste using a normal toothbrush, against Streptococcus mutans in high caries risk patients.A total of 32 participants were recruited to the current clinical trial using convenience sampling randomly either to miswak or fluoride toothpastes groups (n=16). The bacterial count represented as colony-forming units per milliliter (CFU/ml) was assessed at baseline and after 1 week, 1 month and 3 months. Moreover, the ion release for silicone, calcium, phosphorus, and fluoride from both toothpastes was analyzed in addition to the pH of both toothpastes and their supernatants. Intergroup comparison was performed using independent t test, while intragroup comparison was performed using repeated measures ANOVA followed by tukey post-hoc test and paired t test when appropriate.There was no statistically significant difference between both toothpastes for the S. mutans count within each follow up period, however the bacterial count significantly decreased over time in both groups. Signal Fluoride toothpaste exhibited statistically significant higher ion release when compared to the Dabur Miswak toothpaste. There was no statistically significant difference between either toothpastes regarding pH (P = 0.5368), while comparison between supernatants of toothpastes have shown statistically significant difference (P = 0.0194), with a higher pH in miswak toothpaste.Miswak herbal toothpaste possesses a potent antibacterial effect, yet its remineralization potential is questionable due to its inferior ion release that will affect the ion substantivity in saliva, which is an important factor in remineralization.
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    Multivariate analysis of the effect of staining beverages on the optical properties of two provisional restorative materials
    (2023) Sánchez-Tito, Marco; Blanco-Victorio, Daniel-José; Chauca-Carhuajulca, José
    To evaluate the effect of staining beverages on the color stability, translucency and gloss of two provisional restorative materials.Sixty discs (8 mm x 2 mm) were manufactured for Duralay and Protemp 4. The discs were randomly divided according to the beverages: tea, coffee, wine, Coca-Cola and “Chicha morada” (n=12). The discs were polished and initial recordings of color and translucency were made with a spectrophotometer, and the gloss was measured with a glossmeter. The discs were immersed for 5 days in each of the beverages at 37◦C, and the color, translucency and gloss were recorded again. The differences between the initial and final records were calculated to obtain the values of ΔE, ΔTP, ΔGU. For the analysis, the two-way MANOVA model was chosen, and the significance level was set at 5%.A significant interaction was observed between the type of material and the staining beverages on the changes observed in the values of ΔE, ΔTP, ΔGU (p<0.05). ΔE values for Duralay and Protemp 4 were affected by coffee (7.48±1.53) and wine (11.02±1.07), respectively. The greatest change in ΔTP for Duralay were generated by tea (-1.79±0.62), and coffee (-5.65±0.66) for Protemp 4. Gloss was affected mainly by coffee for both materials (Duralay = -6.44±1.17 , Protemp 4 = -8.28±1.09).The type of material and the pigment drinks act together to influence changes in color, translucency and gloss. The methacrylate-based resin was more stable than the bis-acrylic resin to changes in color, translucency and gloss.