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Medication-related osteonecrosis of the jaw (MRONJ) is a recurring complication resulting from the long-term therapy with bisphosphonates or antiresorptive drugs such as denosumab or antiangiogenic drugs. This paper describes a 5-years follow-up case of Stage 3 of MRONJ (AAOMS) in a 69-year-old patient treated with piezosurgery and topical application of platelet-rich fibrin (PRF). Medical treatment included antibiotic therapy and a topical treatment with PRF in solid and liquid form. This treatment showed initially the reduction of pain and leakage exudate and a complete wound healing in 25 days. The Injectable-Platelet Rich Fibrin (i-PRF) injections led to a complete resolution of oro-cutaneous fistulas in 50 days showing its ability of releasing growth factors and chemotaxis agents involved in tissue repair mechanisms. Preparation simplicity and the low cost of PRF allow to consider this method as an excellent alternative treatment for the healing of tissues in MRONJ patients.Dentin dysplasia (DD) is a rare autosomal dominant disorder of dentin development, which is generally divided into two types based on the clinical and radiographic appearance of the affected dentinal tissues Type-I (Radicular DD) and Type-II (Coronal DD). This paper reports the case of a 17-year-old female patient with both classical and atypical features of radicular DD in the permanent dentition. The present case shows clinically normal appearing crowns, localised mobility in the maxillary teeth, completely obliterated pulp chambers, widened root canals without any obliterations and the presence of multiple periapical radiolucencies. The clinical and radiographic findings observed in this present case report are different from those reported in the past literature, which suggests that the present case could be a variation of radicular DD.Ameloblastoma is a true benign neoplasm of odontogenic epithelial origin mostly seen in the mandible. After odontoma, it is the second most commonly seen odontogenic neoplasm. Ameloblastoma comprises of several clinical, radiological and histological varieties, making it the most significant odontogenic neoplasm. Among these, the unicystic type is the least explored due to the fewer numbers of reported cases. Clinically and radiographically, it represents a cyst, but displays classic ameloblastomatous epithelial lining part of the cyst cavity, with or without intraluminal and/or mural tumor growth. We present an unusual case of unicystic ameloblastoma showing mural proliferation with mixed histological pattern [Plexiform, Follicular and Acanthomatous] of the mandible in a 32-year-old male.The majority of maxillary defects can be rehabilitated with pedicled flaps. However, when there are very large resections of the maxilla and flap success is questionable, then the defect may be obturated with a conventional hollow bulb clasp retained obturator or implant retained obturator prosthesis. POMHEX price However, inadequate retention, stability and support may be associated with the use of a conventional obturator and in case of recurrence the success of implant is questionable. A precision attachment becomes the silver lining. They have been used to retain obturator for some time. The use of precision attachments in a dentate maxillectomy patient can yield significant functional improvement while maintaining the obturator's aesthetic advantages. This clinical report describes the successful prosthetic rehabilitation of maxillary defects with an obturator retained using two different extracoronal resilient precision attachments. Attachment retained prosthesis provides a successful closure for the defect but also better esthetics, retention, better tolerability and better mastication and speech.Achondroplasia is a genetic disorder that is due to mutation of fibroblast growth factor receptor (FGFR3) gene and it results in dwarfism. It is inherited as an autosomal dominant trait. The classical clinical features seen are disproportionate dwarfism, rhizomelic shortening (proximal limbs), short fingers and toes with trident hands, large head with prominent forehead (frontal bossing), small mid face with flattened nasal bridge, spinal kyphosis or lordosis, varus (bowleg), and valgus (knock knee) deformities. Oral findings include macroglossia, tongue thrust swallowing pattern, posterior crossbite, anterior open bite, anterior reverse overjet, etc., This case report present the features and oral treatment protocol for Achondroplasia.Nonunion post-mandibular fractures are relatively uncommon. They pose severe challenge in terms of treatment and quality of life. The cause for pseudo-union is multi-dimensional. Removal of the cause or treating the same is an absolute need to provide correct treatment. Successful correction of a case of pseudo-union of fractured mandible occurring after two previous treatment attempts is presented. The possible explanation for the pseudo-union as well as the precautions to be taken to prevent such occurrence is discussed.
Obstructive sleep apnea (OSA) is a condition affecting the upper airway among a vast number of people around the world.
To determine the prevalent risk factors of OSA and its association with craniofacial skeletal pattern.
Cross-sectional, community-based study.
In the first stage, questionnaire and physical examination were done for 1000 subjects between 20 and 70 years of age. Subjects were categorized as snorers and non-snorers. Snorers were further grouped as high-risk and low-risk snorers. In the second stage, polysomnography (PSG) was done for randomly selected high-risk subjects. Craniofacial skeletal pattern of OSA-diagnosed subjects were compared with non-OSA subjects using lateral cephalograms.
Analysis was performed using IBM SPSS 20. Independent sample t-test was used. A P value < 0.05 was considered as statistically significant.
The study population represented the following high-risk snorers 22.4%, low-risk snorers 13.9%, and non-snorers 63.7%. Excessive daytime sleepiness was present in 7.7%. Among high-risk, 80 underwent PSG, and 75 were diagnosed as OSA (94%) and 5 non-OSA subjects. Increased body mass index and neck circumference were statistically significant. Cephalometric evaluation showed difference in maxillomandibular relationship, narrowing of airway space, and inferiorly displaced hyoid.
OSA is a major public health problem. Obesity is a strong predictor for OSA. Thus, high-risk subjects for sleep apnea could be identified using routine clinical examination, investigations, and anthropometric parameters.
OSA is a major public health problem. Obesity is a strong predictor for OSA. Thus, high-risk subjects for sleep apnea could be identified using routine clinical examination, investigations, and anthropometric parameters.