Gorlin-Goltz Syndrome and Neoplasms: A Case Study

Gorlin syndrome is a rare autosomal dominant disorder exhibiting high penetrance and variable expressivity. It is characterized by facial dysmorphism, skeletal anomalies, multiple basal cell carcinomas, odontogenic keratocysts (OKC), palmar and plantar pits, bifid ribs, vertebral anomalies and a variety of other malformations. Various neoplasms', such as medulloblastomas, meningiomas, ovarian and cardiac fibromas are also found in this syndrome. Objective: To describe a twelve-year-old patient with Gorlin-Goltz syndrome, with basal cell carcinomas and promyelocytic leukemia developed after receiving craniospinal radiation for a medulloblastoma. Mild ribs as well as mandibular and maxillar OKC were also diagnosed. Conclusion: The patient with Gorlin-Goltz syndrome should receive close follow-up for early detection of malformations and malignant neoplasias.

Morphological assessment of dentine and cementum following apicectomy with Zekrya burs and Er:YAG laser associated with direct and indirect Nd:YAG laser irradiation

Objectives. This study aimed to assess the apical surface morphology of maxillary central incisors resected 3.0 mm from the tooth apex using Zekrya burs or Er:YAG laser, with or without subsequent direct Nd:YAG laser irradiation (apical and buccal surfaces) and indirect irradiation (palatal surface).Study design. Forty maxillary central incisors were instrumented and obturated. The roots were divided into 4 groups according to the root resection method (Zekrya bur or Er: YAG laser -1.8 W, 450 mJ, 4 Hz, 113 J/cm(2)) and further surface treatment (none or Nd: YAG laser -2.0 W, 100 mJ, 20 Hz, 124 J/cm(2)). The teeth were prepared for SEM analysis. Scores ranging from 1 to 4 were attributed to cut quality and morphological changes. The data were analyzed by the Kruskal-Wallis test and by Dunn's test.Results. SEM images showed irregular surfaces on the apical portions resected with Zekrya burs, with smear layer and grooves in the resected dentine and slight gutta-percha displacement and plasticization. on the other hand, apicectomies carried out with Er: YAG laser showed morphological changes compatible with ablated dentine, with rough surfaces and craters. In spite of the presence of plasticized gutta-percha, with the presence of bubbles, an irregular adaptation of the filling material to the root walls was also observed. Direct Nd: YAG laser irradiation of the apical and buccal surfaces of the resected roots resulted in areas of resolidification and fusion in the dentine and cementum, with a vitrified aspect; indirect Nd: YAG laser irradiation of the palatal surfaces yielded a lower number of changes in the cementum, with irregular resolidification areas.Conclusions. There were no differences in terms of cut quality between the use of burs and Er: YAG laser or between the 2 surfaces (apical and buccal) treated with Nd: YAG laser with direct irradiation. However, morphological changes were significantly less frequent on surfaces submitted to indirect irradiation (palatal) when compared with those directly irradiated. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: e77-e82)

Flap vs. "flapless" surgical approach at immediate implants: a histomorphometric study in dogs

AimTo compare the remodeling of the alveolar process at implants installed immediately into extraction sockets by applying a flap or a "flapless" surgical approach in a dog model.Material and methodsImplants were installed immediately into the distal alveoli of the second mandibular premolars of six Labrador dogs. In one side of the mandible, a full-thickness mucoperiosteal flap was elevated (control site), while contra-laterally, the mucosa was gently dislocated, but not elevated (test site) to disclose the alveolar crest. After 4 months of healing, the animals were sacrificed, ground sections were obtained and a histomorphometric analysis was performed.ResultsAfter 4 months of healing, all implants were integrated (n=6). Both at the test and at the control sites, bone resorption occurred with similar outcomes. The buccal bony crest resorption was 1.7 and 1.5 mm at the control and the test sites, respectively.Conclusions"Flapless" implant placement into extraction sockets did not result in the prevention of alveolar bone resorption and did not affect the dimensional changes of the alveolar process following tooth extraction when compared with the usual placement of implants raising mucoperiosteal flaps.To cite this article:Caneva M, Botticelli D, Salata LA, Souza SLS, Bressan E, Lang NP. Flap vs. "flapless" surgical approach at immediate implants: a histomorphometric study in dogs.Clin. Oral Impl. Res. 21, 2010; 1314-1319.doi: 10.1111/j.1600-0501.2009.01959.x.

Healing outcomes at implants installed in grafted sites: an experimental study in dogs

Aim: To evaluate the integration of implants installed using a surgical guide in augmented sites with autologous bone or deproteinized bovine bone mineral (DBBM) blocks, concomitantly with a collagen membrane.Material and methods: Mandibular molars were extracted bilaterally in six Labrador dogs, the buccal bony wall was removed, and a box-shaped defect was created. After 3 months, flaps were elevated, a bony graft was harvested from the ascending ramus, and secured to the lateral wall of the defect by means of screws. In the left mandibular side, a DBBM block was fixed into the defect. A resorbable membrane was applied at both sides, and the flaps were sutured. After 3 months, flaps were elevated, and a customized device was used as surgical guide to prepare the recipient sites in the interface between grafts and parent bone. One implant was installed in each side of the mandible. After 3 months, biopsies were harvested, and ground sections were prepared for histologic evaluation.Results: One autologous bone block graft was lost before implant installation. The width of the alveolar crest at the test sites (DBBM) was 5.4 +/- 1.2 mm before, 9.4 +/- 1.2 mm immediately after grafting, and 9.3 +/- 1 mm at implant installation. At the control sites (autologous bone), the corresponding values were: 5.2 +/- 1, 9 +/- 1.2, and 8.7 +/- 0.9 mm, respectively. All implants installed were available for histologic evaluation (n = 5). The autologous bone grafts, rich in vessels and cells, were integrated in the parent bone, and only little non-vital bone was found. The BIC% was 56.7 +/- 15.6% and 54.2 +/- 13.2% at the buccal and lingual aspects, respectively. At the test sites, the DBBM appeared to be embedded into connective tissue, and very little newly formed bone was encountered within the grafts. The BIC% was 5.8 +/- 12.3% and 51.3 +/- 14.2% at the buccal and lingual aspects, respectively.Conclusions: Autologous bone blocks used to augment the alveolar bony crest horizontally allowed the complete osseointegration of implants installed after 3 months of healing. However, similar blocks of DBBM did not promote osseointegration, although the installed implants were stable owing to the osseointegration in the sites of the parent bone.

Antimicrobial photodynamic action on dentin using a light-emitting diode light source

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Morphology and incidence of torus palatinus and mandibularis in Brazilian Indians

The incidence and morphology of torus platinus and mandibularis was verified in 200 Indians, residents of two Brazilian Indian Reserves in Sao Paulo State, Brazil. A low incidence of both types of exostoses was observed, with torus palatinus occurring more frequently than mandibularis. These structures did not occur in individuals less than 10 years of age. Flattened torus palatinus predominated in relation to the other forms.

Prevalence of taurodontism in premolars

Taurodontism does not involve molar teeth exclusively. To call attention to the occurrence of this phenomenon in premolars, 4,459 extracted mandibular and maxillary premolars were examined. Eleven showed evidence of taurodontism. Roentgenograms taken from a buccolingual direction confirmed the diagnosis of taurodont teeth.

Determinação da relação central. Estudo sobre as posições laterais da mandíbula, em relação à linha mediana facial, em função de dois métodos para esta determinação.

The authors studied the lateral positional desviations of the mandible, in relation to the facial median line in 30 (thirty) full edentulous patients, with the purpose to verify the influence of the unstrained guided (chinpoint guidance) and deglutition methods for the determination of centric relation. According the results obtained they conclude that the unstrained guided method produced a mandibular lateral desviation with a mean value of the 0.752 mm and in the deglutition method the mean value observed was 1.109 mm. The statistical analysis of the results revealed for the unstrained guided method a proportion of the points to the right and left of the median line not statistically significant, while for the deglutition method the difference was statistically significant at a level of 5%.

Evolução do peso corporal e desenvolvimento da mandíbula de ratos em função da administração de flúor.

The body weights evolution and the development of mandible were analyzed in rats that received 0.25 mg F contained into a commercial product, during 30 and 60 days consecutively, beginning at birth. The study presented the following conclusions: 1. The treated animals showed body weights always inferior to the controls, with more evident difference at 60 days period; 2. Analysis showed a reduction in the horizontal linear measurements, but not in the length of the mandibular diastem. No influence was observed in relation to the verticals.

Garré's osteomyelitis: a case report.

This is a case report of Garré's osteomyelitis caused by infection from a lower left molar which was successfully managed by root treatment following several unsuccessful attempts with antibiotic therapy alone. After 18 months there was complete resolution of the bony lesion.

Free autogenous cartilage grafts to the mandible of rats-histological study.

The present study was designed to histologically evaluate the behavior of free autogenous cartilage grafts to the mandible of rats. A 3-mm segment was removed from the last rib of male adult rats and transplanted fresh to a receptor bed prepared on the mandibular ramus. The results showed that the grafts maintained their vitality up to 120 days and the perichondrium was biologically integrated to the osseous bed. Appositional growth of the grafts was found. New bone formation was observed in close proximity to the grafts, but newly formed trabeculae did not arise from perichondrium.

The glandular odontogenic cyst: a case report.

A case of a glandular odontogenic cyst is reported. All clinical, radiographic, and histopathologic features are discussed and compared with the descriptions in the literature already published about this new lesion.

Albright's syndrome: review of the literature and case report.

Albright's syndrome is characterized by the presence of polyostotic fibrous dysplasia, endocrinopathies and brown spots on the skin. In the present article the authors describe a case occurring in a 20-year-old female patient, who is currently being followed radiographically after a mandibular bone biopsy.

Penetration of a light-cured glass ionomer and a resin sealant into occlusal fissures and etched enamel.

PURPOSE: To evaluate the penetration of a light-cured glass ionomer and a resin sealant into occlusal fissures and etched enamel. MATERIALS AND METHODS: Forty-eight maxillary and mandibular caries-free premolars scheduled for extraction for orthodontic reasons were isolated, the occlusal surfaces subjected to prophylaxis and acid-etched with orthophosphoric acid prior to the application of the VariGlass VLC glass ionomer and Concise resin sealants. The teeth were extracted, two longitudinal median sectiors from each tooth were ground to a thickness of 80-100 microns, and the sealant penetration into the fissures evaluated. The sections were placed in nitric acid to dissolve the enamel so the lengths of the tags which had penetrated into the etched enamel could be measured at different sites on the walls of the fissures. RESULTS: Both sealants adapted well to the fissures but penetrated deeper into shallow, open fissures than into deep, constricted fissures. The VariGlass VLC tags into etched enamel were generally longer than the Concise projections.

Pulpal and periodontal reactions of immature permanent teeth in the dog to intrusive trauma.

Pulpal and periodontal tissues of immature incisors of 10 dogs were radiographically and histopathologically evaluated immediately, 7, 15, 30 and 60 days after experimental intrusion induced by mechanical blows. Forty upper central and mesial lateral incisors showing incomplete root formation on radiographs were submitted to intrusive force. After the observation periods, the dogs were killed, two at a time. The hemi-maxilas were removed and processed for histopathologic examination. The traumatized teeth showed accelerated apical formation with reduced radicular length. Pulpal vitality was maintained and the subjacent tissues did not present irreversible changes. All traumatized teeth re-erupted spontaneously.