A 3D Finite Element Analysis of Bone Tissue in 3-Unit Implant-Supported Prostheses: Effect of Splinting Factor and Implant Length and Diameter

This study aimed to assess the effects of splinting in 3-unit implant-supported prostheses with varying the splinting factor, length of the implant, and the diameter of the 1°molar (1°M) implant on cortical bone tissue (CBT). Twelve 3D models were simulated, which represented the posterior maxillary with 3 implants, supporting 3-unit FDP varying the splinting factor (single-unit crowns, splinted crowns straight-line and offset implant configuration [OIC]), length of the implant (7mm and 8,5mm), and the diameter of the 1°M (Ø4 mm and Ø5 mm). The CBT was analyzed by maximum principal stress and microstrain maps. The increase in implant diameter improved the biomechanical behavior of rehabilitation. The increase of the implant diameter in the 1°M associated with OIC generated the best biomechanical behavior for CBT. The splinting was effective in decreasing stress and microstrain, mainly when associated with OIC and implant diameter of Ø5 in the 1°M. The effect of increasing the diameter of the implant referring to the 1°M for single-unit crowns was more effective than the effect of the splinting of implants with Ø4 mm in straight-line. The diameter and splinting factors showed to be more important than implant length to reduce the stress and microstrain on CBT.

Adjuvant aqueous ozone in the treatment of bisphosphonate induced necrosis of the jaws: report of two cases and long-term follow-up

Bisphosphonate induced necrosis of the jaws (BONJ) does not have a unique protocol of treatment and many therapeutic approaches have been arising in oral medicine with debatable results. A male and a female attended the University Oral Surgery Clinic presenting oral bone lesions induced by intravenous and oral bisphosphonates respectively as complications of dental extraction. Treatment included daily mouthwashes and weekly intra oral irrigations with 4 mg/L of aqueous-ozone, antibiotic therapy and sequential superficial debridment for sequestrectomies. Long-standing follow-ups showed complete mucosa covering of exposed bone area and resolution of purulent secretion. Antibacterial and antifungal properties of aqueous ozone may have played important roles in the treatment. The outcome measured intra oral examination and panoramic radiographs of the affected bone. The application of aqueous ozone daily mouthwashes and weekly professional irrigation were safe; free from adverse effects, easily of handling and worked as an important adjuvant therapeutic strategy for the treatment of BONJ.

Oral koilocytic dysplasia: long-term clinical control. A case report

Leukoplakia, a common lesion in the oral cavity, is considered a premalignant lesion that can develop into carcinoma. In 1986, a group of pathologists described a variant of epithelial dysplasia and named it "koilocytic dysplasia" (KD). This article presents a case of KD that was identified for 12 years as "carcinoma in situ". Even after removal of the lesion, it recurred with no signs of malignancy. The histopathological findings revealed all of the signs of KD (koilocytosis, acanthosis, multinucleated keratinocytes and atypical mitoses). Liquid-based cytology and hybrid capture were performed to confirm the diagnosis. Despite a professional recommendation to have the lesion removed surgically, the patient chose periodic clinical control. The mechanism of HPV transmission in the oral cavity still remains partially unknown. Additional studies on this subject are required to better understand the role of HPV in cell transformation in the oral cavity.

Fibro-osseous lesions associated with simple bone cysts: three case reports and review of the literature

An uncommon association between simple bone cyst and fibro-osseous lesions has been reported in the Literature. Here we report three additional cases, including two related to florid cemento-osseous dysplasia and one with fibrous dysplasia. All patients were African-American women, with a mean age of 39.7 years. The treatment of choice for the simple bone cyst was curettage to cause bleeding into the empty cavity. After 18 months, there was a recurrence of the cyst associated with fibrous dysplasia and a second intervention was necessary. One patient has been lost to follow-up and the other patients are currently asymptomatic. In conclusion, we describe a rare association between simple bone cyst and fibro-osseous lesions. Knowledge of this association is important for correct diagnosis and patient approach.

Orofacial granulomatosis of the lip: a report of 2 cases with histological and immunohistochemical analyses and intralesional corticotherapy

Orofacial granulomatosis is a generic term applied to manifestations of several diseases including sarcoidosis, Crohn's disease, Melkersson-Rosenthal syndrome, cheilitis granulomatosa of Miescher, tuberculosis and foreign-body reactions. What bonds these diseases together is the presence of noncaseating granulomas. A typical clinical manifestation of orofacial granulomatosis is recurrent labial swellings that eventually persist. This article describes 2 cases of OG diagnosed with the aid of immunohistochemical analysis and successfully treated with intralesional steroids.

Angina bullosa hemorrhagica: report of 4 cases

Angina bullosa hemorrhagica is characterized by the sudden appearance of solitary or multiple hemorrhagic blisters on oral mucosa, with diameters ranging from 2 mm to 3 cm. The soft palate is most commonly affected, but angina bullosa hemorrhagica may also appear on the buccal mucosa, lips and tongue border. Clinically, the blisters have a dark red to purple appearance, and may or may not be painful. The blisters usually break, releasing bloody content and leaving an ulcer surface that heals within 7 to 10 days. In this article the authors describe four cases of angina bullosa hemorrhagica attended in Stomatology Department of Dental School, Sao Paulo State University. In case 1, a 29-year-old male presented with a sudden hemorrhagic blister on the soft palate. A drainage was performed and after seven days of follow-up the patient reported no symptoms. In case 2, a 63-year-old male presented complaining of a blister on the palate six days earlier that had spontaneously broken. General exam showed hypertension under medical control. An incisional biopsy was performed and after seven days follow-up the healing was completed. In case 3, a 61-year-old male arrived complaining of a sudden appearance of an hemorrhagic blister on the soft palate that had spontaneously broken. The patient had systemic hypertension under medical control. The ulcer healed in 10 days follow-up. In case 4, a 49-year-old woman presented complaining of pain and an ulcer on the soft palate. The patient reported the rapid onset of a blood blister during a meal that broke in few minutes. The resolution occurred after 14 days. Angina bullosa hemorrhagica seems to be more common than reported in the literature and knowledge of the condition is important to right diagnosis and approach when necessary.

The influence of temperature on the embryonic development of the annual fish Cynopoecilus melanotaenia (Cyprinodontiformes, Rivulidae)

The present study aims to provide data about the time required for Cynopoecilus melanotaenia kept at different temperatures to complete embryonic development. This information can be valuable for optimizing laboratory culture and facilitating future use of this species as a test organism in toxicity tests. Temperature effects on hatching rate are presented as well as information related to embryonic development stages. Eggs were observed daily, from start to finish of embryonic development. Thirteen developmental stages were described. Eggs were kept at two constant temperatures (20 degrees C and 25 degrees C) and at a variable ambient temperature (16-25 degrees C-mean = 21 degrees C, sd = 1.95), to determine developmental rate (velocity) at each temperature. A shorter incubation period was necessary to complete development at 25 degrees +/- 1 degrees C. However, all embryos kept at this temperature hatched with morphological defects, which prevented their survival. No significant difference in developmental time period (p = 0.05) was observed at the 20 degrees C and 16 degrees-25 degrees C (mean = 21 degrees C, sd = 1.95) temperatures.