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Maxillofacial Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
If the upper and lower teeth do not seem to meet properly, this may indicate a fracture of the maxilla or mandible. Some dental malocclusions are pre-existing and are developmental in origin. A haematoma in the floor of the mouth strongly suggests a mandibular fracture. Fractured teeth exposing the pulp may be very painful and require early dental management. Broken or avulsed teeth should be accounted for. They may be: Lost at the scene of the accidentIntruded into the gum InhaledIngestedLying in the soft tissues, particularly the lip, as a foreign body If a tooth cannot be accounted for, a chest radiograph should be taken to exclude its presence in a bronchus or the presence of smaller fragments further down the bronchial tree. Tooth fragments in the lung should be referred for a specialist opinion and attempted bronchoscopic removal. Retained teeth fragments may lead to chronic thoracic infection.
Treatment Planning
Published in M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson, Restorative Techniques in Paediatric Dentistry, 2021
M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson
Extraction of teeth in a child with any form of bleeding disorder is contraindicated. Accordingly, for these children pulpotomies or pulpectomies are mandatory as long as the tooth is restorable. Every effort should therefore be made to save the tooth, even to the extent of trying the various forms of pulp treatment on several occasions.
Gene Therapy in Oral Tissue Regeneration
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Fernando Suaste, Patricia González-Alva, Alejandro Luis, Osmar Alejandro
The dental pulp is a soft connective tissue located at the center cavity of the tooth; this is composed of nervous and vascular cells. The principal factor from tissue damage occurs as a result of caries. The primary treatment to protect the tissue from damage is the pulp capping procedure; through this treatment, the dental pulp is protected from necrosis through the deposition of calcium hydroxide. Other methods have employed the use of growth factors that have been installed directly at the site of the injury (OP-1, TGF-13, BMP-4, and BMP-2). Through the use of Gene Therapy Dental Pulp Stem Cells DSPCs transfected with Vascular Endothelial Growth Factor (VEGF) and Stromal cell-Derived Factor-1α (SDF-1α), have proven to be an effective treatment that allows an increase in pulp regeneration in vivo (Goldberg et al. 2001; Zhu et al. 2018).
Is tooth conservation possible in odontogenic sinusitis? Prospective evaluation of affected teeth condition-based protocol
Published in Acta Oto-Laryngologica, 2023
Akiko Ito, Muneo Nakaya, Kazuhiro Tada, Junko Kumada, Wataru Kida, Yasuhiro Inayoshi
Patients visiting the Otolaryngology Department at Tokyo Metropolitan Tama Medical Center between April 2017 and March 2019 with a diagnosis of ODS who failed to respond to previous medical treatment were enrolled. Only patients with ODS stemming from dental caries or periapical periodontitis were included. Examinations for endodontic and periodontic lesions and for any relationship between a lesion and the maxillary sinus were done using computed tomography (CT). All those patients met the following criteria: (1) presence of intranasal endoscopic findings (purulent discharge, polyp in the middle meatus, bulging uncinate process), (2) maxillary sinus shadow shown in CT images, (3) periapical lesion of maxillary tooth in CT images, (4) communication between maxillary sinus and root apex or periapical lesion in CT images. For further dental evaluations, dental scan or orthopantomography were performed in most cases. At the commencement of treatment for untreated root canal, pulp test was performed. Based on CT findings evaluated by dental surgeons, the dental pathologies were grouped by discontinuity with the sinus floor; or by the presence in the affected tooth of periapical pathosis; a radicular cyst; periapical periodontitis with vertical bone resorption; or periapical periodontitis with marginal periodontitis (Figure 2). We defined dental mobility as a condition in which the movement is more than 1 mm in a buccolingual direction and depressible (Miller index 3) [16].
Cell homing strategy as a promising approach to the vitality of pulp-dentin complexes in endodontic therapy: focus on potential biomaterials
Published in Expert Opinion on Biological Therapy, 2022
Elaheh Dalir Abdolahinia, Zahra Safari, Sayed Soroush Sadat Kachouei, Ramin Zabeti Jahromi, Nastaran Atashkar, Amirreza Karbalaeihasanesfahani, Mahdieh Alipour, Nastaran Hashemzadeh, Simin Sharifi, Solmaz Maleki Dizaj
Dental tissue engineering must consider two distinct sections of a tooth, each with its own set of characteristics [7]. The dental pulp is the soft, stromal tissue situated at the center of the tooth, surrounded by dentin. It is an extensively vascularized and innervated connective tissue that is required to maintain the homeostasis of teeth and thus their vitality. It comprises of fibroblasts, odontoblasts, vascular cells, neural cells and immune cells such as macrophages (histiocytes) [8], granulocytes, mast cells and plasma cells [9]. In addition, stem cell populations reside in the microvasculature and in other niches of the dental pulp [10,11]. Dental pulp stem cells (DPSCs) maintain tissue homeostasis after differentiating into odontoblasts. These form new dentin when the original post-mitotic odontoblasts are lost as a result of dental diseases such as caries. Odontoblasts comprise highly differentiated cells that come from the neural crest, form primary dentin and maintain dentin throughout life. In addition, various signaling molecules mediate these tissue interactions [12]. Several studies have reported recent progress in developing dental pulp regeneration [13,14].
COVID-19 and oral diseases: Assessing manifestations of a new pathogen in oral infections
Published in International Reviews of Immunology, 2022
Afsar R. Naqvi, Joel Schwartz, Daniela Atili Brandini, Samantha Schaller, Heba Hussein, Araceli Valverde, Raza Ali Naqvi, Deepak Shukla
In this pursuit, Yu et al., invigorated the potential role of COVID-19 infection on the recovery of endodontic emergency patients (Mean age: 42.24 ± 18.32 years, 52.08% males whilst 47.92% were females) [60]. Four patients admitted in this study had previous COVID-19 history or possible COVID-19 cases that were identified by designed questionnaire. Symptomatic irreversible pulpitis appeared as the most common disease in this study and the therapy time was shortened to avoid optimal SARS-CoV-2 exposure to dental practitioners by asymptomatic patients or vital pulp cases such as pulpitis. However, this case series did not show any direct correlation regarding exacerbations of endodontic disease, especially pulpitis, in four individuals positive for SARS-CoV-2 or those exposed to COVID-19 subjects.