Mostrando entradas con la etiqueta Oral Surgery. Mostrar todas las entradas
Mostrando entradas con la etiqueta Oral Surgery. Mostrar todas las entradas


CLINICAL CASE : Brain abscess secondary to a dental infection in an 11 year old child

Clinical Case

A primary molar dental abscess was implicated as the cause of a brain abscess in an 11-year-old boy.

This case report describes the neurological signs and symptoms, and acute management of a brain abscess in a child.

A brain abscess is provisionally diagnosed from the patient’s medical history, as well as the presence of signs and symptoms such as fever, headache, nausea, vomiting, focal neurological deficit, altered mentation, speech alterations, papillary edema, and neck stiffness or seizures.

A definitive diagnosis of brain abscess is confirmed through imaging.

The dental source of infection is identified by the exclusion of more probable foci such as the ears, heart, lungs, eyes or sinuses.

Read Also: EMERGENCY : Multidisciplinary approach in the immediate replantation of a maxillary central incisor

Introduction : Dental abscesses and facial cellulitis put dentists on alert for potentially life-threatening conditions such as sepsis or airway obstruction, but the risk of a brain abscess is a complication of odontogenic infection that dentists rarely consider.

This report describes the case of an 11-year-old boy whose brain abscess and associated neurological signs were most likely attributable to an abscessed primary molar.

The description of the neurological signs and symptoms, and the history and management of this case will inform dentists about the real possibility of a brain abscess of dental origin.


°Canadian Dental Association
°Dr. Hibberd / Dr. Nguyen


Early Premolar Extraction: An Uncommon but Very Effective Treatment Option


The terminology “serial extraction” in Orthodontics was first described in the late 1920’s when Kjellgren decided to plan the extraction of certain deciduous and permanent teeth at early stages of the dentition development.

Since the extractions are under taken at the transitional dentition. This type of treatment is defined as “Early Treatment” in Orthodontics.

The main indication for this treatment approach is for patients with severe crowding caused by tooth size arch discrepancies. In other words, when maxillary and/or mandibular arches cannot accommodate teeth, extraction becomes an interesting option.

Although this treatment option has been used for almost a century in the contemporary orthodontics it’s indication is very specific.

Since it’s an irreversible approach (permanent teeth are early extracted) the clinician should carefully diagnosis the case before selecting this option.

Read Also: ORTHODONTICS : Serial extraction of primary teeth

In addition, as time passed by, orthodontics specialty has dramatically evolved and developed several options to gain space instead of extracting teeth.

On the other hand, the idea to early extract permanent teeth continues to be an interesting treatment option in clinical orthodontics mainly in severely crowded patients.

The aim of this paper is to present a case report of a ten-year-old male patient who presented severe crowding and treatment option was to extract four first premolars at early stages of the dentition development.


° Adeniyi M J, A O Soladoye. Plasma Lipid Profile and Uric Acid in High Fat Fed Female Rats Treated with Oral Contraceptive. Biomed J Sci & Tech Res 1(3)-2017. BJSTR. MS.ID.000256. DOI: 10.26717/BJSTR.2017.01.000256


Surgical excision of mucocele with local anesthesia in an 8-month-old baby


Mucoceles are common disorders of the minor salivary glands, occurring specially on the lower lip.

Their occurrence in newborn babies has rarely been reported.

In addition, the surgical removal of oral lesions in babies has often been performed with general anesthesia, which option is usually related to the patients' ages, irrespective of the lesion's size and the access to anatomic region where it is located.

The present report, however, details the treatment of a mucocele excision performed in an 8-month-old baby with local anesthesia.

This case illustrates well that knowledge of the lesion and dentist's experience in the attendance of babies is important, as often only conservative treatment with local anesthesia is required.

Therefore, clinicians and parents should be reassured that early surgical intervention under local anesthesia will provide a swift and satisfactory resolution to the problem.

Mucoceles are probably the most common disorders of the minor salivary glands, typically presenting as single bluish or translucent asymptomatic nodules, especially on the lower lip.

Read Also: Dental do's and don’ts during pregnancy

They are fluctuant and movable because of their mucinous contents. The diameter may range from a few millimeters to a few centimeters.

If left without intervention, episodic decreases and increases in size may be observed, corresponding to rupture and subsequent mucin production.

The majority of mucoceles are extravasation type in which there is pooling of mucus in the connective tissue presumably arising from trauma to a salivary duct.


Odontologia Clínico-Científica
Carla Vecchione Gurgel / Natalino Lourenço Neto / Dafna Geller-Palti / Vivien Thiemy Sakai / Thaís Marchini de Oliveira / Maria Aparecida de Andrade Moreira Machado

ORAL SURGERY : Guideline on Pediatric Oral Surgery

oral surgery

The American Academy of Pediatric Dentistry (AAPD) intends this guideline to define, describe clinical presentation, and set forth general criteria and therapeutic goals for common pediatric oral surgery procedures that have been presented in considerably more detail in textbooks and the dental/medical literature.

Preoperative evaluation

Medical : Important considerations in treating a pediatric patient include obtaining a thorough medical history, obtaining appropriate medical and dental consultations, anticipating and preventing emergency situations, and being prepared to treat emergency situations.

Dental : It is important to perform a thorough clinical and radiographic preoperative evaluation of the dentition as well as extraoral and intraoral soft tissues.

Radiographs can include intraoral films and extraoral imaging if the area of interest extends beyond the dentoalveolar complex.

Read Also: Management of Facial Space Infection in a 9-Year-Old Child - A Case Report

Behavioral considerations Behavioral guidance of children in the operative and perioperative periods presents a special challenge. Many children benefit from modalities beyond local anesthesia and nitrous oxide/oxygen inhalation to control their anxiety.

Management of children under sedation or general anesthesia requires extensive training and expertise. Special attention should be given to the assessment of the social, emotional, and psychological status of the pediatric patient prior to surgery.


°Guideline on Pediatric Oral Surgery


EMERGENCY : Reimplantation of avulsed dry permanent teeth after three days


Avulsion is a traumatic injury which results in loss of the tooth from the alveolus, while reimplantation is the technique of reinserting an avulsed tooth into the alveolus or tooth socket after its loss.

The success of reimplantation depends on many factors among which are the time lapse before the tooth is reimplanted in the socket and the storage medium of the avulsed tooth.

Other factors which may affect the success of reimplantation include the condition of the tooth, particularly the periodontal ligament tissue remaining on the root surface, sex, age, type of tooth reimplanted, stage of root formation, type of cleansing procedure following contamination of the root surface, duration of splinting, and the use of antibiotics.

With favorable conditions such as the periodontal ligament remaining on the root surface, the tooth stored in adequate storage medium for not more than 60 minutes, and immediate reimplantation after the accident, the tooth may be retained for as long as 5 to 10 years and few for a lifetime, but some fail soon after reimplantation.

Read Also: ORAL SURGERY : Guideline on Pediatric Oral Surgery

Unfavorable conditions include teeth out of the mouth for more than 6 hours in no storage media and without periodontal ligament on the root surface.

In such cases, the reimplanted tooth fails with subsequent loss of the tooth.

This is because dry storage affects pulp revascularization and survival of the periodontal ligament cells along the root surface resulting in either replacement resorption or loss of the tooth.


°Nigerian Journal of Clinical Practice
°IN Ize-Iyamu, BDO Saheeb


ORAL SURGERY : Conservative treatment of the dentigerous cyst: report of two cases in childrens

Dentigerous Cyst

The purpose of this paper is to present two cases of dentigerous cyst associated to permanent teeth in children treated by conservative techniques.

Dentigerous cyst is the most common developmental cysts of the jaws.

Conservative treatment is very effective to this entity and aims at eliminating the cystic tissue and preserving the permanent tooth involved in the pathology.

Two techniques are described as conservative treatment for these cysts, marsupialization and the decompression. Two children presented with dentigerous cysts.

A female child was affected by a large lesion at the right side of the mandible associated to tooth 45. The other lesion arose at the left maxilla associated to tooth 21 of a male child. Each dentigerous cyst promoted severe tooth displacement.

The first patient was treated with decompression and the second with marsupialization.

Read Also: ORAL SURGERY : Guideline on Pediatric Oral Surgery


Dentigerous cyst is the most common odontogenic development cyst. It can involve any included tooth, although molars and canines are the most affected ones. Cystic formation involving the crown of premolars and incisives is rare.


°Brazilian Journal of Oral Sciences
°Manoela Carrera; Danilo Borges Dantas; Antônio Mareio Marchionni; Marília Gerhardt de Oliveira; Miguel Gustavo Setúbal Andrade


Mucocele of the lower lip in a 1 year old child


Mucocele is a common oral lesion, but it is rarely observed in the infant.

The aim of this study is to present the case report of a 1 year old male patient, with a mucocele of the lower lip, describing the clinical characteristics and surgical treatment performed under local anesthesia with no recurrence observed after nine months follow-up, and also to show the histological features of this benign oral lesion.

INTRODUCTION: Mucocele is a common benign lesion of the oral mucosa that etymologically means a cavity filled with mucus (muco means mucus and coele means cavity), which is the secretory product of salivary glands.

Read Also: ORAL PATHOLOGY : Guideline on Dental Management of Heritable Dental Developmental Anomalies

The mechanisms for the development of these lesions are two, mucus extravasation, generally regarded as being of traumatic origin, and mucus retention, resulting from obstruction of the duct of a minor or accessory gland.

The mucus extravasations phenomenon is ussually formed secondary to rupture of an excretory duct of a salivary gland, which leads to an outpouring of saliva into the surrounding tissues.

The resulting pool of glandular secretion is first surrounded by inflamamatory cells and later by reactive granulation tissue consisting of fibroblasts.


° Pediatric Dental Journal
° Janaina Merli Aldrigui / Patricia Eberson da Silva / Flávia Caló Aquino Xavier


ORTHODONTICS : Serial extraction of primary teeth

The term serial extraction describes an orthodontic treatment procedure that involves the orderly removal of selected deciduous and permanent teeth in a predetermined sequence.

Serial extraction can be defined as “the correctly timed, planned removal of certain deciduous and permanent teeth in mixed dentition cases with dento-alveolar disproportion in order to: Alleviate crowding of incisor teeth.

The term serial extraction describes an orthodontic treatment procedure that involves the orderly removal of selected deciduous and permanent teeth in a predetermined sequence.

Serial extraction can be defined as “the correctly timed, planned removal of certain deciduous and permanent teeth in mixed dentition cases with dento-alveolar disproportion in order to: Alleviate crowding of incisor teeth.

Thus it is one of the positive interceptive orthodontic procedure generally applied in most discrepancy cases where supporting bone is less than the total tooth material.

You may also like : What Are The Normal Ages For Teeth Falling Out?

Justification for serial extraction:

Dental crowding – The result of inadequate arch size, insufficient basal bone, and / or excessive tooth material – is epidemiologically the most common type of malocclusion.

It can be eliminated by making the dental arch larger or reducing the amount of tooth material. Expansion of the dental arches by orthodontic alignment may be possible if the tooth material is not too excessive.

However, the stability of expansion may well be compromised by the insufficient alveolar basal bone.

Youtube / Dr. Rafi Romano


ORAL SURGERY : Surgical techniques for the treatment of ankyloglossia in children


Ankyloglossia, also known as tongue-tie, is a congenital anomaly characterized by an abnormally short lingual frenulum.

Its prevalence is around 4.4% to 4.8% in newborns, with a male to female ratio of 3:1.0.

Clinically, the term has been used to describe different situations, such as a tongue that is fused to the floor of the mouth as well as a tongue with impaired mobility due to a short and thick lingual frenulum.

There is continuing controversy over the diagnostic criteria and treatment of ankyloglossia.

Several studies establish diagnostic criteria based on the length of the lingual frenulum, amplitude of tongue movement, heart-shaped look when the tongue is protruded and thickness of the fibrous membrane.

In children, ankyloglossia can lead to breastfeeding difficulties, speech disorders, poor oral hygiene and bullying during childhood and adolescence.

During the 18th century, midwives used to divide the lingual frenulum with their sharp fingernails. For over a century, a grooved tablespoon was created specifically to release the tongue-ties.

Read Also: ORAL SURGERY : Guideline on Pediatric Oral Surgery

Pediatricians used similar devices over decades, but recurrence was common. Nowadays, several surgical techniques have been described to correct an abnormal frenulum.

The following techniques are of particular interest in Pediatric Dentistry: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser.

Therefore, the purpose of the present article was to describe a series of clinical cases of ankyloglossia, which were approached by various techniques.

Additionally, information on the indications, contraindications, advantages and disadvantages of the techniques was presented.


°Journal of Applied Oral Science
°Surgical techniques for the treatment of ankyloglossia in children: a case series
°Marina Azevedo JUNQUEIRA / Nayara Nery Oliveira CUNHA / Lidiane Lucas COSTA e SILVA / Leandro Borges ARAÚJO / Ana Beatriz Silveira MORETTI / Carlos Eduardo Gomes COUTO FILHO / Vivien Thiemy SAKAI

Ludwig’s Angina: A Case Report

Ludwig’s Angina

Ludwig’s angina is a serious, a rapidly progressive cellulitis of the floor of the mouth which, involves the submandibular, submaxillary, and sublingual spaces of the face, it is life threatening if not early recognised and complications like septicemia and asphyxia caused by expanding edema of soft tissues of the neck may occur.

A 11-year-old boy referred to, our clinic had tender swelling of the floor of his mouth.

Based on his history and symptoms, the diagnosis of Ludwig’s angina was suspected. Infected teeth were diagnosed in oral and radiological examination.

The child was treated appropriately by extraction of infected teeth after antibiotic therapy. Many departments may have limited experience of the disease because of its rare occurrence.

So, it is important to recognize Ludwig's angina in the earlier stages of the disease.

Read Also: ORAL PATHOLOGY : Dental erosion in children: A literature review


Ludwig’s angina was firstly described by Wilhelm Fredrick von Ludwig in 1836. Ludwig’s angina is a serious, life threatening if not early recognised and treated due to septicemia and asphyxia caused by expanding edema of soft tissues of the neck.

Ludwig's angina has been occurred more usually in adults than children. Death from thi infection is approximately 10% to 17% in the pediatric population.

Conventionally, Ludwig’s angina has been more seen in patiente with poor oral hygiene. Most of the cases are due to infected lower molars or pericoronitis, which is result of inflammation of the soft tissues surrounding the crown of a partially erupted tooth, most commonly the second or third molar.


°JBR Journal of Interdisciplinary Medicine and Dental Science
°Mine Simsek / Esma Yildiz and Mutar Hamdi Aras


Tongue-tie assessment: clinical aspects and a new diode laser technique for its management

tongue Tie

Ankyloglossia, also known as tongue-tie, is a congenital oral condition characterised by a short, thickened, or abnormally tight lingual frenulum.

This anomaly can cause varying degrees of reduced tongue mobility, and has been associated with functional limitations including atypical swallowing, speech articulation problems, mechanical problems such as the inability to clean the oral cavity, and psychosocial stress.

In many cases, ankyloglossia can be resolved through surgical procedures; however, it should also be noted that, despite the reduced length of the lingual frenulum, in many cases the elasticity of the mouth floor may allow normal tongue mobility, avoiding frenectomy.

Tongue-tie also affects breastfeeding in infants, making a natural act a difficult and sometimes impossible task, and much has been published on this topic.

However, renewed interest in breastfeeding has brought to light many problems and challenges concerning infant feeding, and statistics indicated mothers’ renewed preference for breastfeeding; thus considerable fresh data is now accumulating.

Read Also: ORAL MEDICINE : How to manage a pediatric patient with oral ulcers

Mothers and infants may experience a variety of difficulties in mastering breastfeeding: a breastfeeding mother may experience sore nipples, blocked ducts, nipple and breast infection, and signs of low milk supply.

Infants may be unable to transfer milk adequately, in part due to their inability to maintain an effective latch and seal onto the breast.

These infants sleep badly and gain inadequate weight, sometimes being diagnosed as “failure to thrive”. Anatomical factors, such as tongue-ties and frenulum/lip-ties, should be carefully considered as primary factors in creating breastfeeding difficulties.


° R. Crippa / M. Paglia / F. Ferrante / A. Ottonello / F. Angiero
° European Journal of Paediatric Dentistry vol. 17/3-2016
° Photo : The Dental Arcade - Blog


Midline space closure in the mixed dentition: A case report

Oral Medicine

The present case report describes a mesiodens in a 9-year-old boy. The purpose of this case report is to emphasize the importance of space closure in the mixed dentition facilitating the eruption of a permanent tooth.

The clinical, radiographic and therapeutic considerations are presented.

The outcome of the present case report is to alert the clinician that an early extraction of the mesiodens can be useful as it allows greater space conservation which can be utilized for the permanent tooth to erupt.

Introduction : Teeth which are in excess from the normal number are known as supernumerary teeth.

The supernumerary teeth when located in the maxillary central incisor region are called as mesiodens. Their prevalence has been estimated to be 0.15 to 2.2% of the population with a preference of male.

Read Also: ORAL SURGERY : Guideline on Pediatric Oral Surgery

It can be single or multiple in an arch. The presence of a mesiodens is usually found to be impacted, with a conical crown and a single root.

The diagnosis of the mesiodens is made by clinical and radiographic examinations. During dental development, the presence of a midline diastema and a supernumerary tooth in the maxillary arch could be devastating from the esthetic view.


° Aakash Sharma / Nanjunda Swamy / Sadanand Kulkarni


ORAL SURGERY : Inverted mesiodens: case report


Mesiodens is the term used for describing the supernumerary tooth that occurs in the maxilla, between the central incisors, in the midline region.

These may erupt in the oral cavity or keep themselves impacted. Their presence causes cleaning inadequate, impossibility or difficult of the eruption of the regular teeth and having the aesthetic compromised.

This paper aims at showing that early identification of supernumerary teeth, planning and correct approach, allow the preservation of the teeth and adjacent structures.

This article presents the clinical case of a seven-year-old child, male, who sought for treatment complaining that teeth 11 didn't appear in the buccal cavity. Clinical and radiographic exams were done and they demonstrated the presence of the supernumerary tooth.

Read Also: ORAL SURGERY : Guideline on Pediatric Oral Surgery

The plan of treatment aimed at the correct localization, extraction of this supernumerary tooth and continuous follow up of the case.

INTRODUCTION : "Mesiodens" is the term used to describe the supernumerary tooth that occurs in the maxilla, between the central incisors, in the midline region.


° RGO - Revista Gaúcha de Odontologia
° Eneane MIRANDA, Luciene Dornas MENDES, Sérgio Milton Martins de Oliveira PENIDO, Cláudia Valéria de Sousa Resende PENIDO


An unusual presentation of oral mucocele in a young pediatric patient


Mucocele is a common condition of the minor salivary glands that is generally found on the lower lip. Although etiology is uncertain, mucocele are usually caused by local trauma.

Cases involving infants are rarely reported in the literature. The objective of this study is to report an unusual case of mucocele in the first year of life that was treated with surgical removal and postoperative follow-up.

This report illustrates the main features of clinical interest and discuss classification, differential diagnosis and the treatment approaches described in the literature.

INTRODUCTION : The term mucocele is used to denote the clinical manifestations of two different phenomena that affect the minor salivary glands: mucus extravasation cyst and mucus retention cyst 1-3.

Extravasation of mucus into underlying connective tissue is the result of rupture of an excretory gland of a minor salivary gland, caused by trauma or laceration.

Read Also: ORAL SURGERY : Guideline on Pediatric Oral Surgery

An inflammatory reaction is induced in adjacent tissues, in which neutrophil and macrophage defense cells predominate, creating granulation tissue surrounding the pooled mucus, isolating the lesion and giving it the appearance of a pseudocyst.

A recurrent characteristic is periodic reduction of the swelling due to rupture and partial release of fluid, soon followed by recurrent build up.


° Simone Helena Ferreir / Daiane Fin / Paulo Floriani Kramer / Mariana Cezar Ilha / Tássia Silvana Borges / Henrique Castilhos Ruschel


Congenital Mucocele of The Lower Lip: Case Report and Literature Review


Oral mucoceles (OMs) are known as asymptomatic benign soft tissue lesions mostly seen in the oral cavity.

Their clinical characteristics include painless, soft, smooth, spherical, translucent, fluctuant single or multiple nodules with minimal irritation.

Although they may appear at any age, most OMs are widely seen in the second and third decade of life. Mucoceles have been classified as either extravasation type or retention type.

Extravasation type usually occurred when mucin from the ruptured salivary duct (s) is encapsulated in connective tissue around the gland.

Retention type is an actual cyst accumulated with mucin and lined by ductal epithelium.

Read Also: ORAL PATHOLOGY : Dental erosion in children: A literature review

Mucocele formation is related to mucus extravasation from accessory salivary glands and usually has a traumatic origin, especially following lip biting.

The lower lip is the most common site of the mouth, however, a mucocele can be found in the tongue, floor of the mouth (ranula), and the buccal mucosa.


° Journal of Islamic Dental Association of IRAN (JIDAI) Autumn 2017 ;29, (4) / Gh. Ansari / S-H. Daneshvar


Multidisciplinary management of ankyloglossia in childhood


Background: Partial ankyloglossia is a limitation which restricts the possibility of protrusion and elevation of the tip of the tongue due to the shortness of either the lingual frenulum or the genioglossus muscles or both.

The principal objective of this paper is to present our protocol of action for the treatment of ankyloglossia.

The specific objectives are to study patients with ankyloglossia treated by the Service of Maxillofacial Surgery and the Service of Speech Therapy of our pediatric Hospital, describe the diagnostic procedures, the pre-surgical intervention, the surgical technique undertaken and the post-surgical rehabilitation taking into account the level of collaboration of the patients, and finally, describe the surgical complications and the referral of patients.

Material and Methods: This is a descriptive study of healthy patients, without any diagnosis of syndrome, ranging between 4 and 14 years that have been surgically treated and rehabilitated post-surgery within a period of 2 years.

Results: 101 frenectomies and lingual plasties have been performed and patients have been treated following the protocol of action that we hereby present.

Read Also: ORAL MEDICINE : How to manage a pediatric patient with oral ulcers

After the surgical intervention, the degree of ankyloglossia has been improved, considering correction in 29 (28%) of the patients (95% CI: 20%, 38%), reaching, with the post-surgical orofacial rehabilitation, a correction of 97 (96%) of the participants (95% CI: 90%, 98%).

Conclusions: The chosen surgical technique for moderate-severe ankyloglossia in our centre is the frenectomy and lingual plasty.

The myofunctional training begins one week before the surgical intervention so that the patients learn the exercises without pain.


° Journal section: Oral Medicine and Pathology
° Elvira Ferrés-Amat / Tomasa Pastor-Vera / Eduard Ferrés-Amat / Javier Mareque-Bueno / Jordi PratsArmengol / Eduard Ferrés-Padró