July/August 2019

Table of Contents

Clinical Articles

  • Oral and Maxillofacial Surgery Mandibular fracture after third molar removal: a case report

    Thiago Coelho Gomes da Silva
    Almir Walter de A. Maranhão Filho
    Marilia Gabriela Mendes Alencar
    Manoela Moura de Bortoli
    Belmiro Cavalcanti do Egito Vasconcelos

    Surgical removal of third molars is associated with complications that can be as common as pain and trismus and as rare as mandibular fracture. A fracture can occur when the resistance of the bone tissue is lower than the forces applied by the surgeon during the procedure. The aim of this article is to report a case of jaw fracture after tooth extraction and subsequent surgical treatment of the fracture under general anesthesia with an option for a submandibular approach. A plate and screw system with a 2.4-mm profile was used for osteosynthesis after reduction of the fracture. The patient was followed up for 6 months after surgery and reported no functional or esthetic complaints. Treatment of mandibular fractures should aim to reestablish functional occlusion and mandibular continuity with the least possible risk of adverse sequelae. Planning for each individual case of third molar extraction requires accurate clinical examination and image evaluation to lessen the risk of fracture.

    2019 July/August; 67(4):e7-e10.
    Full Article (PDF)
  • Special Patient Care Prosthetic rehabilitation of a child with X-linked hypohidrotic ectodermal dysplasia: a case report and 12-month follow-up

    Daniele Vieira Cassol
    Thiago Isidro Vieira
    Ivete Pomarico Ribeiro de Souza
    Luciana Pomarico

    The hereditary condition known as ectodermal dysplasia (ED) is characterized by the absence of or a defect in 2 or more ectodermally derived structures such as skin, nails, hair, sweat glands, or teeth. Patients with this disorder usually present with reduced salivary gland function and absence of some or all teeth, which compromises orofacial function and development. In addition, children with ED usually experience difficulty in social interactions because of their appearance. This article reviews previously published case reports pertaining to ED and describes oral rehabilitation with removable partial dentures (RPDs) in a 5-year-old girl diagnosed with X-linked hypohidrotic ED, which presented as hypodontia. An orthodontic expander screw was inserted in the maxillary prosthesis to correct the patient’s crossbite, and periodic recall examinations were scheduled to monitor the effects of the patient’s growth on occlusion and fit of the prosthesis. The child was monitored for 12 months, during which she exhibited significant improvement in physiologic function, appearance, and social behavior. Because negative esthetic, functional, and psychological consequences are associated with this condition, dentists must be knowledgeable about its common oral manifestations.

    2019 July/August; 67(4):e1-e6.

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  • Periodontics Comparison of root surface roughness produced by air polishing combined with hand instrumentation or ultrasonic instrumentation: an in vitro study

    Rajendran Poornima
    Kukkamalla Meena Anand
    Pratibha Gopalkrishna

    The root surface roughness produced by hand scaling and subsequent glycine powder air polishing (GPAP) during periodontal maintenance therapy was compared with that produced by ultrasonic scaling and subsequent GPAP. In this in vitro study, hand scaling with curettes produced smoother root surfaces than ultrasonic scaling. Adjunctive use of GPAP for 5 seconds along with hand scaling or ultrasonic scaling resulted in improved root surface smoothness.

    2019 July/August; 67(4):75-77.

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  • Orofacial Pain Prevalence of temporomandibular disorders in rugby players

    Daniel Bonotto
    Carlos Antonio Schäffer Penteado
    Eli Luis Namba
    Paulo Afonso Cunali
    Rodrigo Nunes Rached
    Luciana Reis Azevedo-Alanis

    Playing rugby is associated with high rates of dental and facial trauma, and facial trauma in sports has been associated with development of temporomandibular disorders (TMDs). The prevalence of TMDs in a group of 30 rugby players (53.3%) was significantly greater than that observed in a control group of 28 nonathletes (14.3%; P = 0.002). Athletes also reported significantly more tooth clenching than did nonathletes (P = 0.003).

    2019 July/August; 67(4):72-74.

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  • Restorative Dentistry Metal endocrown approach for a maxillary second molar: a novel technique

    Saad A. Alhazzani
    Mohammed S. Aldossary

    Nonvital teeth with repeated restoration failures are particularly challenging to dental practitioners. This case report describes the fabrication of a novel cast metal endocrown following the failure of 2 different types of restorations (post and core–retained crown and ceramic endocrown). This approach was used to preserve the tooth and avoid extraction. 

    2019 July/August; 67(4):67-71.

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  • Laser Therapy/Electrosurgery Low-level laser therapy as adjunctive treatment for a sodium hypochlorite accident: a case report

    Fernanda Paula Yamamoto-Silva
    Lorena Rosa Silva
    Kaique Leite de Lima
    Maria Alves Garcia Santos Silva
    Carlos Estrela
    Brunno Santos de Freitas Silva

    A large, painful ulcer caused by a sodium hypochlorite accident during endodontic treatment was treated with dexamethasone and amoxicillin to control pain and prevent secondary infection as well as low-level laser therapy to speed healing. 

    2019 July/August; 67(4):63-66.

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  • Removable Prosthodontics Risk factors for mandibular bone resorption in complete denture wearers

    Fernanda Rodrigues de Souza Santos
    Maira Foresti Vieira Munhoz
    Luis Henrique Theodoro Alves
    Marcelo Tavares
    André Gustavo Paleari
    Germana de Villa Camargos

    This study aimed to evaluate the impact of factors related to the patient (age, sex, bruxism, and general health) or prosthesis (use of old dentures, duration of denture wear, and nocturnal wear) on the mandibular ridge resorption rate (RRR) of complete denture (CD) wearers. In this retrospective cohort study, researchers estimated the mandibular RRR by using panoramic radiographs (n = 120) obtained at the time of the clinical examination. The results suggested that advanced age, use of old dentures, and bruxism have a negative influence on the mandibular RRR.

    2019 July/August; 67(4):58-62.

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  • Special Patient Care Prevention and treatment options for medication-induced xerostomia

    Diana Quilici
    Kaitlyn N. Zech

    Medication-induced xerostomia often results in rampant caries and complicates restorative options. Knowledge of the medications that contribute to xerostomia as well as available treatments allows the dentist to improve the patient’s quality of life. This article provides a comprehensive review of causative medications, risk assessment, preventive measures, and palliative treatments for patients with medication-induced xerostomia. 

    2019 July/August; 67(4):52-57.

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  • Basic Science Horizontal root fracture in a maxillary central incisor: a case report

    T. Bob Davis

    This report aims to remind clinicians that no or minimal treatment may be the best option in certain cases. After a fall resulted in a horizontal root fracture of a central incisor and partial extrusion, the patient had no tooth pain and no signs of pathology. Treatment was limited to reduction of the extrusion, placement of a local antibiotic, and prescription of periodontal medication. The tooth was closely monitored at regular recalls, and over time the root exhibited good bone repair. 

    2019 July/August; 67(4):47-50.

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    Special Patient Care Allergy topics for dental practitioners

    Allison Ramsey
    Alan H. Brodine

    Penicillin allergy, local anesthetic hypersensitivity, latex allergy, contact hypersensitivity, and anaphylaxis are among the allergic reactions encountered in dental practice. This article reviews the literature pertaining to the epidemiology, diagnosis, and management of these reactions as they relate to dentistry. Recognition and appropriate treatment of anaphylaxis also are reviewed. 

    2019 July/August; 67(4):38-45.

    Full Article (PDF)
    Self-Instruction Exercise No. 443
  • Oral Medicine, Oral Diagnosis, Oral Pathology An unusual clinical manifestation of oral melanocytic nevus

    Silas Antonio Juvencio de Freitas Filho
    Natália Galvão Garcia
    Gabriela Moura Chicrala
    Paulo Sérgio da Silva Santos
    Denise Tostes Oliveira

    Melanocytic nevi are acquired or congenital benign neoplasms found often in the skin but rarely in the oral mucosa. This article describes an atypical case of oral hypopigmented melanocytic nevus in a 39-year-old woman referred for evaluation of a well-circumscribed papule with discrete brownish spots in the buccal mucosa.

    2019 July/August; 67(4):35-37.

    Full Article (PDF)

    Implants Splinted wide-short implants in the posterior region of an atrophic mandible opposed by an edentulous maxilla: immediate loading and 1-year follow-up

    Fernanda Faot
    Raissa Micaella Marcello-Machado
    Caio Hermann
    Flávia Noemy Gasparini Kiatake Fontão

    This case report describes the clinical treatment of a patient with bilateral bone atrophy in the posterior regions of the mandible. Two wide-short implants splinted to 1 standard implant were used for rehabilitation on the right side, while 3 standard implants were placed on the other side. The use of wide-short implants splinted to a conventional implant improved mandibular occlusal stability in an area of reduced bone height. 

    2019 July/August; 67(4):29-33.

    Full Article (PDF)
    Self-Instruction Exercise No. 442

    Basic Science Use of virtual reality as a learning environment in dentistry

    Rafael Morales-Vadillo
    Janet-Ofelia Guevara-Canales
    Víctor-Carlos Flores-Luján
    José-Martín Robello-Malatto
    Rosario-Haydée Bazán-Asencios
    Carlos-Enrique Cava-Vergiú

    This study compared the efficacy of using 3-dimensional interactive platforms designed in a virtual reality program to that of traditional teaching methods for developing students’ understanding of dental clinical situations. The results suggest that the Second Life environment helps students to understand anatomical interactions that are difficult to observe in real life, is attractive to students, and contains tools with high didactic potential.

    2019 July/August; 67(4):21-27.

    Full Article (PDF)
    Self-Instruction Exercise No. 441


  • Self-Instruction Answers Exercises No. 423, 424, and 425 from the July/August 2018 issue

    2019 July/August; 67(4):79.

    Full Article (PDF)
  • Oral Diagnosis Antral opacity and Spiked roots

    Galal Omami

    2019 July/August; 67(4):78, 80.

    Full Article (PDF)
  • Pediatric Dentistry Preeruptive intracoronal resorption

    Jane A. Soxman

    2019 July/August; 67(4):19-20.

    Full Article (PDF)
  • Public Health Understanding and addressing patients’ use of tobacco

    Larry Williams

    2019 July/August; 67(4):16-18.

    Full Article (PDF)
  • Pharmacology The new dental anesthesiology specialty: implications for the general dentist

    Jason H. Goodchild
    Mark Donaldson
    Brian Chanpong

    2019 July/August; 67(4):12-15.
    Full Article (PDF)
  • Restorative Dentistry Modification of the gingiva-implant interface of tissue-level implants

    Roger A. Solow

    2019 July/August; 67(4):8-11.

    Full Article (PDF)
  • Editorial Civility

    Roger D. Winland

    2019 July/August; 67(4):6.

    Full Article (PDF)