Subcutaneous Benign Fibrous Histiocytoma: Rare Presentation on Cheek—Case Report and Review of Literature

Fibrous histiocytoma is a benign tumor of mesenchymal origin. The tumor frequently appears in sun exposed areas on skin and orbital tissues. The subcutaneous appearance of this tumor in deep soft tissues is rare. We present here the eighth reported case of subcutaneous benign fibrohistiocytoma in a 27 year old male patient. Histopathology of the tumor comprises fibroblastic and histiocytic cells which mimic dermatofibroma, xanthomas and nodular fasciitis. Special stains like vimentin can only differentiate these tumors.     

A Large Sialolith Perforating the Wharton’s Duct: Review of Literature and a Case Report

Sialolithiasis accounts for the most common cause of diseases of salivary glands. The majority of sialoliths occur in the submandibular gland or the Wharton’s duct. This article discusses review of literature, predisposing factors, signs and symptoms, diagnostic methods and various modalities available for the management of sialolithiasis. This case report presents a case of sialolith of a large size in the left Wharton’s duct, which was explored and removed via an intra-oral approach.     

Eagle's Syndrome Caused by Traumatic Fracture of a Mineralized Stylohyoid Ligament—Literature Review and a Case Report

Eagle's Syndrome is the common name for a series of clinical symptoms arising from an elongated styloid process of the temporal bone. The syndrome is named for Watt W. Eagle, M.D., who described its occurrence in a series of articles beginning in 1937. Common presentations of Eagle's Syndrome are a post-tonsillectomy, nerve irritation and an impingement on either the external or internal carotid artery. The styloid process is the first section of the stylohyoid chain, formed by the stylohyoid ligament. Sections of this structure have the ability to mineralize, forming a rigid segment. This mineralized segment is then subject to fracture due to traumatic injury. The literature is reviewed for examples of traumatic fracture of the mineralized stylohyoid ligament, and a clinical case is presented.     

Pleomorphic Adenoma of Soft Palate: Unusual Occurrence of the Major Tumor in Minor Salivary Gland—A Case Report and Literature Review

Salivary gland tumours constitute about less than 4 % of all head and neck tumours. Pleomorphic adenoma, also called benign mixed tumour, is the most common tumour of the salivary glands. About 80–90 % of these tumours occur in the major salivary glands mainly parotid gland and 10 % of them occur in the minor salivary glands. The most common site for pleomorphic adenoma of the minor salivary glands is the palate, followed by the lips and the cheeks. Other rare sites include the floor of the mouth, tongue, tonsil, pharynx, retromolar area and the nasal cavity. Here, we are reporting a case of pleomorphic adenoma of the minor salivary glands of the soft palate in a 36-year-old Indian female. The mass was removed by wide local excision with adequate margins under general anesthesia. There was no recurrence seen after a follow-up period of 1 year.     

Relationship Between Periodontics and Restorative Procedures: Surgical Treatment of the Restorative Alveolar Interface (Rai)––Case Series

Maintenance of a healthy periodontium is fundamental for the long term success of prosthetic restorations. Thus, prosthetic procedures with subgingival margins may affect the periodontal health if the distances between the junctional epithelium and supracrestal connective tissue attachment aren’t respected, or if there is insufficient space to maintain the health of the interproximal tissues, leading to gingival inflammation, connective tissue attachment loss and bone resorption. The restorative alveolar interface (RAI) technique was described as the portion of the root surface extending from the alveolar crest apically to the restorative margin coronally. RAI consists of modifying the restorative margin position into a healthier environment, respecting the biological width and therefore allowing effective plaque control. This paper describes four clinical cases with indication for the RAI technique for maintenance of periodontal health. The cases were associated with prostheses. All cases were evaluated at 90 days and exhibited a healthy periodontal tissue. Successful outcomes were observed in the different indications for the RAI technique.     

Curcumin—A Natural Medicament for Root Canal Disinfection: Effects of Irrigation,Drug Release,and Photoactivation

IntroductionCurcumin incorporation into polymeric fibers was tested for its antimicrobial properties and potential use in root canal disinfection.MethodsCurcumin-modified fibers were processed via electrospinning and tested against a 7-day old established Actinomyces naeslundii biofilm. The medicaments tested were as follows: curcumin-modified fibers at 2.5 and 5.0 mg/mL, curcumin-based irrigant at 2.5 and 5.0 mg/mL, saline solution (negative control), and the following positive controls: 2% chlorhexidine, 1% sodium hypochlorite, and triple antibiotic paste (TAP, 1 mg/mL). All medicaments, except for the positive controls, were allocated according to the light exposure protocol (ie, photoactivation with a light-emitting diode every 30 seconds for 4 minutes or without photoactivation). After treatment, the medicaments were removed, and 1 mL saline solution was added; the biofilm was scraped from the well and used to prepare a 1:2000 dilution. Spiral plating was performed using anaerobic blood agar plates. After 24 hours, colony-forming units (colony-forming units/mL, n = 11/group) were counted to determine the antimicrobial effects.ResultsData exhibited significant antimicrobial effects on the positive control groups followed by the curcumin irrigants and, lastly, the photoactivated curcumin-modified fibers. There was a significant reduction of viable bacteria in curcumin-based irrigants, which was greater than the TAP-treated group. Curcumin-free fibers, saline, and the nonphotoactivated curcumin-modified fibers did not display antimicrobial activity.ConclusionsCurcumin seems to be a potential alternative to TAP when controlling infection, but it requires a minimal concentration (2.5 mg/mL) to be effective. Photoactivation of curcumin-based medicaments seems to be essential to obtain greater antibiofilm activity.     

A Scoping Review of 4 Decades of Outcomes in Nonsurgical Root Canal Treatment,Nonsurgical Retreatment,and Apexification Studies—Part 2: Outcome Measures

IntroductionInconsistencies in the definitions of endodontic outcome terminology jeopardize evaluations of proposed interventions and patient care quality. This scoping review aimed to provide groundwork to develop a set of basic outcomes in endodontics.MethodsWe performed a comprehensive literature search for randomized controlled trials, cohort studies, case-control studies, and case series (≥10 patients) published after 1980 with patients ≥10 years of age with any preoperative pulpal and periapical diagnosis in permanent teeth requiring nonsurgical root canal treatment, retreatment, or apexification. Abstracted data on outcome assessment methods, assessors, and domains were reported after univariate and bivariate analyses.ResultsTreatment outcomes were evaluated radiographically (88%) or clinically (73%). Although 2-dimensional radiography exceeded 3-dimensional radiography, the use of the latter has increased since 2010, mostly for nonsurgical retreatments. Of 19 identified outcomes, 5 were most frequent: success (168 studies, 40%), radiographic healing (128 studies, 30%), survival (of an asymptomatic tooth [48 studies, 12%] or of a procedure code in administrative databases [31 studies, 7%]), pain assessment (14 studies, 3%), and quality of life (11 studies, 3%). Clinician-centered outcomes have been most frequently studied since the 1980s (71%), in academic settings (76%), and using a prospective design (45%). Patient-centered outcomes were reported in 19% of studies before 2010 and 30% since 2010. They were more common among retrospective studies (49%).ConclusionsPatient-centered outcome measures are lacking in endodontic studies. The state of available research can provide a baseline for the development of a core outcome set in endodontics, which should represent the important patient-centered outcomes in conjunction with well-validated clinician-centered outcomes.     

The MRI Study as a Diagnostic and Therapeutic Indicator in the Non-Surgical Management of Temporomandibular Joint Disorders: Phase I Management—A Case Report

The dental profession frequently points to occlusion, muscle disorders or psychological stress as principal causes of temporomandibular joint (TMJ) disorders. Diagnosis and management is confusing, and no general consensus exists. Recent advances in magnetic resonance imaging (MRI) have allowed a means of evaluating large numbers of patients for internal derangements in an objective non-invasive fashion. This has unequivocally confirmed prior arthrographic and surgical observation that partial or complete dislocation of the articular disk with condylar compression of sensitive superior posterior joint space neurovascular elements is the principal pathophysiologic mechanism of TMJ disorders. TMJ disorders have been shown to be a general progression of degenerative joint disease characterized by joint space compression with displacement and degeneration of articular hard and soft tissues, most commonly the result of trauma. This article illustrates how the author has combined several different dental and medical diagnostic procedures with clinical therapeutic measures to manage patients to improved function and remission of symptoms by controlling the position of the joint hard structures in an objective fashion.