Buccal Area Research Articles

Evaluation of the effect of injectable platelet-rich fibrin (i-PRF) in wound healing and growth factor release in rats: a split-mouth study

This experimental study aimed to evaluate the effects of injectable platelet-rich fibrin (i-PRF) on mucosal healing and the release of growth factors in rats. 40 rats were used; i-PRF was administered in the right buccal area while saline was injected in the left. Cytokeratin, FGF, PDGF, TGF, and VEGF expressions were determined with immunohistochemistry. Gene expressions of EGF, TGF-β, and VEGF were analysed. Epithelialization started on the 3rd day, and connective tissue maturation was more prominent in the i-PRF-applied group. Also, the releases of VEGF, EGF, TGF-β, PDGF, and FGF were higher in the i-PRF group during the 14 days. Gene expression analysis showed that changes in TGF-β at 14 days after i-PRF injection and VEGF after 21 days were statistically significant. The results of this study suggested that autologous i-PRF application enhanced the healing of oral mucosal wounds by increasing the release of growth factors for 21 days.

Current Perspectives on Paradental Cyst: A Literature Review.

Paradental cyst (PC) is an uncommon type of odontogenic cyst of inflammatory origin, which develops near the cervical margin of the outside of the root of a vital tooth. The category of paradental cyst includes the buccal bifurcation cyst, which is found in the buccal area adjacent to the mandibular first or second molars in children. A conclusive diagnosis of a PC needs to correlate the surgical, radiographic, and histologic findings. When strict diagnosis is neglected, they can be easily misdiagnosed and mistreated. PCs associated with mandibular first and second molars and those associated with the mandibular third molar may have slightly different clinical manifestations but have almost completely different treatment principles due to the distinction in location. For the third molars, removal of both the tooth and the cyst is preferred. However, when the first or second molars are affected, it may be advisable to perform enucleation of the lesion while preserving the associated tooth. There are also more conservative methods to retain vital permanent teeth within the mandibular arch. Additionally, the cyst wall primarily consisted of granulation tissue firmly attached to the periodontal ligament space. The exact origin of these cysts was a subject of ongoing debate, but they were believed to primarily arise from either the reduced enamel epithelium or the inflammatory proliferation of junctional/sulcular epithelium, which originate from the superficial mucosa during tooth eruption. The aim of the present review was to update information on clinical manifestations, diagnosis and treatment strategies of cysts and discuss their pathogenic mechanisms. Raising familiarity with the distinctive features is beneficial for accurately diagnosing these lesions and effectively caring for the patients.

Pilot Study: Periosteal Mattress Sutures as an Alternative to Pins and Screws in Guided Bone Regeneration in the Esthetic Zone.

To quantify the buccal bone thickness, area, and perimeter following guided bone regeneration (GBR) using stabilizing periosteal sutures. The loss in hard tissue volume may impair proper implant placement. GBR has been used to regenerate the lost alveolar ridge prior to or at the same time as dental implant placement. The most important factor for GBR success is graft stability. The periosteal mattress suture (PMS) stabilizing technique is an alternative to pins and screws to stabilize bone grafting material and has the advantage of not requiring the removal of the fixing devices. A CBCT was acquired before and 6 months after surgery from six patients who underwent GBR with the PMS stabilizing technique. Images were analyzed for buccal bone thickness, area, and perimeter. The mean change in buccal bone thickness was 3.42 mm (± 1.31 SD) and proved statistically significant (P = .005). The mean change in bone crest area also proved statistically significant (P = .001). No significant difference was found in bone perimeter (P = .12). The PMS technique delivered optimal results without clinical complications. This study shows the potential of this technique as an alternative to pins or screws for graft stabilization in the esthetic zone.

Effect of Low Heat Steam Sterilization on the Volumetric Stability of Three Different 3D Printing Materials for Dental Implant Surgical Templates: An in vitro Study

Background: Computer-guided surgical templates are considered critical instruments and are proposed to be sterilized before surgery. However, steam heat sterilization process may result in volumetric changes in the acrylic resin materials and this may compromise the accuracy of the drilling process during surgery. Objective: The aim of this in vitro study was to investigate the effect of steam heat sterilization on the volumetric and morphological dimensions of 3D printed surgical guides that could affect the accuracy of guided implant surgery. Methods: A total of fifteen templates of the same size and shape were printed from three different resin materials (five templates from each material) based on digital data of a clinical case previously planned with a special implant planning software. Following the printing procedure, all templates were digitally scanned using an intraoral scanner before and after steam heat sterilization at 121°C for 20 minutes. The scan data were saved in STL files and volumetric and morphological changes were evaluated before and after sterilization process by using appropriate software. Results: The results showed dimensional alterations within the three tested materials, before and after the sterilization process. Mean percentage of volumetric change was -1.53% for Visijet, 0.50% for MED610 and 1.9% for eResin. A larger deformation of the surgical guides at the sleeve and buccal wire areas was also observed. Conclusion: We can conclude that low steam heat sterilization seems to affect differently the three investigated implant template materials. Visijet and eResin showed a significant difference between the initial and the final volume of the surgical guides. This could possibly decrease the accuracy of computer guided surgery.

Effect of polydeoxyribonucleotide on early bone formation in lateral bone augmentation with immediate implant placement: an experimental in vivo study

This study investigated early bone formation using collagenated biphasic calcium phosphate (CBCP) with or without polynucleotide (PDRN). Third (P3) or fourth (P4) premolars of six male beagle dogs were extracted and 5-mm-high dehiscence defects were created, followed by 3D-printed implant placement. The buccal bone defects were grafted with (i) CBCP and collagen membrane or (ii) CBCP soaked in polydeoxyribonucleotide (CBCP/PDRN) and collagen membrane. Samples of the experimental sites were harvested at 2- and 6-weeks post-surgery. The specimens were evaluated with radiologic and histomorphometric analysis. No significant differences were found between the CBCP and CBCP/PDRN groups in the micro-CT analysis at 2 or 6 weeks. No significant differences were observed in bone-to-implant contact (BIC) or bone area fraction occupancy (BAFO) in buccal augmented and lingual non-augmented areas. In the qualitative analysis, the new bone (NB) area and NB proportion in buccal augmented areas showed significantly higher values in the CBCP/PDRN group than in the CBCP group at 2 and 6 weeks. Peri-implant buccal dehiscence defects with immediate 3D-printed implant placement were corrected using a collagen membrane and CBCP or CBCP/PDRN. PDRN might have the potential to facilitate early bone formation with sufficient stability over time in dehiscence defects.

Langerhans Cell Histiocytosis in the Oral Cavity

Background: Langerhans cell histiocytosis (LCH) is a rare hematological malignancy. The incidence of this disease is only 1% of soft tissue and lymph node cancer. Clinical manifestations and organ involvement vary widely. Lesions in the oral cavity are rare. LCH occurs more often in children, 10 times more often than in young adults.
 Case presentation: A 20-year-old male came with the main complaint of a lump on the roof of the mouth and the right inner cheek. Physical examination of the face and oral cavity found a mass attached to the palate 1x1x1 cm with the same color as the surrounding tissue, flat surface, soft consistency, could be moved, and a mass was found in the left buccal 2x2x2 cm, with the same color as the surrounding tissue, flat surface, cystic consistency, not fixed and can be moved. Hematology laboratory examination was within normal limits, so no examination was carried out for bone marrow puncture (BMP). From the results of a CT scan of the head and neck, a solid mass was found with a hypodense part in it in the right buccal area attached to m. right masseter, and in the left hard palate area, which was suggestive of Langerhans cell histiocytosis. The results of histopathological examination of the lesion which underwent an incisional biopsy showed positive S100 and CD1a, this patient was diagnosed with Langerhans cell histiocytosis LCH. Next, this patient was treated with excision of the mass in the palate and buccal area. The patient was treated in the surgical inpatient department for 2 days, and the postoperative wound was in good condition.
 Conclusion: Cases of Langerhans cell histiocytosis (LCH) are very rare cases that have different clinical symptoms depending on the organs involved, so it is important to understand this disease better. In this case, it was unilocal LCH without the involvement of other organs, so only local therapy was carried out in the form of surgical excision and observation was carried out after 3 months after surgery with the results of the wound improving without any new lumps appearing.

Optimal Insertion Torque for Orthodontic Anchoring Screw Placement: A Comprehensive Review

The optimal insertion torque (IT) for orthodontic anchoring screws (OASs) was hypothesized to vary with OAS features and insertion methods. This review examines the indexed English literature, to determine the appropriate IT range for OAS success based on area of insertion and OAS features. Eleven original articles with OAS placement in humans including IT and success rate were selected and were used to evaluate the relationships among IT, success rates, screw design, and placement methods at different sites. The ITs and success rates ranged from 6.0 ± 3.2 to 15.7 ± 2.3 Ncm and from 62.5 to 100.0% in the upper and lower buccal alveolar areas, respectively. For the mid-palatal area, the range was 14.5 ± 1.6 to 25.6 ± 5.5 Ncm and 83.0 to 100.0%, respectively. ITs of 5–12 and 6–14 Ncm were found to be optimal for the commonly used φ1.5–1.7 mm OASs in the upper and lower interproximal areas, respectively. In the mid-palatal suture area, ITs of 11–16 and 20–25 Ncm were considered suitable for tapered φ1.5 mm and φ2.0 mm OASs, respectively. Although identified optimal IT ranges deserve the recommendations, care must be taken to monitor the IT during placement constantly.

EARLY MEDICAL CORRECTION OF PERIORBITAL EDEMA AFTER AESTHETIC PERIORBITOPLASTY OF UPPER AND LOWER EYELIDS

The article discusses the results of clinical observation, the use of the thrombolytic Russian drug Jrombovazim® for oral use in the early postoperative period, after aesthetic extended surgeries of the periorbital area of the upper and lower eyelids, as well as the buccal area. A comparative clinical dynamic evaluation of the results of soK tissue edema correction with and without thrombolytic therapy was carried out. The performed correction indicates the rate of regression of postoperative edema, lymphostasis, hematomas in the area of surgical intervention in patients with drug administration of Jrombovazim

Repair of Surgical Defect by Pectoralis Major Flap Versus Free Radial Forearm Flap in Buccal Carcinoma: Assessment of Quality of Life

Background: Soft tissue reconstruction of the oral cavity is the most critical factor in achieving a successful functional result. Malignant lesions occurring in the buccal area are usually treated with primary surgical and/or radiotherapy of the head and neck region. Depending on the location and size of the buccal tumor, radical surgical treatment often affects all oral function such as speech, swallowing, chewing, oral rehabilitation, nutrition and appearance. To maximize postoperative function, flap repair is currently the preferred method for reconstruction of buccal defects after major surgery. Among the flaps most commonly used are pedicle pectoralis major myocutaneous flap and the free radial forearm fasciocutaneous flap. The choice of the best reconstructive option is still controversial. Objective: To find out the quality of life after repair of surgical defect by pectoralis major flap versus free radial forearm flap in buccal carcinoma. Methods: This prospective study was conducted in the department Otolaryngology- Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from September 2017 to August 2019. A total number of 44 cases of buccal carcinoma patient who had the inclusion criteria were enrolled as a study sample. These subjects were selected from the Department of Otolaryngology-Head & Neck Surgery, Department of Oral & Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, National Institute of ENT, Tejgaon, Dhaka. Comparison of nominal or ordinal variables between patients who have undergone surgery with either the RFFF or PMMF were analyzed using a chi-square test. The UW-QOL scores were compared for each domain using the nonparametric Mann-Whitney test. P-value < .05 was accepted as the level of significance. Results: In this study 40 out of 44 patients were completed UW-QOL questionnaires. The median age was 52 (range 40-65years), the male-female ratio was 1.44:1. All were habituated in either smoking or betel leaf/ nut or alcohol. Most of them were illiterate to the primary level of education and suffering from stage- iii tumor. All these variables were statistically insignificant except gender. Patients reconstructed with RFFF felt better in shoulder domains than PMMF but felt worse appearance domains and these were statistically significant in both 3 months and 6 months postoperatively. Conclusion: The study result had shown that reconstruction of the defect after buccal cancer resection using either RFFF or PMMF significantly influences patient’s quality of life. This study will provide valuable information for surgeons who will decide reconstruction modalities for buccal cancer and also will help the patients getting a better outcome. Bangladesh J Otorhinolaryngol 2023; 29(1): 32-38

Influence of the maxillary dimensions and anterior teeth anatomy on the buccal impaction of upper permanent canines: A three-dimensional case-control study

The diagnosis of impacted upper permanent canines (IUPC) is a relatively common clinical finding. The aim of this study was to investigate the association of the buccal impaction of upper permanent canines with their dimensions and the maxilla bone base. Cone beam computed tomography files of 66 patients were allocated into: impaction group (ICG/n=33/mean age 15.7±3.9years), with 44 impacted canines by the buccal side; control group (CG/n=33/mean age 15.66±3.99years), matched for age and sex, with 66 canines normally erupted. The following measurements were obtained from ICG and CG groups: linear and volumetric canine dimensions, linear measurements of upper permanent central and lateral incisors, measurements of the anterior perimeter and transverse segments of the maxilla. Independent Student's t-test was used for intergroup analysis with correction of Bonferroni (α=0,005). Higher values were found in the means of the variables regarding to the anterior teeth crowns in the ICG group, however, without a significant difference (P<0,005). The upper arch anterior perimeter of the individuals with canine impaction through buccal area was reduced compared to CG (P=0.001). It can be concluded that individuals with upper buccal impacted permanent canine showed a significantly smaller anterior perimeter of the maxillary arch when compared to the control group. Although greater canine mesiodistal diameter was found in this group, there is no statistical association with the occurrence of this condition.

Efficacy of mixture of injectable-platelet rich fibrin and type-1 collagen particles on the closure of through-and-through periapical bone defects - A randomized controlled trial.

To determine the efficacy of a combination of injectable-platelet rich fibrin and type-1 collagen particles on the healing of through-and-through periapical bone defect and subsequent closure of bony window. The clinical trial was registered in ClinicalTrials.gov(NCT04391725). Thirty eight individuals with radiographic evidence of periapical radiolucency in maxillary anterior teeth and confirmed loss of palatal cortical plates in cone beam computed tomographic imaging were randomly assigned to either experimental group(n=19) or the control group(n=19). Mixture of i-PRF and collagen as a graft was applied to the defect in adjunct to periapical surgery in experimental group. No guided bone regeneration procedures were used in the control group. The healing was evaluated using Molven's(2D) and modified PENN 3D(3D) criteria. Percentage reduction of the buccal and palatal bony window area, and complete closure of through-and-through periapical bony window (tunnel defect) were assessed using Radiant Diacom viewer software(Version 4.0.2). The reduction in the periapical lesion area and volume was measured using Corel DRAW and ITK Snap software. Thirty four participants(18 and 16 in the experimental and control group, respectively) reported for follow-up at 12 months. There was 96.9% and 97.96% reduction of buccal bony window area in experimental and control groups respectively. Similarly, palatal window showed 99.03% and 100% reduction in experimental and control groups respectively. No significant difference in both buccal and palatal window reduction was noticed between the groups. A total of 14 cases(7 in experimental and 7 in control group) showed complete closure of through-and-through bony window. No significant difference in clinical, 2D and 3D radiographic healing, percentage reduction in area and volume was observed between experimental and control group(P>0.05). Neither the area nor the volume of lesion, and the size of buccal or palatal window had significant effect on healing of through-and-through defects. Endodontic microsurgery results in high success rate in large peripical lesions with through-and-through communication with more than 80% reduction in volume of lesion and size of both buccal and palatal window after one year. Mixture of type-1 collagen particles and i-PRF, adjunct to periapical micro-surgery did not improve the healing in through-and-through periapical defects.

Effects of different treatment modalities on biomechanical behavior of maxillary incisors with external invasive cervical resorption at different progression levels.

This study aimed to evaluate the biomechanical behavior of maxillary incisors with external invasive cervical resorption (EICR) at different progression levels after receiving different modes of treatment under occlusal forces using finite element analysis (FEA). Three-dimensional (3D) models of intact maxillary central incisors were constructed and modified to include EICR cavities with different progression levels in the buccal cervical areas. The EICR cavities confined to dentin were repaired using Biodentine™ (Septodont Ltd., Saint Maur des Fausse ́s, France), resin composite, or glass ionomer cement (GIC) . Additionally, EICR cavities with pulp invasion requiring direct pulp capping were simulated as repaired using Biodentine only or 1 mm thick Biodentine and either resin composite or GIC for the rest of the cavity. Moreover, models with root canal treatment and EICR defects repaired using Biodentine, resin composites, or GIC were also generated. A force of 240 N was applied to the incisal edge. The principal stresses in the dentin were evaluated. GIC showed more favorable results than the other materials in EICR cavities confined to the dentin. However, Biodentine alone resulted in more favorable minimum principal stresses (Pmin ) compared to other materials in EICR cavities with close pulp proximity. Exceptionally, the models localized in the coronal third of the root with a circumferential extension of the cavity >90° showed more favorable results for GIC. The presence of root canal treatment had no significant effect on stress values. Based on this FEA study the use of GIC in EICR lesions confined to the dentin is recommended. However, Biodentine may be a better option for restoring EICR lesions close to the pulp with or without root canal treatment. Except when the circumferential extension of the cavity is >90°, the use of GIC may be more advantageous.

Endodontic operative field asepsis: a comparison between general dentists and specialists

Objective The aim was to evaluate the establishment of an aseptic endodontic operative field in general dentistry by assessing general dentists’ ability to reduce the amount of contamination to a non-cultivable level, and to compare the operative field asepsis at a general dentistry clinic with that at an endodontic specialist clinic. Materials and Methods A total of 353 teeth were included in the study (153 in general dentistry, 200 at the specialist clinic). After isolation, control samples were taken, the operative fields disinfected with 30% hydrogen peroxide (1 min) followed by 5% iodine tincture or .5% chlorhexidine solution. Samples were collected from the access cavity area and buccal area, placed in a fluid thioglycolate medium, incubated (37°, 7 d), evaluated for growth/non-growth. Results Significantly more contamination was observed at the general dentistry clinic (31.6%, 95/301), than at the endodontic specialist clinic (7.0%, 27/386) (p <.001). In general dentistry, significantly more positive samples were collected in the buccal area than in the occlusal area. Significantly more positive samples were collected when the chlorhexidine protocol had been used, both in general dentistry (p <.001) and at the specialist clinic (p =.028). Conclusions The result from this study shows insufficient endodontic aseptic control in general dentistry. At the specialist clinic, both disinfection protocols were able to reduce the amount of microorganisms to a non-cultivable level. The observed difference between the protocols may not reflect a true difference in the effectiveness of the antimicrobial solutions, as confounding factors may have contributed to the result.

Healing of Large through-and-through Periapical Lesion 24 Managed by Non-Surgical Endodontic Treatment

The present case report demonstrates the nonsurgical endodontic treatment intervention of a large through-and-through periapical lesion in the anterior maxillary region of an 18-year-old female with a chief complaint of regular swelling and drainage of pus from the buccal and palatal areas of the maxillary anterior region of gingiva with no history of pain. The treatment includes thorough chemomechanical debridement, followed by complete endodontic therapy. The root canal was filled with calcium hydroxide for 2 weeks, followed by a bioceramic apical plug and obturation. Clinical and radiographic re-evaluations up to 2 years showed a total cure of periapical lesion. This case report shows that the conservative nonsurgical approach leads to the complete healing of large periapical lesions.

Periodontal status following orthodontic mini-screw insertion: A prospective clinical split-mouth study.

Anchorage control is one of the most important determinants of orthodontic treatments. Mini-screws are used to achieve the desired anchorage. Despite all their advantages, there is a possibility that treatment will not be successful due to conditions related to their interaction with the periodontal tissue. To evaluate the status of the periodontal tissue at the sites adjacent to the orthodontic mini-implants. A total of 34 teeth (17 case and 17 control) in 17 orthodontic patients requiring a mini-screw in the buccal area to proceed with their treatment were included in the study. Oral health instruction was provided to the patients prior to the intervention. In addition, scaling and root planing of the root surface were done using manual instruments and ultrasonic instruments if needed. For tooth anchorage, a mini-screw with Elastic Chain or Coil Spring was used. The following periodontal indices were examined in the mini-screw receiving tooth and the contralateral tooth: plaque index, pocket probing depth, attached gingiva level (AG), and gingival index. Measurements were made before the placement of the mini-screws and 1, 2, and 3 months following that. The results revealed a significant difference only in the amount of AG between the tooth with mini-screw and the control tooth (p = 0.028); for other periodontal indices, there were no significant differences between the two groups. This study showed that periodontal indices in adjacent teeth of the mini-screws do not change significantly compared to other teeth and mini-screws can be used as a suitable anchorage without posing a threat to the periodontal health. Using mini-screws is a safe intervention for orthodontic treatments.

A Split-Mouth Clinical Comparative Evaluation of the Anesthetic Efficacy of Articaine and Lignocaine for Maxillary Bicuspids Extraction.

Aim The study compared the anesthetic effectiveness of articaine and lignocaine when premolars are extracted bilaterally for orthodontic purposes. Material and methods This prospective split-mouth study was performed on 30 cases selected from orthodontic referral patients reporting to the Oral and Maxillofacial Surgery Department at Maharaja Ganga Singh Dental College and Research Center, Rajasthan, India, for bilateral extraction of premolars under local anesthesia. We used 4% articaine hydrochloride and adrenaline 1:100000 (AH) as group A and 2% lignocaine hydrochloride with adrenaline 1:100000 (LH) on the control side as group B. For premolar anesthetization, 0.6-1.6 ml of AH and 1-2 ml of LH were injected submucosally in the buccal vestibular area. The extraction procedure was then carried out after achieving adequate anesthesia. The pain was assessed with Visual Analog Scale. The average onset time and duration of anesthesia were recorded. Data collected were summarized with descriptive statistics.The SPSSversion 23.0 (IBM Corp., Armonk, New York) was used for data entry, validation, and analysis. Means of continuous variables were compared using the student t-test. All tests were 2-tailed and significant at equal or less than 0.05. (p≤0.05). Results When comparing the overall anesthetic efficiency, Group A had a lower overall pain score of 0.43 while Group B had a higher overall pain score of 2.9. The average onset time of anesthesia in Group A was 1.2 minutes and 2.55 minutes in Group B. In Group A, the average duration of anesthesia was 70 minutes, and 46.5 minutes in Group B. These parameters were statistically significant with a p-value of <0.05. Conclusion The study concluded that as an alternative to lignocaine, articaine could be used effectively for maxillary premolar extractions for orthodontic reasons obviating palatal injection which is very painful to the patient.

Distribution patterns of occlusal contact areas on natural posterior teeth – Evaluations of a cross-sectional population-based study with the Greifswald Digital Analyzing System (GEDAS)

AimThe aim of our investigations is to optimize the anatomical basis for the design of a sufficient occlusal relationship, especially in view of the innovative technologies by analyzing the occlusal contact point patterns at cusp structures according to A-, B-, C- localization tooth by tooth on the individual occlusal surfaces in the posterior region in static habitual occlusal position. Materials and methodsIn 3300 subjects of the population-based Study of Health in Pomerania (SHIP 1) the interocclusal registration in habitual intercuspation using silicone registration was used and analyzed by using the special evaluation software Greifswald Digital Analyzing System (GEDAS II).Chi square test was used to investigate whether the distribution of contact areas differed in the group of premolars or molars - each considered separately for maxilla and mandible - on the basis of the probability of error p < 0.05. ResultsIn 709 subjects (446 male with a mean age of 48.9 ± 13.04 years; 283 female with a mean age of 52.4 ± 14.23 years) the antagonistic situation was specifically considered on natural posterior teeth without conservative or restorative-prosthetic interventions, i.e. without caries, fillings, crowns or other restorations. On the basis of these subjects, the silicone registrations were analyzed using GEDAS II. For the first and second upper molars, the ABC contact distribution was the most frequent: 20.4 % for the first and 15.3 % for the second molar. The second most frequent contact area for maxillary molars was area 0. The upper molars had contact areas only at the maxillary palatal cusp (B-/C-contacts). This contact relationship was most frequent in the maxillary premolar (18.1–18.6 %). In mandibular premolars, with the buccal cusps areas A and B were frequently involved (15.4–16.7 %). Mandibular molars showed a frequent contact pattern involving all A-, B-, C- and 0- contact areas (13.3–24.2 %). To capture the possible influence of the antagonistic dentition situation, the antagonistic situation was specifically considered and except for the mandibular premolars (p < 0.05) the contact distribution did not differ for molars and maxillary premolars regarding the dental status of the antagonistic teeth.Natural posterior teeth without occlusal contacts were observed from 20.0 % in the second lower molars to 9.7 % in the first upper molars. ConclusionOur results suggest a clinically relevant due to the fact, that this study is the first population-based epidemiological study to analyze the occlusal contact point patterns at cusp structures according to A-, B-, C- localization tooth by tooth on the individual occlusal surfaces in the posterior region in static habitual occlusal position in order to optimize the anatomical basis for the design of a sufficient occlusal relationship.

Outcome of Vertical Skeletal Pattern in the Buccal Corridor Area Show during Posed Smile

Aim: To determine link between a patient's buccal relationship and vertical skeletal corridor region display during a posed grin. Study design: Descriptive study. Place and duration of study: Department of Orthodontic, Ayub Dental College from 1st July 2022 to 31st December 2022. Methodology: One hundred and seventy patients with normal, additional and insignificant buccal corridors were enrolled. The patient's Frankfort Horizontal plane parallel to the floor, their lips relaxed, and their teeth in centric occlusion, lateral cephalograms were obtained. Results: The measurement of the buccal corridor area visible during a frontal grin varies from 0 mm to 4.50mm. The average size of the buccal corridor was 1.799±0.9904 mm. The ratio of lower anterior facial height towards total anterior facial height ranged from 48° to 67° with mean anterior facial height was 45.246±2.48. Conclusion: Lower anterior facial height has a substantial impact on how much of the buccal corridor region shows during posed smiles, and a rise in ratio causes less buccal corridor area to display. Keywords: Inter-commissure width, Inter-pre-molar width, Inter-pupillary distance

Textbook outcome was associated with better survival in oral cancer surgery in southern Taiwan.

To explore the impact of textbook outcome (TO) on long-term survival in oral cancer surgery. In total, 386 patients with tumor resection, neck dissection (ND), and reconstruction between 2011 and 2020 were included. TO was defined as negative margin; adequate ND; no 3-day emergency room revisit; no 30-day readmission; and length of stay ≤22 days. Multivariate Cox regression was used to evaluate the impact of TO and 5-year overall survival (OS). The TO rate was 35%. Younger age, subsite in buccal area, Charlson Comorbidity Index Score of 0, higher body mass index, higher hemoglobin, higher albumin, and unilateral ND were associated with TO. 5-year OS was 70.5% in overall TO patients and 49.0% in non-TO patients (HR, 0.47; 95% CI, 0.31-0.70; p < 0.001). Non-TO was associated with an increased mortality rate (aHR, 1.73; 95% CI, 1.14-2.63) after adjusting other factors and the result remained robust with inverse probability of treatment weighting analysis. The impact of TO on OS was more significant in age <60, advanced stage, and diagnosis year before 2018. Not achieving TO in oral cancer surgery was associated with worse long-term outcome. TO could be used as a proxy for surgical quality improvement.

HAMARTOMATOUS GROWTH IN A CHILD, AMELOBLASTIC FIBRO-ODONTOME: A CASE REPORT

Introduction: Ameloblastic fibro-odontoma is a rare, mixed, benign, odontogenic tumor with significant prevalence in the mandible. It is characterized by histologic features of ameloblastic fibroma with the formation of enamel and dentine. It usually affects pediatric patients and is associated with teeth, leading to delay in eruption or a deviation in the dental eruption pathway. This is a case report of Ameloblastic fibro-odontoma and its management in a 11 y Case Report: ear old boy. Intra-oral examination revealed an edema in the buccal area of the mandible's posterior right region. Radiographic examination showed an expansile, mixed radiolucent-radiopaque lesion with well-defined corticated border. Surgical enucleation and curettage was performed under general anesthesia. Histopathologic findings led to diagnosis of Ameloblastic fibro-odontoma. Although Ameloblastic fibro-odontoma is a rare tumor, its Conclusion: prevalence is more in children’s jaw. Conservative surgical treatment allowed the normal development with no sign of recurrence observed during the 6-month follow-up period.