Maxillary Left Quadrants Research Articles

Effect of antioxidant on tooth sensitivity after bleaching.

This study aimed to investigate the effect of antioxidant (sodium ascorbate) on tooth sensitivity after two in-office bleaching techniques (light-activated and chemical bleaching). Ten patients aged 18-25 were bleached in four groups according to bleaching materials and/or antioxidant used. Group A: Maxillary right quadrant received light-activated bleaching with antioxidant. Group B: Maxillary left quadrant received light-activated bleaching without antioxidant. Group C: Mandibular right quadrant received chemical bleaching without antioxidant. Group D: Mandibular left quadrant received chemical bleaching with antioxidant. The tooth sensitivity was recorded using Numerical Rating Scale (NRS) and Schiff Scale (SS) immediately after treatment, 1 day, 1 week, 2 weeks, and 1 month follow-up periods. Group B exhibited higher sensitivity values than Group A. This difference was statistically significant on the first day after treatment (p = 0.027* in NRS and p = 0.046* in SS). Furthermore, antioxidant incorporation in Group D led to a reduction in teeth sensitivity values compared to Group C. This disparity was highly significant on the first day after treatment (p = 0.001* in NRS and p < 0.001** in SS). The antioxidant (10% sodium ascorbate) reduces the intensity of tooth sensitivity at the different follow-up periods, especially after 1 day from bleaching. Using 10% sodium ascorbate after bleaching is advisable to reduce post-operative tooth sensitivity.

Maxillary radiolucency in a 39-year-old man

A 39-year-old man came to an oral and maxillofacial surgery office for evaluation of a lesion in the left maxilla. The patient’s general dentist referred him after a radiolucency within the posterior maxillary left quadrant was noted on a routine panoramic radiograph. He had no symptoms and denied pain or swelling in the area of the lesion. The patient reported a history of tooth extraction in the area many years ago. Medical, family, and social histories were noncontributory. Extraoral head and neck examination was unremarkable, with no evidence of adenopathy, palpable masses, or facial asymmetry, and cranial nerves were grossly intact. Dr. Alamri is a senior resident, Advanced Oral and Maxillofacial Pathology Program, Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY. Dr. Violante is a periodontist in private practice, Buffalo, NY. Dr. Schellati is an oral and maxillofacial surgeon in private practice, Victor, NY. Dr. Hinchy is an assistant professor, Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY. Dr. Aguirre is the program director, Advanced Oral and Maxillofacial Pathology Program and a professor, Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY.

A Retrospective Clinical Audit of Bracket Failure among Patients Undergoing Orthodontic Therapy

Objective Bonding failure is a problem in orthodontic therapy and has been associated with orthodontic emergencies and delayed treatment time. The aim of this study is to determine the bracket failure rate among patients undergoing orthodontic therapy. Materials and Methods From the archives of posttreatment records, 200 total cases were selected, out of which 122 cases had detailed treatment records. Cases with incomplete records, large restorations, or enamel aberrations were excluded from the study. Descriptive statistics were applied to obtain sample characteristics, and a chi-square test was applied to compare the bracket failure between different categories. Result Out of the 122 samples enrolled in the study, female and male patients comprised 71% and 29%, respectively. Class I malocclusions were the most common problem (56%), followed by Class II (41%) and Class III (3%). The bracket failure rate was 3.43%, and 32% of the patients had an incidence of bracket failure. There was no significant difference in bracket failure among genders (p=0.344), malocclusion types (p=0.191), or operators (p=0.188). The maxillary left quadrant was the most common site of bracket failure, followed by the mandibular right quadrant. Conclusion Bracket failure is relatively uncommon. It is not affected by the gender or age of the patient or by malocclusion type. The maxillary left and mandibular right quadrants are the most common sites of bracket failure.

The plaque and gingivitis inhibiting capacity of a commercially available mouthwash containing essential oils and ethyl lauroyl arginate. A randomized clinical trial

Objective: A commercially available mouth rinse with ethyl lauroyl arginate and essential oils claims to have better antimicrobial properties than the traditional essential oil products. The aim of this study was to compare the plaque and gingivitis inhibiting effect of the commercial product containing essential oils with ethyl lauroyl arginate with one placebo and one negative control in a modified experimental gingivitis model.Materials and methods: In three groups of healthy volunteers, experimental gingivitis was induced and monitored over 21 d, simultaneously treated with the commercial test solution, 21.6% hydro-alcohol solution and sterile water, respectively. The maxillary right quadrant of each individual received mouthwash only, whereas the maxillary left quadrant was subject to both rinsing and mechanical oral hygiene. Compliance and side effects were monitored at d 7, 14, and 21. Plaque and gingivitis scores were obtained at baseline and d 21.Results and conclusion: Although the commercial product containing essential oils with ethyl lauroyl arginate performed statistically significantly better regarding average plaque scores on all surfaces combined than the placebo (p = .018) and negative control (p = .003) when no mechanical tooth cleaning was performed, the product still left the patient with enough plaque to cause gingivitis and thus seemed of questionable clinical benefit to the patient. ClinicalTrials.gov Identifier is NCT02884817.

Comparing the effect of 0.06% -, 0.12% and 0.2% Chlorhexidine on plaque, bleeding and side effects in an experimental gingivitis model: a parallel group, double masked randomized clinical trial

BackgroundChlorhexidine is the gold standard of dental plaque prevention. The aim of the present study was to compare the plaque and gingivitis inhibiting effect of commercial products containing 0.2%, 0.12% and 0.06% chlorhexidine in a modified experimental gingivitis model.MethodsIn three groups of healthy volunteers, experimental gingivitis was induced and monitored over 21 days and simultaneously treated with the commercial solutions containing 0.2%, 0.12% and 0.06% chlorhexidine. The maxillary right quadrant of each individual received mouthwash only, whereas the maxillary left quadrant was subject to both rinsing and mechanical oral hygiene. Compliance and side effects were monitored at days 7, 14, and 21. Plaque and gingivitis scores were obtained at baseline and day 21.ResultsThe commercial mouthwash containing 0.2% chlorhexidine resulted in statistically significantly lower plaque scores than the 0.12 and 0.06% mouthwashes after 21 days use, whereas no statistically significant difference was found between the effects of the two latter.ConclusionA commercially available mouthwash containing 0.2% chlorhexidine had statistically significant better effect in preventing dental plaque than the 0.12% and 0.06% solutions.Trial registrationClinicalTrials.gov NCT02911766. Registration date: September 9th 2016.

Evaluation of tooth size in patients with congenitally-missing teeth.

Background and aims Hypodontia is a common developmental abnormality of dentition. This study aimed to determine tooth width in patients affected with mild hypodontia and compare the results with a control group without tooth agenesis. Materials and methods The orthodontic records of 25 patients with congenital missing of one or two teeth (hypodontia group), and 25 subjects with full dentition (control group) were selected. The greatest mesiodistal width of each tooth was measured on the study models by a digital caliper. Tooth width measurements were compared between the groups using a student t-test at p < 0.05 of significance. Results Patients with hypodontia showed narrower teeth than the control subjects. The differences in tooth size between the two groups were statistically significant for the first and second premolars and first molar in the maxillary right and for the second premolar in the maxillary left quadrants (p < 0.05). In the lower arch, the first and second premolars and also first molar in both sides of hypodontia patients demonstrated significant reduction in tooth size compared to the control group (p < 0.05). Conclusion These findings suggest that patients with mild hypodontia have narrower teeth than normal subjects especially in posterior segments, which may have clinical implications during the orthodontic treatment process.

Foreign Body Reaction to Facial Dermal Fillers: Case Report

We present a patient who developed a delayed granulomatous reaction after injections of hyaluronic acid and bovine collagen glutaraldehyde that were introduced 6 and 4 years, respectively, previous to her present visit. She was a healthy 65-year-old woman, who was seen in November 2010 at the Columbia University Salivary Gland Center with a tentative diagnosis of a left buccal facial swelling caused by a "blocked parotid duct." The swelling was only slightly painful and had developed 1 month previously after a periodontal surgical procedure that involved the maxillary left quadrant. Questioning indicated that the swelling did not fluctuate in size nor had it changed its configuration since its sudden inception 2 days after the periodontal surgery. Visibly, the swelling was slightly erythematous. Palpation caused only mild discomfort and revealed the swelling to be quite firm in tone. The lesion involved the left facial buccal tissues, with its extraoral center corresponding to the intraoral location of the parotid duct orifice. The swelling was diffuse, with no definitive outline. It measured approximately 3 cm horizontally and 3.5 cm in height. Posteriorly, palpation of the left parotid gland revealed the gland to be painless, normal in tone, and not swollen. No swelling or discomfort was evident on the right side. No trismus was present.

Incidence and patterns of needlestick injuries during intermaxillary fixation

Intermaxillary fixation (IMF) carries an appreciable risk of occupational exposure to bloodborne viruses. Our aim was to establish the incidence and patterns of needlestick injuries during IMF at DAV Dental College. We surveyed 12 residents working in the Department of Maxillofacial Surgery for 1 year (December 2008 to December 2009) to find out how many injuries occurred during IMF. A total of 40 needlestick injuries were recorded during 172 IMF procedures (23%). Most injuries occurred in the maxillary left quadrant ( n = 16, 40%). Procedures done during the night had a much higher incidence (13/29, 45%) compared with 27/153 (18%) done during the day. Of the 40 injuries, 31 (78%) were recorded as superficial, the rest being deep. All injuries affected the non-working hand, and 39 (98%) were caused by a wire. Surgeons are at high risk of occupational exposure to bloodborne viruses from needlestick injuries during IMF. Detailed attention to the pattern of these injuries could help to develop improved strategies to minimise the incidence.

Florid cemento osseous dysplasia in association with dentigerous cyst

We present a case of florid cemento-osseous dysplasia occurring in a 20-year-old Indian woman. The subject presented with three lesions involving the maxillary right quadrant, maxillary left quadrant and mandibular left quadrant. The mandibular left quadrant also demonstrated a cyst.The diagnosis was made by correlating the clinical presentation with that of the radiological and histopathological findings. This is a rare entity because of an unusual combination of Asian race along with the association of dentigerous cyst.

Longevity of Band and Loop Space Maintainers Using Glass Ionomer Cement: A Prospective Study

This was to prospectively investigate the success and median survival rate of band and loop space maintainers using glass ionomer luting cement for attachment. A total of 40 children (22 females and 18 males) between the ages of 3.4 and 7.3 years participated in the study. Each patient received only one band and loop space maintainer. For each child, the same paediatric dentist carried out all diagnosis, band selection, and impression taking and appliance cementation. The same dental technician fabricated all appliances. The luting cement used was Ketac-Cem-Maxicap. Regular follow up appointments were scheduled at 4-6 months intervals. Variables, which might have affected the median survival time for the appliances were tested using Log-Rank and Chi-square tests. 40% of the band and loop space maintainers were successful and 57.5% failed during the study period (40 months). The most common cause of failure was decementation (82% of all failed cases). The overall median survival time was 19.9 months. Appliances fitted in the maxillary and mandibular left side of the mouth showed a statistically higher survival rate than those fitted in the right side (maxillary left quadrant = 35 months, mandibular left quadrant = 28 months, maxillary right quadrant = 14 months, mandibular right quadrant = 16 months) (p<0.008). Although the overall median survival time was clinically acceptable (19.9 months), the failure rate of the band and loop space maintainers in general was high (57.5%). The main reason for failure was decementation of the band. Further studies are required to compare glass ionomer cements with more recent resin modified luting cements.

Palatal Neurofibroma Associated With Localized Periodontitis

Neurofibromatosis type 1 (NF1) is the most common form of neurofibromatosis. While typically considered a dermatologic disorder, intraoral signs of neurofibromatosis occur quite commonly. This clinical entity can be confused with periodontitis because of the presence of periodontal pockets. In this report, we present the case of a palatal neurofibroma with radiographic involvement in a patient with NF1. A 40-year-old female patient was referred from her general dentist to evaluate advanced periodontitis in the maxillary left quadrant. The patient's medical history was significant for a soft tissue lesion excised from her back 11 years previously and diagnosed as a neurofibroma. Subsequent medical examination at that time confirmed a systemic diagnosis of NF1. A comprehensive periodontal evaluation was performed, and panoramic and periapical radiographs were taken. Teeth were tested for vitality. An incisional biopsy was completed for histopathologic examination. The periodontal evaluation revealed the presence of 6 to 9 mm probing depths adjacent to teeth #14 and #15. Panoramic and periapical radiographs showed a circumscribed 0.8x0.9-cm unilocular radiolucency superimposed over the root of tooth #13 and extensive horizontal bone loss on the distal side of #15. Incisional biopsy confirmed the presence of a neurofibroma, and because of the extent of the lesion, the patient was referred to the Oral and Maxillofacial Surgery service for complete excision. Neurofibromas can cause extensive destruction of alveolar bone, mimicking periodontitis. Due to the potential systemic and genetic implications, the diagnosis of neurofibroma requires appropriate medical referral.

Diphenylhydantoin Induced Gingival Hyperplasia in Ferrets: A Precautionary Note

Diphenylhydantoin appears to modify the tissue response in ferrets to a gingival irritant. In the present study, ferrets were tested for the tissue response to a local irritant in their maxillary right quadrant, while their maxillary left quadrant was the control. A low incidence of hyperplasia was induced only in irritated gingival tissue of animals receiving DPH. The problems encountered in comparing the hyperplasia produced in ferrets and humans were also discussed.

Interproximal Contact and Marginal Ridge Relationships in Periodontally Healthy Young Males Classified as to Orthodontic Status

Three groups of periodontally healthy young males, classified as to orthodontic status, were evaluated for proximal contact and marginal ridge relationships in the maxillary left quadrant. The majority of anterior teeth did not have satisfactory proximal contacts on both the mesial and distal aspects. Open or defective proximal contact relationships were common in all three orthodontic groupings. In posterior areas, the orthodontically treated group had the highest percentage of open contacts. The orthodontically treated group had a significantly higher percentage of even marginal ridges in the teeth that are customarily banded.

Odontodysplasia

Odontodysplasia is a rare dental deformity which manifests itself clinically as one or more quadrants of hypoplastic, hypocalcified, and late-erupting teeth. Histologically, the teeth affected by odontodysplasia present abnormalities in all derviatives of the tooth germ. To date, no particular etiologic factor has been commonly agreed upon as the cause of this dental malformation. Two cases of odontodysplasia are presented in this article. In the first case the condition manifested itself throughout the entire maxillary left quadrant. In the second case the condition was contained within the left maxillary central incisor region. Histologic examination of both cases revealed many similarities. The possible etiologies of the two cases are discussed, and the conclusion is that, despite the differences between regional and singular odontodysplasia, the histologic similarities support a common etiology.

Unusual Endodontic Complication: Report of Case

A patient was referred for endodontic treatment. She had a soft tissue defect of the face that communicated with the left nasal cavity. Paresthesia was present in the maxillary left quadrant. The patient had been treated previously for pain and tenderness in the maxillary left central incisor. This patient developed an unusual complication after the first therapy and obtained treatment by other specialists.