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Temporomandibular Joint Disorders (TMD’s) represents a cluster of disorders that include the Temporomandibular Joint (TMJ) and also the masticatory apparatus. Any alteration in its function will have an impact on the overall function of the masticatory apparatus and in turn the stomatognathic system. Though the aetiology, symptoms, and treatment modalities for TMD’s have been extensively studied, they remain a subject of prime concern for clinicians as it not only affects the form and function but also negatively affects the overall standard of living of the patient. Symptoms of TMD’s such as chronic pain, restriction of function, and psychological effects lead to a lower Quality of Life (QoL) for the patient, which is caused due to various factors such as chronic pain, sleep deprivation, and stress or anxiety. Additionally, personal, professional, and social problems directly or indirectly affect the lifestyle of the patient. Some extra-craniofacial symptoms such as otologic and neurologic symptoms tend to worsen the situation. Majority of patients reporting to an orthodontist present with atleast one symptom of TMD that has affected their QoL. Various questionnaires can be used to assess the patient’s QoL, and plan the treatment accordingly. Managing TMD’s at an early stage while considering these factors and a multidisciplinary approach may help in improving the QoL of the patient.

Medication-related osteonecrosis of the jaw (MRONJ) is an intractable disease that is typically observed in patients with osteoporosis or tumors that have been treated with either bisphosphonate (BP) or antiangiogenic medicine. The mechanism of MRONJ pathogenesis remains unclear, and no effective definitive treatment modalities have been reported to date. Previous reports have indicated that a single injection of benidipine, an antihypertensive calcium channel blocker, in the vicinity of a tooth extraction socket promotes wound healing in healthy rats. The present study was conducted to elucidate the possibility of using benidipine to promote the healing of MRONJ-like lesions. In this study, benidipine was administered near the site of MRONJ symptom onset in a model rat, which was then sacrificed two weeks after benidipine injection, and analyzed using histological sections and CT images. The analysis showed that in the benidipine groups, necrotic bone was reduced, and soft tissue continuity was recovered. Furthermore, the distance between epithelial edges, length of necrotic bone exposed in the oral cavity, necrotic bone area, and necrotic bone ratio were significantly smaller in the benidipine group. These results suggest that a single injection of benidipine in the vicinity of MRONJ-like lesions can promote osteonecrotic extraction socket healing.

Objectives: The purpose of present study was to investigate and correlate the histological findings in central giant cell granuloma and peripheral giant cell granuloma of jaws with clinical and radiographic interpretations of the lesion. Material and Methods: In present study, data from 14 cases of central giant cell granuloma (CGCG) and 9 cases of peripheral giant cell granuloma (PGCG) were analysed, focusing on demographic, clinical and radiographic features. For each patient, microscopic slides were assessed in terms of histologic features of giant cells i.e. number of giant cells, mean number of nuclei/giant cell, pattern of distribution, size and relative size index of giant cells, percentage fractional surface area (FSA) occupied by giant cells and stromal characteristics. Data collected was subjected to statistical analysis. Fisher-exact test, Pearson’s correlation coefficient, one-way ANOVA test and Student’s t-test were used for analysis. Results: No significant difference was found between PGCG and CGCG in relation to all the traits that were evaluated. It was observed that mean number of giant cells and mean FSA was more in aggressive CGCG as compared to non-aggressive CGCG. Conclusions: Further studies on large sample size are required to confirm the relationship between histomorphometric features of giant cells and behaviour of giant cell granulomas of jaws.

Maxillary osteitis is a bone tissue disease or condition with a dentoalveolar origin. This condition remains a public health concern in most developing countries, particularly in the Ivory Coast. Without appropriate management, it can alter the patient's overall health owing to aesthetic, functional, and psychological complications. This study aimed to provide a better understanding of odontogenic maxillary osteitis to consequently improve its diagnosis and medical care. Three major etiologies of maxillary osteitis have been reported: infectious, traumatic, and physicochemical causes. According to the literature, osteitis is grouped into two clinical forms, namely circumscribed osteitis and diffuse osteitis. Their diagnosis is based on a rigorous clinical examination as well as radiographic, histological, and bacteriological examinations. At the Cocody University Hospital's Odontostomatological Consultation and Treatment Center (CCTOS), patients with the late stages of the condition present with significant, disabling, and unsightly osteocutaneous-mucous lesions. Treatment of this osteitis is preventive, curative, and restorative. Odontogenic maxillary osteitis is encountered frequently and typically at a late stage at the Cocody University Hospital's CCTOS. To limit aesthetic and functional damage, raising awareness among African people about oral hygiene and the need for regular consultations should be encouraged.

Introduction.The problem of improving the methods and means of prevention, diagnosis and treatment of maxillofacial inflammatory diseases remains one of the most pressing problems of surgical dentistry. The reason of continued high percentage of patients in the overall structure of dental disease some authors attribute to the rising incidence of atypical forms of inflammation, developing on a background of altered reactivity of the organism and the changing properties of microorganisms, constantly adapting to new conditions of existence. Level of disease prevention is one of the indicators of the nature and level of social- economic, political, scientific-technical conditions in the country. Aim of the Investigation.To identify the main factors that determine the prevalence of acute odontogenic osteomyelitis in industrial city. The Materials and Methods.A retrospective analysis of medical records of patients with acute odontogenic osteomyelitis of the jaws undergoing inpatient treatment for the 2009 - 2013 period, in the department of maxillofacial surgery and surgical dentistry of Zaporozhye. Recording and processing the following criteria of data: diagnosis, age, sex, cause of the disease, the patient's place of residence, length of hospital stay, employed patients, therapy. Results and discussion.During the 2009 - 2013 period in Maxillofacial department of Zaporozhye 482 patients were hospitalized with acute odontogenic osteomyelitis. Average age hospitalized with acute odontogenic osteomyelitis during the analyzed period of time was 37 ± 12,7 years. Residents of the Zaporozhyecity present 78%, 68.9% of them are working people. Analysis showed that the terms of negotiability duration for dental care was after 5 ± 1,3days the onset of symptoms, and in 78% of patients did not suffer. There was an inverse relationship between the number of working patients hospitalized for acute odontogenic osteomyelitis of the jaws, the total number of hospitalizations and length of hospital stay. A retrospective analysis of medical records of maxillofacial department of Zaporozhye showed that against reduction of employed patients we have an increase in the total number of patients with acute odontogenic osteomyelitis. This indicates that the effect of treatment, preventive measures and routine inspections influences the prevalence of the disease. With the continuous monitoring of the dental health of the industrial citylate-seeking patients for dental careare a major cause of acute odontogenic osteomyelitis of the jaws.

OBJECTIVE: The aim of this study was to evaluate the effects of liquid nitrogen cryosurgery on the femoral diaphysis of rats. MATERIAL AND METHODS: The femoral diaphyses of 42 Wistar rats were exposed to three local and sequential applications of liquid nitrogen for 1 or 2 min, intercalated with periods of 5 min of passive thawing. The animals were sacrificed after 1, 2, 4 and 12 weeks and the specimens obtained were processed and analyzed histomorphometrically. RESULTS: The depth and extent of peak bone necrosis were 124.509 µm and 2087.094 µm for the 1-min protocol, respectively, and 436.424 µm and 12046.426 µm for the 2-min protocol. Peak necrosis was observed in the second experimental week with both cryotherapy protocols. CONCLUSIONS: The present results indicate that the 2-min protocol produced more marked bone necrosis than the 1-min protocol. Although our results cannot be entirely extrapolated to clinical practice, they contribute to the understanding of the behavior of bone tissue submitted to different cycles of liquid nitrogen freezing and may serve as a basis for new studies.

OBJECTIVE: The aim of this systematic review was to assess the role of microsurgical reconstruction of the jaws in patients with bisphosphonate-related osteonecrosis, and biological complications after an observation period of at least 12 months. Material and methods: An electronic MEDLINE search supplemented by manual searching was conducted to identify studies reporting data of at least 12 months observation on the microsurgical reconstruction of the jaws in patients with bisphosphonate-related osteonecrosis. RESULTS: Four studies resulted eligible for the analysis yielded. Three out of five studies were free of complications, with a success rate of 100% as no recurrence of osteonecrosis was registered. CONCLUSIONS: Microsurgical reconstruction of the jaws represents a valid treatment modality in patients with bisphosphonate-related osteonecrosis at 3rd stage of the disease.

OBJECTIVE: The aims of this study were to establish parameters in panoramic radiography for interpretation of unilocular radiolucent lesions, and to compare the accuracy of diagnoses given by examiners before and after using these parameters. MATERIAL AND METHODS: In Part I, 12 specialists analyzed 24 images and the diagnostic criteria used by each examiner to make correct diagnoses were used to build a list of basic radiographic parameters for each pathology (ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and idiopathic bone cavity). In Part II, this list was used by 6 undergraduate students (Un), 8 recently graduated dentists (D), 3 oral pathologists, 3 stomatologists, 3 oral radiologists, and 3 oral surgeons to diagnose the corresponding pathologies in the other set of 24 panoramic radiographs (T2). The same analysis occurred without using this list (T1). The method of generalized estimating equations (GEE) was used in order to estimate the probability of making a correct diagnosis depending on the specialty of the examiner, type of lesion, and moment of the evaluation, T1 or T2 (before or after they had access to the list of parameters, respectively). RESULTS: Higher values were obtained for the probability (GEE) of making a correct diagnosis on T2; the group Un presented the highest improvement (14.6 %); no differences between the probabilities were observed either between Un and D, or among the different groups of specialists. CONCLUSIONS: The use of panoramic radiographic parameters did allow improving the diagnostic accuracy for all groups of examiners.

Con el objetivo de describir la evolución del tratamiento de la atrofia alveolar se realiza una revisión bibliográfica actualizada de 25 referencias, se destacan las vestibuloplastias, injertos óseos, biomateriales, implantes endóseos, regeneración ósea guiada y la distracción ósea, que corrigen o compensan la atrofia alveolar con sus indicaciones, ventajas y desventajas.An updated literature review of 25 references was made to describe the development in the treatment of dental alveolar atrophy. Some procedures that correct or compensate alveolar atrophies such as vestibuloplasty, bone grafting, biomaterials, endo-bone implants, guided bone regeneration and bone distraction. Their indications, advantages and disadvantages are set forth.

Entre las múltiples afecciones que se presentan en el complejo bucofacial se encuentra la osteomielitis, una enfermedad ósea poco frecuente, que con el advenimiento de los antibióticos ha dejado de ser un problema de salud para muchos países del mundo. Dada la importancia que tiene su conocimiento para el estomatólogo, se recopilan criterios actuales sobre esta entidad en lo referente a la etiopatogenia, manifestaciones clínicas, diagnóstico y tratamiento, especialmente cuando afecta al maxilar o a la mandíbula. Tomando como base algunas consideraciones generales, y abarcando varios elementos, se exponen las características macroscópicas y microscópicas de las lesiones causadas por esta enfermedad.Among the various affections of the orofacial complex is osteomyelitis, a rare bone disease that, with the introduction of antibiotics, has cesed to be a health problem in many countries. Given the importante of the detection of this disease by the dentist, present criteria on this entity as to etiopathogenecity, clinical manifestations, diagnosis and treatment are collected, specially when the maxilla or the jaw is affected. Taking some general considerations and a number of elements as a basis, some macroscopic and microscopic characteristics of the lesions caused by this disease were set forth in this paper.

Objectives: Cherubism is a congenital childhood disease of autosomal dominant inheritance. This disease is characterized by painless bilateral enlargement of the jaws, in which bone is replaced with fibrous tissue. The condition has sui generis clinical, radiographic and histological features, of which the clinician should be aware for a better differential diagnosis in the presence of a fibro-osseous lesion affecting the bones of the maxillomandibular complex. The purpose of present paper was to review the literature and to report the most important aspects of cherubism in order to facilitate the study of this disease.Material and Methods: Literature was reviewed about cherubism, emphasizing the relevant clinicoradiographic features and treatment. Literature was selected through a search of PubMed and Scielo electronic databases. The keywords used for search were adolescent, cherubism, cherubism/physiopathology, cherubism/treatment, cherubism/radiography. A manual search of the reference lists of the identified articles and the authors’ article files and recent reviews was conducted to identify additional publications. Those studies that described new features about cherubism were included in this review.Results: In total 44 literature sources were obtained and reviewed. Studies that described new features about cherubism physiopathology, diagnostics and treatment were reviewed.Conclusions: Despite the exceptions, cherubism is a clinically well-characterized disease. In cases of a suspicion of cherubism, radiographic examination is essential since the clinical presentation, the location and distribution of the lesions may define the diagnosis. Histopathological examination is complementary. Nowadays, genetic tests should be used for final diagnosis of cherubism.

Se reporta un inusual caso de granulomatosis de células de Langerhans localizado en maxilares en un paciente de 30 meses de edad, quien presentaba además de las lesiones líticas óseas, lesiones de aspecto tumoral en encía palatina y lingual de ambas arcadas dentarias. El examen óseo no arrojaba compromiso de otros huesos. El diagnóstico histológico fue corroborado por el Centro Nacional de Referencia en Anatomía Patológica.A unusual case of Langerhans´ cells is reported, located in maxillae of a 30 months old patients, who, apart from bone lithic injuries, showed injuries of tumoral type in lingual and palatine gingiva of both dental archs. According to bone examination, there weren´t involvement of other bones. Histologic diagnosis was corroborated by National Reference Center in Pathologic Anatomy.