Search Results (96)

This study presents a paleopathological analysis of individual T4.2 from the archaeological site of the castle of Zorita de los Canes (Guadalajara, Spain). The individual exhibits ultradolichocephaly and was dated between the 13th and 15th centuries. Based on the context, the individual could have been a member of the military–religious Order of Calatrava. Standard bioanthropological and paleopathological methods were applied. The results indicate a male aged between 45 and 49 years with a maximum cranial length and width of 230 mm and 122 mm, respectively. The cranial index (53%) allows him to be classified as ultradolichocephalic. The remains present craniosynostosis at the sagittal, squamosal and sphenofrontal sutures, together with underdevelopment of the skull base width and a dolichognathic mandible with the possible presence of type III prognathism. The left hemimandible and hemimaxilla display a large amount of tartar covering the occlusal, labial and lingual areas of the teeth completely. The right hemimandible and hemimaxilla exhibit almost no tartar, and some teeth were lost in vivo. In addition, two stab wounds—to the external occipital protuberance and to the left temple—as well as a contused injury in the left tibia, can be observed without evidence of bone remodeling. Differential diagnosis indicates a case consistent with Crouzon syndrome. This individual is of particular significance because he was a possibly knight of the Order of Calatrava who presents a syndromic craniosynostosis consistent with Crouzon syndrome and exhibits lesions, which may suggest that he could have died in battle. Full article

Background: Acute kidney injury (AKI) is a severe condition with high morbidity and mortality. Mesenchymal stem cells (MSCs) and their conditioned medium (MSCs-CM), containing extracellular vesicles (EVs), have shown therapeutic potential. This study evaluates the effects of stem cells from human exfoliated deciduous teeth (SHED) and their conditioned medium (SHED-CM) on cisplatin-induced AKI in an in vivo model. Methods: Male Wistar rats (n = 21) were randomly divided into three groups: a control group (cisplatin-induced AKI without intervention), a SHED group (receiving intraperitoneal SHED injections), and a SHED-CM group (receiving intraperitoneal SHED-CM injections). Kidney weight, urine parameters, histopathology, and injury scores were assessed. Results: SHED-CM treatment significantly improved renal function, with reduced kidney injury scores (1.42 ± 0.18 vs. 2.57 ± 0.23 in the control, p < 0.05). Kidney weight was lower in the SHED-CM group compared to the control (1.12 ± 0.05 g vs. 1.36 ± 0.07 g, p < 0.05). SHED-CM also significantly increased urine volume (2.41 ± 0.19 mL vs. 1.23 ± 0.14 mL in the control, p < 0.01) and reduced urinary protein concentration (27.3 ± 2.1 mg/dL vs. 48.5 ± 3.4 mg/dL in the control, p < 0.05). Histopathological analysis revealed reduced tubular necrosis and inflammation, with SHED-CM showing superior improvement over SHED. Conclusions: SHED-CM demonstrated superior therapeutic efficacy over SHED injection in mitigating cisplatin-induced AKI, likely due to extracellular vesicle-mediated paracrine effects. These findings support SHED-CM as a promising, non-invasive alternative for MSC-EV-based AKI therapy. Full article

Dysfunctions and disorders of the craniomandibular system are accompanied by pathophysiological changes of muscle groups in the throat/neck and facial area, e.g., pain in the jaw and muscles of mastication and disturbance of occlusion, leading to teeth injury (loss of dental hard tissue, fractures/sensibility disorders, etc.). For muscular dysfunctions, even in the context of psychosomatic disorders and chronic stress, hippotherapy is particularly suitable, since it helps actively to relieve muscle tensions. In the current project we combined hippotherapy with progressive muscle relaxation (PMR) to achieve a synergistic effect. The horses used for therapy (two mares and five geldings between seven and twenty-one years old) were especially suitable because of their calm temperament. In two cases, trained therapy horses were used; in five other cases, the patients used their own horses, which were not specially trained. Right from the beginning, the project was accompanied by veterinary support. Conditions of horse keeping (active stable, same-sex groups, no boxes) were assessed as well as the horses themselves prior to, during, and after each therapy unit. In patients, cortisol, as a quantifiable parameter for stress, was measured before and after each therapy unit. From before the start until the end of each therapy unit of 15 min, the heart rate variability (HRV) of both patients and horses was registered continuously and synchronously. In addition, the behavior of the horses was monitored and recorded on video by an experienced coach and a veterinarian. The stress load during the tension phases in the therapy units was low, perceivable in the horses lifting their heads and a slightly shortened stride length. Likewise, the horses reflected the patients’ relaxation phases, so that at the end of the units the horses were physically and psychically relaxed, too, noticeable by lowering their necks, free ear movement, and a decreasing heart frequency (HF). Altogether, the horses benefited from the treatment, too. Obvious stress signs like unrest, head tossing, tail swishing, or tense facial expressions were not noticed at any time. Twenty jumpers served as a control group in different situations (training, tournament, and leisure riding). Full article

Background. Orthodontic extrusion (OE), or forced eruption, is a conservative technique used to recover teeth affected by coronal fractures, traumatic intrusions, or severe caries. It involves applying light, continuous forces to induce vertical tooth movement, promoting tissue remodeling through periodontal ligament stimulation. Materials and Methods. This narrative review included studies investigating OE as a therapeutic approach for the management of deep or subgingival carious lesions, traumatic dental injuries (such as intrusion or fracture), or for alveolar ridge augmentation in implant site development. OE is typically performed using fixed appliances such as the straight-wire system or, in selected cases, clear aligners. Forces between 30 and 100 g per tooth are applied, depending on the clinical situation. In some protocols, OE is combined with fiberotomy to minimize gingival and bone migration. Results. Studies show that OE leads to significant vertical movement and increases in buccal bone height and interproximal septa. It enhances bone volume in targeted sites, making it valuable in implant site development. Compared to surgical crown lengthening, OE better preserves periodontal tissues and improves esthetics. Conclusions. In this narrative review is analized how OE is effective for managing traumatic intrusions and compromised periodontal sites, particularly when paired with early endodontic treatment. It reduces the risks of ankylosis and root resorption while avoiding invasive procedures like grafting. Although clear aligners may limit axial tooth movement, OE remains a minimally invasive, cost-effective alternative in both restorative and implant dentistry. Full article

Background/Objectives: Participation in sports activities is one of the risk factors for traumatic dental injuries. Nevertheless, little data are available in the literature on such problems in persons with disabilities. This study aims to evaluate the prevalence and severity of traumatic dental injuries in athletes with intellectual disabilities and other coexisting chronic diseases, as well as the use of mouthguards and the level of treatment of injuries in this population. Methods: The research was carried out in seven special needs schools. Two calibrated dentists performed dental examinations in 100 subjects practicing sports, aged 8–30 years (study group), and in 128 individuals, aged 8–25 years, who do not perform systematic physical activity (control group). Statistica Software v.10 was used for statistical analysis, with the level of statistical significance at p ≤ 0.05. Results: The majority of individuals had one tooth affected by traumatic injury in the study and control individuals, with the results amounting to 14% and 5%, respectively; the difference between both groups was statistically significant (p = 0.02). Only one athlete used a mouthguard during training and competitions. Restorative treatment of traumatically damaged teeth was performed in six athletes (37%) out of the total sixteen subjects affected by dental injuries from the study group and in two (15%) out of thirteen participants from the controls. Conclusions: This study reveals that dentists should be professionally prepared to meet the special needs of the population with disabilities and chronic disorders to minimize the burden of dental trauma. There is an urgent need for preventive programs for special needs athletes, their parents/caregivers, and trainers concerning the use of mouthguards. Full article

The accurate identification and protection of the lingual nerve during oral surgery are critical to avoid complications such as a loss of taste or sensation and chronic pain. While numerous studies have described the nerve’s anatomy and injury outcomes, no consensus exists on the optimal method to trace its full course. This narrative review systematically examined the literature from 2010 to 2024, using databases like PubMed, MEDLINE, Embase, and Google Scholar. Keywords included “Lingual nerve,” “Course,” “Anatomy,” and “Clinical implications,” combined with Boolean operators. Studies were selected based on defined criteria, and findings were synthesized to highlight key challenges in diagnosing the nerve’s path. This review identifies difficulties at multiple anatomical sites: the foramen ovale, infratemporal fossa, pterygomandibular space, third molar and retromolar regions, premolar/molar areas, floor of the mouth, and anterior gingiva and tongue. Lingual nerve injury, especially during lower third molar surgeries, remains a major concern, often exacerbated by factors like patient age, unerupted teeth, and lingual surgical approaches. Effective prevention hinges on precise anatomical knowledge and meticulous surgical technique. Microsurgical repair remains the primary treatment but often yields unpredictable outcomes. Emerging regenerative therapies show early promise but require further clinical validation. Imaging tools such as magnetic resonance imaging (MRI) and ultrasound may enhance diagnostic accuracy and surgical planning; however, each has limitations in everyday practice. Ultimately, early identification, careful surgical handling, and appropriate imaging support are vital for improving patient outcomes and minimizing the risks of lingual nerve injury. Full article

Background/Objectives: Metabolic dysfunction-associated steatohepatitis (MASH), characterized by liver inflammation, fibrosis, and fat accumulation, can develop into cirrhosis and liver cancer. Despite its increasing prevalence worldwide, there are few established therapies for advanced MASH. We previously demonstrated that stem cells from human exfoliated deciduous teeth-conditioned media (SHED-CM) exerted therapeutic effects in a MASH mouse model. The gut–liver axis is thought to be associated with liver disease progression, and soluble Siglec-9 (sSiglec-9), an immunoinhibitory receptor, is a key protein in SHED-CM that induces anti-inflammatory macrophages and has intestinal epithelial protective effects. Therefore, we evaluated sSiglec-9’s role in intestinal barrier protection in MASH mice. Methods: We evaluated sSiglec-9 effects on intestinal barrier function using in vitro Caco-2 cell monolayers injured by TNF-α and IFN-γ. For the MASH mouse model, male C57BL/6J mice were given a Western diet and high-sugar solution orally; to induce liver injury, CCl4 was intraperitoneally administered for 12 weeks. Mice were treated weekly with 10 ng/g sSiglec-9 or vehicle. Intestinal permeability was assessed by blood 4 kDa FITC-dextran concentration, and intestinal transcriptomes and liver histology were analyzed. Results: sSiglec-9 decreased intestinal permeability and liver inflammation in MASH mice. sSiglec-9 and SHED-CM reduced 4 kDa FITC-dextran permeability in injured Caco-2 cells, and sSiglec-9 significantly reduced intestinal permeability and modulated expression of 34 intestinal genes. The NAFLD Activity Score indicated significantly reduced inflammation following sSiglec-9 treatment. Conclusions: sSiglec-9 may protect intestinal barrier function by mitigating mucosal inflammation. sSiglec-9 treatment may represent a novel therapeutic approach for MASH via gut–liver axis modulation. Full article

Background: The combination of two or more different types of traumatic dental injuries occurring concurrently to the same tooth presents a significant clinical challenge. By focusing on a rare combination of injuries, this case study explores the issues of delayed management of root fractures accompanied by coronal extrusions in immature maxillary permanent central incisors, underscoring the necessity for tailored approaches when guidelines for intervention were unmet. Methods: The case involves an eight-year-old boy who delayed seeking care for approximately a year after suffering trauma to his upper front teeth in a fall accident at school. The clinical examination revealed partial displacement of two maxillary central incisors in an incisal direction, resulting in increased mobility. Radiographs further showed horizontal root fractures in the apical third of both extruded incisors. Encouragingly, the injured teeth exhibited a normal response to electric pulp testing without signs or symptoms of pulpal pathology, suggesting pulp vitality and eliminating the need for root canal treatment. The extruded coronal fragments were repositioned orthodontically using a utility arch. Results: At the 14-month follow-up, the affected incisors were clinically asymptomatic, functionally satisfactory, and esthetically pleasing. Conclusions: Conservative orthodontic management of extrusive luxation concomitant with root fracture in immature permanent teeth may prove effective in select cases, particularly when long-term follow-up and proper oral care are maintained. Full article

Background: Traumatic injuries to the alveolar process and primary teeth in early childhood can have long-term consequences on the development of permanent dentition and eruption pathways. Objective: This case report aims to illustrate the impact of early orofacial trauma on the eruption and development of permanent maxillary incisors and to emphasize the importance of timely interdisciplinary management. Case Presentation: An 8-year-old female patient presented to a pediatric dentistry clinic with delayed eruption of the maxillary anterior permanent teeth. In contrast, her monozygotic twin sister exhibited complete eruption of all permanent anterior teeth, raising parental concern regarding a possible pathological delay. Her medical history revealed orofacial trauma at the age of two, resulting in an alveolar process fracture, avulsion of the primary maxillary left central incisor (tooth 61), and luxation of the primary maxillary right central incisor (tooth 51). A clinical examination demonstrated sufficient arch space without signs of eruption and enamel defects on tooth 52. Radiographic evaluations, including panoramic imaging and cone beam computed tomography (CBCT), confirmed the presence of impacted permanent teeth with structural anomalies suggestive of trauma-related developmental disturbances. Results: The patient underwent a multidisciplinary treatment over a three-year period involving pediatric dentistry, oral surgery, and orthodontics. Management included surgical exposure of the impacted teeth followed by orthodontic traction to guide the eruption and treatment of enamel hypoplasia. Conclusions: This case highlights the long-term consequences of early traumatic dental injuries on permanent dentition development. It underscores the necessity of early diagnosis and a coordinated interdisciplinary approach to optimize outcomes and enhance the long-term oral health and quality of life of affected individuals. Full article

Background/Objectives: Dental avulsion involves the complete displacement of the tooth from its socket and falls into the most severe categories of the various types of traumatic dental injuries. Successful replantation of the tooth depends on various factors such as the time between the event and replantation, as well as the extra-alveolar storage medium and duration. The adoption of the correct handling measures and use of an appropriate storage medium are key factors that affect the long-term prognosis of the avulsed tooth following replantation. This systematic review and meta-analysis aim to determine if Hank’s Balanced Salt Solution (HBSS) is the most effective storage medium to preserve periodontal (PDL) cell viability following avulsion. Methods: A comprehensive review of the literature available was conducted on the 18 November 2024 across three databases, namely EBSCO (including PubMed-Medline), Scopus, and Web of Science. The review was written according to and following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement created in 2009 and updated in 2020. The following PICO question was constructed for the systematic review: “In patients with avulsed permanent teeth, is Hank’s balanced salt solution more effective in preserving periodontal cell viability to increase the likelihood of a more successful replantation than any other storage media technique available?” A meta-analysis was also conducted with the selected studies, and the software used for this was R 4.3.1 (R Core Team (2018)). Results: A total number of 443 articles were found in the initial search. Of these 443, 9 articles were included in the final systematic review and meta-analysis. 6 out of the 9 articles conclude HBSS to be the most superior storage medium for the preservation of the PDL cells, whilst the other three concluded PDL cell preservation was higher in Morinda citrifolia juice, propolis, and coconut water, suggesting a suitable alternative to HBSS. Nonetheless, the meta-analysis indicated that PDL cell viability was significantly higher using HBSS compared to all other storage media. Conclusions: The systematic review and meta-analysis have provided adequate data in favor of the alternative hypothesis, indicating that Hank’s balanced salt solution is the most effective storage medium in the preservation of periodontal cell viability following the avulsion of permanent teeth. Full article

Stressors such as injuries, embryonic instability during development, and higher levels of stress hormones such as testosterone can result in increases in fluctuating asymmetry in reptiles and other vertebrates. Digit asymmetry, digit ratio variability, and skull trait asymmetry such as eye and jaw size have been correlated with stress level in both snakes and lizards. Teeth asymmetry has also been used as a biomarker for stress and brain laterality. Body size is correlated with many potential stressors, yet there has been little research on how body size in reptiles relates to asymmetry. We investigate teeth asymmetry within the lizard family Varanidae, a clade with a diverse range of sizes consisting of the largest living lizard, Varanus komodoensis. Using a landmark/semi-landmark analysis, we derived Centroid Size for 671 pairs of teeth from 13 varanid species, and asymmetry was derived for each pair. Right-biased asymmetry was significantly greater in the upper tooth row, but breaking up tooth positions into further sections did not yield a significant difference. We found a significant positive linear correlation between body size and right-biased teeth directional asymmetry within Varanus, but only when excluding V. komodoensis. This significant correlation may result from fewer potential predators and more potential food items, thus resulting in less overall stress. When analyzed separately, V. komodoensis individuals with <180 mm head length demonstrated a positive, yet non-significant, trend along a similar trajectory to their congenerics with a high goodness of fit. On the other hand, individuals > 180 mm showed a high degree of scatter, with several specimens having pronounced left-biased asymmetry. We suspect that this dramatic change was due to a combination of ontogenetic niche shift, bigger home ranges, a greater susceptibility to negative anthropogenic influences, and/or a male bias in the bigger specimens sampled, but a larger sample size is required to determine if there is statistical significance in these intra-specific trends. Body asymmetry can reflect brain laterality, which may be a potential driver for the teeth asymmetry seen here. Full article

Objective: The canalis sinuosus in the premaxillary region often has accessory canals palatal to the central and lateral incisors. These small anatomical structures are of increasing interest due to numerous case reports of postoperative complications following surgery in the upper anterior region. Methods: This study examined the number, position, and extent of the accessory foramina of the canalis sinuosus in 210 patients. Furthermore, this study examined the distances to neighboring teeth and to the buccal cortical bone in edentulous patients. Three-dimensional tomographic (CBCT) images were created with a resolution of 0.2 voxels and were evaluated using the Osirix MD 11.0 program. Results: The results showed a prevalence of 97% for accessory foramina, confirming them as a clear anatomical structure. Males had significantly more terminal openings of the canalis sinuosus than females, with clustering in the fourth to sixth decades of life. The foramina had a mean extension of 0.9 mm and a mean distance of 4.6 mm to adjacent teeth. Conclusions: This narrow position is particularly relevant for surgical procedures. Greater attention should be focused on larger foramina in implant planning, as postoperative complications are increasingly being described. Foramina and accessory canals should be detected in three-dimensional, navigated implant planning in order to minimize the risk of injury during oral surgery. Full article

Background: In Saudi Arabia, dental trauma is regarded as one of the most important issues affecting schoolchildren. This study evaluated Saudi Arabian schoolteachers’ knowledge, attitude, and practice regarding emergency dental trauma management. Methods: A cross-sectional study was conducted on 263 schoolteachers from 25 schools; 50.9% were females. A questionnaire was used to collect respondents’ personal and professional data and information on managing dental injury scenarios and the respondents’ attitudes toward dental injuries. A multivariate logistic regression analysis was carried out for the independent and outcome variable of inadequate knowledge regarding dental trauma management. Results: Male teachers had better knowledge than female teachers regarding emergency management of avulsed teeth. Compared to female teachers, male teachers would scrub a tooth with a toothbrush to replant it back into its socket if it fell onto the ground and was covered with dirt. Males had a significantly higher percentage of believing it is not teachers’ responsibility to care for tooth injuries in schools. Teachers with teaching experience of 5–10 years had a significantly higher percentage of training in dental emergencies. Teachers with bachelor’s degrees agreed on the need for teacher involvement to save the tooth in a timely manner. Compared to general teachers, physical education teachers would put the tooth back in the mouth and send the child to the dentist immediately if they were hit in the face and the upper front tooth fell out of their mouth. Teachers with a diploma level of education and teachers with a general type of teaching qualification were 2.15 times (CI = 0.98–3.11, p = 0.002) and 3.19 times (CI = 1.71–4.22, p = 0.0001) more likely to have a higher level of inadequate knowledge regarding dental trauma management. Conclusions: There is a need to raise teachers’ awareness and improve their dental trauma emergency management training. Full article

Background: Root fractures are defined as injuries involving dentine, cementum, and the pulp. They are rare, and they account for 0.5–7% of the dental injuries in the permanent teeth. Root fractures may be the result of direct trauma to the teeth or indirect trauma to the oral cavity. Their incidence is highest in the group of adolescent patients aged 11 to 20 years. The purpose of the paper is to review the literature supported by a case series with three different types of root fractures with various healing patterns, though all with successful long-term treatment outcomes. Case series: All presented patients were boys aged 10 to 11 years. Root fractures occurred as a result of direct impact with the teeth by an object. Only one boy had his root-fractured teeth endodontically treated. However, one of the teeth was misdiagnosed with pulp necrosis, and the other became non-vital after additional trauma. Conclusions: Root fractures in young patients have good healing potential. Appropriate and early diagnostic and therapeutic procedures for treating root-fractured teeth are necessary to achieve favorable healing and a good long-term prognosis. Regardless of the pattern of healing of fractured roots and the treatment provided, patients require long-term follow-up and the need to plan a management strategy in case complications occur. Failure of the healing of fractured root is a worst-case scenario, especially in patients of developmental age. In such cases, the primary goal of treatment is to preserve the alveolar ridge until growth is complete. Full article

The aim of this study was to investigate the epidemiology of dental trauma in a public dental clinic in Banja Luka, Bosnia and Herzegovina, from 2019 to 2024. Methods: This research was conducted as a retrospective cross-sectional study. The data were analysed and compared between injured primary and permanent maxillary and mandibular teeth. Results: The review of the dental records revealed 73 patients (49 boys and 24 girls) with TDIs, involving 55 primary and 64 permanent teeth. Most of the patients (27 patients, 36.98%) were aged 7–9 years. The main cause of TDI was falls in both dentitions (81.81% of injured primary teeth and 73.43% of injured permanent teeth). The time of arrival after a TDI for assistance in the dental clinic for most cases was after 24 h in both dentitions, 45.45% of injured primary teeth and 48.43% of permanent teeth. For both dentitions, enamel fractures were the most common injury of hard dental tissues and the pulp, and the necrosis of the maxillary central incisor was the most common complication. Conclusions: It is very important to improve trauma management and increase public knowledge on the way parents seek proper treatment for the TDIs of their children, and in due time. Full article