Hungarian Journal of Dentistry

Incidence and histopathological examination of oral leukoplakia

2024-10-22T11:49:45+00:00

Introduction: Leukoplakia is one of the most common lesions of potentially malignant lesions of the oral cavity. It is important
to clarify the histopathological diagnosis underlying cases clinically diagnosed as leukoplakia, which is crucial in
determining the prognosis and the required therapy.
Material and Methods: 75 patients diagnosed with oral leukoplakia were histologically sampled between April 2021
and April 2024 at the Department of Oral Diagnostics, Department of Dento-alveolar Surgery, Semmelweis University.
Histopathological analysis of the histopathological samples was performed on the basis of hematoxylin-eosin staining
and in selected cases immunohistochemical analysis was performed at the Department of Pathology and Experimental
Cancer Research.
Results and discussion: The 75 patients were classified according to the location of leukoplakia in decreasing order
of frequency: gingiva/ edentulous jaw ridge (n = 26), buccal (n = 16), floor of the mouth (n = 12), tongue (n = 11), palate
(n = 6), lip (n = 2). Multifocal appearance was also seen (n = 2). Histological sampling was usually a partial and not total
excision of the lesion. Histopathological findings were hyperkeratosis (without dysplasia) in 51 cases, 19 cases with mild
dysplasia, 5 cases with moderate dysplasia. There were no cases with severe dysplasia. In 61 cases were homogeneous
and in 14 cases non-homogeneous leukoplakia. Dysplasia was significantly more frequent in clinically non-homogeneous
leukoplakia (p = 0.0088). 32 of the 75 patients were smokers and 43 were non-smokers. Our results showed
that smoking had no significant effect on the presence and severity of dysplasia. Patients were followed up continuously
(6 months follow-up). Average follow-up time: 17.4 months (range: 1–38 months).
Conclusion: Patients diagnosed with oral leukoplakia require histopathological sampling for histopathological examination
and long-term follow-up is recommended to prevent late malignant transformation.

Measuring the hardness via nanoindentation of a fiber-reinforced dental composite in the root canal

2024-10-22T11:49:45+00:00

Introduction: Using short fiber-reinforced composite (SFRC) materials, individualized root posts can be fabricated to reinforce
root canal treated teeth (Bioblock technique). The question regarding this technique is the efficiency of SFRC polymerization
in different depths of the root canals. Additionally, whether the polymerization of SFRC could be improved
with light transmission methods remains a question to be answered.
Materials and methods: 20 plastic teeth (4 groups, n = 5/group) simulating root canal treatments were used for this
research, which). All teeth were restored with SFRC material, starting from 6 mm deep in the root canal till the orifice.
In group 1 and 3, the root canal was filled with SFRC material in layers, while in groups 2 and 4, it was filled in a bulkfill
manner. In group 1 and 3, the SFRC material was light cured through a fiberglass post, whereas in group 2 and 4,
a modified light source was utilized. After embedding and sectioning the samples hardness of the SFRC material at
2 mm intervals in the root canal were measured (1st, 2nd and 3rd layer, from apical to coronal direction).
Results: For the 1st layer, light curing through the fiberglass post (group 3) resulted in significantly higher hardness
compared to the modified light conductor (group 4) in the bulk-fill application method. In the 2nd layer, both group 1 and
3 showed significantly higher hardness compared to group 4.
Conclusion: Illumination through a fiberglass post provides outstanding hardness for SFRC material in bulk-fill application
in the apical and middle layers.

Full mouth rehabilitation of a therapy-resistant epileptic, mentally disabled person with special needs

2024-10-27T16:53:17+00:00

The dental health of those individuals who require special dental care is way worse than the healthy population. In most
cases, they need sedation or general anaesthesia during treatment and also require teamwork of a complex multidisciplinary
team. These people with special needs are mostly young and have no tooth loss, so providing them with the necessary
dental treatment at the right time is highly important.
The patient is a 29 year old male with therapy-resistant epilepsy and mild mental retardation. First, his cooperative
tendency was estimated by providing him with professional dental treatment and taking impressions. As his neurologist
advised, teeth with hopeless prognoses were extracted in general anaesthesia, and also surgical coronal lengthening in
the maxilla and mandible was carried out in the same way. After the conservative dental treatment process, metalceramic
bridges were made using ceramic coverage only on the buccal surfaces. At the four-year control dental visit, even
though he had epileptic seizures more often than before, his denture showed no signs of any damage. In the case of patients
with special needs, estimating the cooperative tendency and creating the proper treatment individually is a must.
In the following article, we present a complex full-mouth rehabilitation of a therapy-resistant epileptic, mentally retarded
person who requires general anaesthesia for some of the treatments.

Prosthodontic treatment of a patient with psoriasis using digital workflow

2024-10-22T11:49:46+00:00

Introduction: Psoriasis is an inflammatory skin disease mainly caused by genetic factors and age. Several risk factors
have been identified: stress, smoking, excessive alcohol consumption, and obesity. Patients with psoriasis who were not
treated in the literature had a significantly higher incidence of certain dental pathological conditions.
Case report: The 58-year-old patient in this case report suffers from psoriasis, for which he is receiving biological therapy.
He had no other influencing factors in his medical history. In 2022, he visited the Department of Restorative Dentistry
and Endodontics of Semmelweis University to prepare his permanent prosthesis. Two prostheses made with digital workflow
were indicated for the maxilla. Both restorations were made of monolithic full-contour zirconia. For the upper right
posterior region, a 4-unit bridge was produced using CAD/CAM technology with the abutment teeth of 17 and 14. In the
anterior region, the patient had three implants (13, 11, and 21), therefore, a 5-unit screw-retained bridge restoration with
a titanium base was designed. After removing the temporary prosthesis, the abutment teeth were shoulder-prepared, and
the scanbodies were fixed into the implants, followed by the precision-situational and antagonistic scans. Before scanning,
the exact fit of the scanbodies was also checked on radiographs. The habitual bite was retained and transferred to the final
intercuspid position using the software used. The finished dentures were first checked on the 3D-printed model and then
tried in the mouth. The bridge is anchored on the implants by one screw for checking the passive fit in radiographs. Then
the bridge was fixed by all screws using 35Ncm. The patient did not report any discomfort during the short and long-term
check-ups, the prostheses functioned well, and the patient maintained good oral hygiene.
Conclusion: Nowadays, digital workflow is a predictable procedure for fixed and implant-anchored restorations. Patients
undergoing biological therapy are treated with particular care; it is always essential to consult the patient’s primary
care physician, especially when invasive procedures are involved.

Restoration of a molar tooth using hybrid ceramic overlay

2024-10-22T11:49:45+00:00

Thanks to developments in dental CAD/CAM technology, a variety of materials are now available for dental restorations,
including different types of hybrid ceramics, also known as resin matrix ceramics. Hybrid ceramics are characterized by
their inorganic ceramic content and varying proportions of organic polymer content. Additionally, the structure and composition
of the ceramic grains differ across products. Hybrid ceramics are primarily utilized for individual restorations,
such as crowns, veneers and inlays/onlays/overlays. This case study presents the use of Vita Enamic (Vita Zahnfabrik,
Germany) hybrid ceramic overlay for restoring a lower root canal treated molar tooth. Overall, hybrid ceramics are considered
suitable for the mechanical and aesthetic restoration of teeth.

Prosthodontic rehabilitation with overdenture based on gerostomatological principles

2024-10-22T11:49:46+00:00

Introduction: Gerostomatology is a medical discipline dealing with the dental care of elderly patients. With advancing
age, changes in tooth structure and tooth loss have a major impact not only on the oral health but also on general health.
The loss of teeth in patients’ life leads to reduced chewing and swallowing ability which affects the digestive system. In
addition, a less aesthetic appearance and difficulties in speech affect the psychological state of the individual and impair
the quality of social life.
Case report: 70-year-old female patient with gerostomatological factors affecting dental treatment. She was dissatisfied
with her previous dental prosthesis made according to the dysgnath bite form, in particular mandibular prognathism.
After professional oral hygiene treatment and restorative dental procedures the final prosthodontic treatment plan was
an upper and lower telescopic overdenture. Facebow and an intraoral central bearing device were used to determine the
centric relation position during the procedures.
Summary: In developing societies, the role of dentists is increasingly valued in improving the quality of life of the elderly,
whereas a well-functioning, aesthetic prosthodontic treatment has an impact on many aspects of our patients’ lives.
Overdentures seem to be an ideal choice as a prosthodontic treatment, they meet the requirements of gerostomatology.

Prosthodontic care and management of patients with MRONJ from different microbiological backgrounds

2024-10-22T11:49:46+00:00

Medication-related osteonecrosis of the Jaw (MRONJ) is a severe condition of multifactorial origin, with its exact etiological
factors still not fully understood. Besides bisphosphonates, many other drugs are responsible for the development of
this condition. The etiology of MRONJ is not precisely known, but infectious origins are being attributed to greater significance.
Recently, several authors have highlighted the potential role of Actinomyces strains in the disease course.
This publication presents the prosthetic rehabilitation of two MRONJ patients with different microbiological backgrounds
and thus different treatments. One patient received solely surgical therapy, while the other underwent both surgical and
long-term conservative treatment, resulting in recovery for both. Both patients regularly attend follow-up appointments,
show no signs of MRONJ recurrence, and are satisfied with their dental prostheses both functionally and aesthetically.