Pyogenic Granuloma of Lower Lip: An Unusual Presentation

Pyogenic granuloma is a benign inflammatory hyperplasia of connective tissue. It depicts an overzealous tissue response to a known stimulus or injury and is commonly found in the gingiva, especially in the anterior maxilla, and rarely on lips, oral mucosa, and tongue. It is commonly seen during the second, third, and fourth decade in females, with predilection in the third decade. This case report depicts the unusual presentation of pyogenic granuloma of the lower lip in an 11-year-old male child following a positive history of trauma and lip biting, which was successfully managed by excision under local anesthesia.

The Shape of Nasopalatine Canal as a Determining Factor in Therapeutic Approach for Orthodontic Teeth Movement—A CBCT Study

The aim of this study was to evaluate the impact of the nasopalatine canal (NPC) shape and its morphometric characteristics on expected teeth movement by assessing the distance to maxillary central incisors (MCIs) according to NPC type. The retrospective study was performed on 133 CBCT images. The following parameters were obtained: the antero-posterior diameter (A-P) of the nasal foramen (NF), canal length, A-P and mediolateral diameter (M-L) of the incisive foramen (IF), and the distance between NPC and MCIs. With the exception of being hourglass-shaped, each NPC shape showed specific impacts of NPC shape on the relationship between NPC diameters at different sections and distances to MCIs. In banana-shaped NPC, a significant correlation was observed for A-P NF diameter, while in cylindrical-shaped NPC, a significant correlation was observed for NPC length. The increase in M-L IF, A-P IF, A-P NF, and NPC length in funnel-shaped NPC may be a risk factor for interventions that could result in teeth movement. According to the results, it seems that the proposed methodological approach for analysis of CBCT slices in the anterior maxilla may offer detailed information that could be an additional tool in planning the procedures that result in expected teeth movement.

Anatomical Patterns of the Nasopalatine Canal and Incisive Foramen in an African Setting – a Cross-sectional Study

Purpose: Surgical procedures revolving around the anterior maxilla are of great interest due to their debilitating facial aesthetics and nerve injury effects if complications arise. Hence, sufficient knowledge concerning the morphology and morphometry of the nasopalatine canal (NPC) and incisive foramen (IF) is necessary to prevent such complications from arising. Materials and Methods: Measurements of the NPC and the IF were carried out on 150 CBCT scans. The maxillary bone thickness anterior to the NPC was measured at 3 levels. Independent t-test and chi-square test were performed to determine the presence of sexual dimorphism. Results: The presence of one Stenson’s foramen was most prevalent. The mean length of NPC was 13.21 ± 3.25 mm with significantly longer canals in males. The most prevalent shape of NPC was cylindrical in sagittal view and a single canal in coronal view. The mean angulation of NPC was 118.42° to the horizontal plane. The average dimensions of the IF were 3.53 mm and 3.07 mm in the anteroposterior and mediolateral diameter respectively while the most common shape was round. The anterior maxillary bone was thicker in males and generally reduced in thickness from the anterior nasal spine superiorly towards the alveolar crest inferiorly. Conclusion: This study highlights the anatomical characteristics of the NPC and IF, with significant sexual dimorphism observed regarding the number of Stenson’s foramina, length of NPC, shapes of the NPC and IF as well as alveolar bone thickness anterior to NPC.

Evaluation of Stress Generated with Different Abutment Materials and Angulations under Axial and Oblique Loading in the Anterior Maxilla: Three-Dimensional Finite Element Analysis

Purpose. The aim of this study was to assess and correlate the stress distribution in an anterior maxillary implant-supported prosthesis with 0°(degree), 15°, and 25° angulated titanium and zirconia abutments using a three-dimensional (3D) finite element analysis (FEA). Materials and Methods. Six FEA models consisting of a dentate anterior maxilla with a single bone-level implant of dimension 4.2 × 10 mm placed in the region of left maxillary central incisor and abutments of dimension 4.2 mm made of titanium and zirconia each with angulation 0° (IA and IB), 15° (IIA and IIB), and 25° (IIIA and IIIB) and ANSYS Workbench software were utilized to design a layered zirconia crown. Unilateral axial and oblique loads of 178 N were applied on the palatal aspect of the crown of left maxillary central incisor. Average von Mises stress values were evaluated in the implant and the peri-implant bone quantitatively and qualitatively. Results. Stress was shown to increase with an increase in angulation in all the areas that were examined. Zirconia abutments showed lesser stress in the implant and surrounding bone than titanium abutments. When compared with the body and apex of the implant, the implant neck values were higher in all models. In between cortical and cancellous bone, the stress recorded was higher in the cortical bone. Conclusion. Within the limitations of this study, straight abutments generated a more uniform and minimal stress in implant and peri-implant bone than angulated abutments. Titanium abutments generated higher stress levels than zirconia abutments. The stresses generated are directly proportional to an increase in abutment angulation, and therefore, straight abutments are most suitable for favourable stress transmission.