Archives

  • Management of penetrating arrow injury of the maxillofacial region, case report
    Vol. 37 No 1 (2024)

    An arrow maxillofacial penetrating injury is an unusual traumatic injury sometimes encountered in developing countries. This rare injury has the potential to be dangerous because the arrow is deeply lodged in maxillofacial region crossed by major vessels, and because damage to one of these vessels should always be suspected. Furthermore, removal of a foreign body may result in complications such as massive bleeding or iatrogenic injury to adjacent structure and complications should always be considered in maxillofacial region. We describe a case of a patient who presented with maxillofacial penetrating arrow injury and analyze the problems faced in its management with emphasis on diagnostic imaging, on surgical planning and on careful surgery management.  

  • Cutaneous cervical metastasis from an esophageal adenocarcinoma mimicking a dental cervical cellulitis: A case report
    Vol. 36 No 1 (2024)

    Cutaneous metastases occur in 0.5 to 9% of all cancers. Esophageal cancer is one of the most aggressive cancers worldwide. Most cutaneous metastases from esophageal cancer were related to squamous cell carcinomas. Few cases have been described about cutaneous metastases related to esophageal adenocarcinomas. These metastases mostly affect patients over 60 years-old, and present as cutaneous asymptomatic nodules.

    A 69-year-old male presented with a painless and extensive left neck cutaneous induration and erythema. The lesion that was initially diagnosed as a dental cervical cellulitis by his dental practitioner. The patient was known since 2019 to suffer from a esophageal adenocarcinoma whose first treatment was surgery. The patient was currently under immunotherapy for a local recurrence.

    We firstly assessed the uncommon cervical cellulitis by carrying out an injected head and neck computed tomography (CT) scan which showed an unspecific skin, dermal and muscular infiltration of the left cervical region. The 18-FDG PET/CT demonstrated a suspicious fixation of the neck that was followed by a skin biopsy. The histological and immunohistochemical examination showed the metastatic adenocarcinomatous origin of the cervical skin lesion. The patient was upstaged to a stage IV of his esophageal cancer and started palliative chemotherapy.

    Special attention must be paid in case of diffuse cervical skin infiltrations, even in the presence of a dental infection, in patients with cancer, in order to perform the correct diagnosis.

  • Solitary median maxillary central incisor syndrome: cone beam computed tomography illustrated review
    Vol. 35 No 1 (2024)

    The solitary median maxillary central incisor syndrome (SMMCI) is a rare autosomal dominant genetic syndrome characterized by the presence of a single central incisor positioned along the midline in both primary and permanent dentition. It is often associated with the holoprosencephaly spectrum, a group of brain and facial malformations. The etiopathogenesis of SMMCI is believed to involve embryonic developmental defects occurring between the 35th and 38th day of gestation, primarily affecting midline facial structures. Several genetic factors, including mutations in the Sonic Hedgehog gene on chromosome 7 and other genetic variants, have been implicated in SMMCI development. Diagnosis is typically made through clinical examination, prenatal ultrasound, and postnatal dental evaluation. Management of SMMCI requires a multidisciplinary approach involving pediatricians, otolaryngologists, neuro-pediatricians, and genetic counselors. Dental interventions may include extraction and space maintenance, orthodontic treatment, prosthodontic options, or esthetic considerations. Further research is needed to understand better the underlying mechanisms and genetic factors associated with SMCI, which will contribute to improved diagnosis and management of this syndrome.

  • An airgun projectile in the maxillary sinus of an adult: a case report
    Vol. 34 No 1 (2024)

    Gunshots with non-powder weapons are relatively common in children, and most of them occur unintentionally. This paper describes the second known case of an adult male in whom a shot from an airgun resulted in the presence of a projectile within the maxillary sinus. A 47-year-old man was shot inadvertently about 10 years earlier and was asymptomatic at the time of reporting. The presence of a foreign body detected on a routine orthopantomogram was confirmed by a medical interview and a three-dimensional radiological examination. The pellet located in the right maxillary sinus was removed from intraoral access through the anterior wall of the sinus. The course of the surgical procedure was complicated by the projectile dislocation in relation to the position determined by radiological examinations. Postoperative care and a 4-year follow-up period were uneventful. The maxillary sinus may be considered a favorable location for a persistent projectile, which may reside in the maxillofacial region asymptomatically for many years. The foreign body may move loosely in the maxillary sinus, which should be taken into account when planning an operation.

  • Taurodontic teeth in cone beam computed tomography: pictorial review
    Vol. 33 No 1 (2023)

    Objective: Taurodontism is a developmental disorder with enlargement of the body of the tooth and lack of cervical constriction, which results in a large pulp chamber and small roots with the apical displacement of furcation. Taurodontism exists in deciduous, and definitive unilateral, and bilateral teeth. We found that taurodontism was also described in 67 syndromes. We proposed a review of the open access literature on taurodontism, a new clinical classification of taurodontic teeth with illustrations from free open access literature, and from our case serie of 15 patients.

    Material and methods: We performed a systematic search for articles with free full text about taurodontism. The search was performed by one observer in PubMed database. We found 168 articles, and after application of inclusion/exclusion criteria we finally selected 136 articles for the review.

    Results: we provided 34 figures of taurodontic teeth related to: 1) Unilateral mandibular first premolar, 2) Unilateral mandibular second premolar, 3) Bilateral mandibular first and second premolar, 4) Bilateral upper maxillary first premolars, 5) Bilateral mandibular second molars, 6) Bilateral upper maxillary second premolar and left first molar, 7) Bilateral upper maxillary third molars, 8) Bilateral upper maxillary first and second molars, 9) Bilateral upper maxillary first, second, and third molars, 10) Bilateral upper maxillary molars (third molars, second, and first left upper molars), and mandibular molars (first right, and left mandibular molars, right third molar), 11) Bilateral upper maxillary molars (first, second, third right, and left upper molars), and mandibular molars, 12) Unilateral first mandibular premolar with cleft, 13) Bilateral molars of the mandible and the upper maxilla (adolescent patient who received chemotherapy at the age of 3-years-old to treat retinoblastoma), 14) Unilateral first maxillary molar (Treacher-Collins syndrome).

    Conclusions: We proposed a new clinical classification of taurodontic teeth based on hypo-, meso-, and hypertaurodontism, and on different types of deciduous, and definitive teeth (42 boxes). We were first to provide free reference images for: 1) upper maxillary second premolar hypertaurodontism, 2) mandibular second premolar mesotaurodontism, 3) upper maxillary third molar meso-and hypertaurodontism, 4) mandibular first molar hypotaurodontism, 5) mandibular third molar mesotaurodontism. We were also first to freely illustrate taurodontism related with chemotherapy, cleft palate patients, and Treacher-Collins syndrome.

  • Le syndrome de Langenbeck: quelles répercussions sur la cinétique mandibulaire ?
    Vol. 32 No 1 (2023)

    Le syndrome de Langenbeck ou hyperplasie des processus coronoïdes mandibulaires est une maladie rare caractérisée par une augmentation de volume des processus coronoïdes. Cette hyperplasie entraîne un conflit osseux limitant l’ouverture buccale. Ce syndrome doit être connu des cliniciens car il entre dans le diagnostic différentiel des limitations d’ouverture buccale. Nous présentons un cas traité avec succès dans notre service. Une prise en charge efficace comporte un versant chirurgical et kinésithérapeutique, qui sont discutés dans notre publication.

  • Sphenopalatine ganglion block with botulinum toxin type A using a three-dimensional injection guide for facial pain of cancerous origin: study of a clinical case.
    Vol. 31 No 1 (2023)

    Objective: Sphenopalatine ganglion block remains a noninvasive therapeutic option to treat diverse facial pain syndromes. The aim of this case report was to verify the effectiveness and safety of three-dimensional (3D) injection guide for sphenopalatine ganglion block in a tongue cancer patient.

    Case report: A 53-year-old man presented with a large squamous cell carcinoma of the right base of the tongue, classified cT4N2M0 and exhibiting excruciating facial pain. A botulinum toxin injection was performed following Dr. Yoshida’s method, using a 3D injection guide.

    Conclusions: Sphenopalatine ganglion block with 3D injection guide can be an effective treatment against cancer pain. In this case report a complete withdrawal of painkillers was obtained less than 24 hours after botulinum toxin injection.

  • Roadmap for daily practice of CBCT in cleft lip palate paediatric patients: a pictorial review.
    Vol. 30 No 1 (2023)

    Objective: to present and to illustrate a new methodology for daily practice in cone beam computed tomography (CBCT) interpretation and reporting in cleft lip palate (CLP) non syndromic paediatric patients. The proposed protocol is based on clinical experience and on systematic search of the literature.

    Material and methods: We performed two types of systematic search of articles: 1) articles related to the use of CBCT in CLP patients, and 2) articles related to the reporting and interpretation of the CBCT images by radiologists. We used two databases PubMed and Google scholar.

    Results: For indications of CBCT in CLP patients we found in PubMed 378 articles and 48 articles were selected for the review; in Google scholar we found 463 articles, and 9 articles were selected for the review. 2) For reporting in CBCT we found 956 articles in PubMed, and 9 articles were selected for the review.

    Conclusions: We presented the 6-steps system for interpretation and reporting information from CBCT of CLP paediatric patients: 1) Step 1 (axial view): presence or absence of bone bridge remnants of alveolar bone graft; Step 2 (3D dental tissue reconstruction): description of dental arch tooth, search for agenesis and supernumerary teeth, description of variation in the position of the tooth explaining the type of existing translation and rotation; Step 3 (coronal view): cleft palate pathway and its extension; anomaly in maxillary, ethmoid and sphenoid sinuses if existing; Step 4 (sagittal and coronal view): checking of the opening (calcification sites) of the sphenooccipital synchondrosis, and checking of anomalies of the occipital bone; Step 5 (3D bone tissue reconstruction): C1-C2 vertebra anomalies; Step 6 (3D soft tissue reconstruction): external ear anomalies. We illustrated our methodology with 46 figures from 5 CBCT of CLP patients.

  • Central mucoepidermoid carcinoma of the maxilla, a challenging diagnosis
    Vol. 29 No 1 (2023)

    Objective: To present a pictorial review on central mucoepidermoid carcinoma.

    Case report: Central mucoepidermoid carcinoma (CMEC), also known as intraosseous mucoepidermoid carcinoma (IMEC), is an extremely rare disease (less than 2-4% of all MEC). However, CMEC is the most frequent malignant salivary gland tumour found in intraosseous locations. Due to this unusual location, diagnosis of CMEC can be challenging. Therefore, CMEC is often mistaken for other intraosseous or odontogenic pathologies. Radiological assessment should include panoramic X-Ray, CBCT and thoracic CT, which should be performed after diagnosis. The recommended treatment includes radical resection surgery, followed by radiotherapy if indicated. A long-term follow-up is recommended for up to 10 years.

    Conclusion: The authors experienced the challenging diagnosis of CMEC through the case of a patient who presented with a slowly growing palatal mass.

  • Paracondylar process and epitransverse process on cone beam computed tomography: a pictorial review based on a serie of 9 patients
    Vol. 28 No 1 (2023)

    Objective: Paracondylar (PCP) and epitransverse processes (ETP) represent rare types of articulations that can occur between the occipital bone and the transverse process of atlas vertebra.

    Material and methods: Five systematic search strings were conducted on PubMed database on 14.01.2022. The search was conducted by one observer to identify studies on PCP, and on ETP in living patients. Open and close access articles were selected as this topic is infrequently described in the main medical literature.

    Results: We provided with a pictorial review of 1) Paracondylar tubercle, 2) Unilateral PCP with cylindrical shape, 3) Unilateral PCP with pyramidal shape, 4) Unilateral PCP with lateral joint with transverse process, 5) Unilateral PCP with superior joint and partial fusion with transverse process, 6) Unilateral ETP with neo-condyle and joint with occipital condyle, 7) Unilateral ETP with joint with occipital bone, 8) Unilateral ETP with a bony bridge with lateral mass (ponticulus lateralis), and 9) Bilateral variation: paracondylar mass and ETP.

    Conclusions: Six figures were found in the selected literature and belong only to articles published in closed access. We provided with additional 41 open access freely available figures. We were first to present CBCT reference figures of: 1) Unilateral paracondylar tubercle, 2) Fusion of PCP with the transverse process of C1, 3) Joint between ETP and the lateral side of occipital condyle, and 4) Presence of bony bridge (ponticulus lateralis) between ETP and the lateral mass of C1. We were also first to describe a bilateral mixt variation with paracondylar mass on one side and ETP on the other side of C1. An open and accessible knowledge support (such as Nemesis journal) is needed to easily find clinical reference CBCT figures of craniocervicofacial bone variations.

  • New bone formation in the mandibular corpus after mucosal healing in a patient with medication related osteonecrosis of the jaw after treatment by bisphosphonates for multiple myeloma: a case report and pictorial review
    Vol. 27 No 1 (2022)

    Objective: First cases of osteonecrosis of the jaw in patient exposed to bisphosphonates were presented in 2003. Bisphosphonates related osteonecrosis of the jaw (BRONJ) was further extended to medication-related osteonecrosis of the jaw (MRONJ) to include antiresorptive and anti-angiogenic drugs. Some directives were described for the treatment of this disease in function of its gravity. Treatments of high stage of MRONJ are subject to discussion because of their morbidity. Complete healing is difficult to reach and often needs combination of invasive and non-invasive treatment.

    Case report: We report and illustrate a clinical case of new bone formation after MRONJ on pamidronate and zoledronate treatment for multiple myeloma. The treatment of choice was sequestrectomy and conservative treatment.

    Discussion: The consensus to reach a complete healing after MRONJ is not already known. More studies are needed.

  • Publications de chirurgie orale et maxillo-faciale dans les pays à ressources limitées en Afrique sub-saharienne : revue de la littérature.
    Vol. 26 No 1 (2022)

    Objective: To determine the subjects and content of publications produced by oral and maxillofacial surgeons practicing daily in less resourced countries in sub-Saharan Africa (SSA). 

    Materials and methods: We used two databases, PubMed and African online journals, for this literature review. We limited our research to the years 2000-2022. We have chosen the articles with the abstract and only in English or French. For each article we looked for the country of origin, the language of the article, the accessibility of the articles; the name of the newspaper, the number and type of illustrations. For each open access article, we looked for the method of payment for publication and the assignment of copyright. We found 1761 articles and finally retained 47 articles.

    Results: Publications from SSA countries are very rare among all publications from the African continent (47/1761= 2.6%). All selected articles were published in 33 different newspapers. 46.8% of articles were written by authors from Tanzania and Sudan. Open access articles represent the majority of published articles (59%). Closed access articles are related to Noma and articles in French. We identified only two scientific journals, African Health Sciences and South Sudan Medical Journal, which were free to readers and authors. The English language was predominant (85%). 53 images were freely accessible to illustrate all the subjects of oral and maxillofacial surgery in SSA countries. We also presented the conclusions of the articles by classifying them by subject: 1) Tumors (13 articles), 2) Traumas/maxillofacial fractures (11 articles), 3) Clefts (4 articles), 4) Infectious diseases (5 articles), 5) Cultural practices (4 articles), 6) Noma (2 articles), 7) Syndromes (5 articles), and miscellaneous subjects (3 articles).

    Conclusions: We presented the system of current scientific publications, the place of scientific publications and the particular aspects of publications on maxillofacial surgery in SSA countries, we proposed possible directions of publication for authors maxillofacial surgeons in SSA countries, as well as the potential place of the journal Nemesis in this African context.

  • Cone beam computed tomography (CBCT) in pediatric dentistry
    Vol. 25 No 1 (2022)

    Objective: The aims of this systematic review of the literature were to investigate the uses of cone beam computed tomography (CBCT) in pediatric dentistry and, if possible, identify the indications.

    Material and methods: A literature search was conducted using the PubMed and Scopus electronic databases and the keywords "CBCT and pediatric dentistry". This search provided us with 1518 references. The selected publications were all clinical articles written in French or English and referring to a pediatric population. After screening, 461 eligible full text articles remained.

    Results: In total, there were 169 references that met the inclusion criteria. Different topics, mainly relating to orthodontics, anatomy, and cleft lips and palate, were discussed. There was large variability in the information concerning the technical parameters. The radiographic protocols that we analyzed showed a large heterogeneity.

    Conclusions: The level of evidence provided by our work is limited because only two randomized double-blind controlled studies are included. Two indications can be distinguished: for orthodontics and for the rehabilitation of cleft lips and palate. There are a multitude of radiographic protocols. More research is needed to identify other potential clinical indications as well as to determine a standard CBCT protocol for children and adolescents.

  • Jael’s syndrome: knife blade impacted in the facial skeleton: an illustrated case report and a review of literature
    Vol. 24 No 1 (2022)

    Objective: This article focuses on the penetrating trauma of the facial mass caused by the knife with retention of the blade fractured in the facial skeleton.

    Case report: We describe preoperative, intra-operative and post-operative outcomes of the knife stabbing in the face, and of the surgical removal of the broken 8cm long blade using two dimensional, and tridimensional computed tomography, and clinical iconography

    Conclusions: We provide the readership with a broader perspective on iatrogenic facial trauma caused by blades with examples from history of medicine, with biomechanical focus, as well as a review of literature on the management, and on the surgical treatment outcomes of such infrequent emergency in maxillofacial surgery.

     

  • Diagnostic value of cone beam computed tomography in complex and compound odontomas: a systematic review and open classification matrix
    Vol. 23 No 1 (2022)

    Objective: Firstly, this review aims to analyse the recent literature about three-dimensional (3D) diagnostic imaging in complex and compound odontomas and compare it to two-dimensional (2D) imaging. Panoramic radiographs help to evaluate the vertical position of odontomas, and occlusal radiographs are used to evaluate the proximity to adjacent teeth. However, cone beam computed tomography (CBCT) can offer volumetric images, and therefore, a more accurate three-dimensional analysis. Secondly, this research aims to construct an open classification matrix for complex and compound odontomas for dentomaxillofacial CBCT radiology protocols based on a systematic literature review.

    Material and methods: Two systematic literature searches were conducted in PubMed (Medline), on 2 February 2022 concerning classification systems, and on 5 February 2022 concerning CBCT images.

    Results: In total, these searches revealed 391 papers by reviewing the databases mentioned above. Six articles were selected for inclusion on classification of odontomas and 13 articles were found on CBCT imaging. Consequently, the construction of an open classification matrix for compound and complex odontomas for dentomaxillofacial CBCT radiology protocols was performed using these 19 articles.

    Conclusions: CBCT offers a more precise position and accurate diagnosis of complex and compound odontomas compared to 2D imaging. Consequently, it enhances the detailed view of the site (multiple or unique), location (intraosseous, partially or completely extragnathic), size, extension (bony expansion, thinning or perforation cortical bone), density and type (denticulo type, particle type, denticulo-particle type, denticulo-amorphous type, amorphous tissue), relationship (with the crown or root of the definitive tooth), adjacent teeth resorption (deciduous or definitive), adjacent teeth (retention or impaction), and distance with adjacent structures (inferior alveolar nerve, sinus maxillaris), as well as adequate surgical planning. Moreover, this research presents an open classification matrix for the most complete description of compound and complex odontomas when analysing CBCT imaging.

  • Carpenter syndrome: cone beam computed tomography pictorial review
    Vol. 22 No 1 (2022)

    Objective: To describe dentoalveolar findings in one pediatric patient with a very rare Carpenter syndrome or acrocephalopolysyndactyly type II, and using cone beam computed tomography (CBCT).

    Case report: We found a syndromic oligodontia, upper canine transmigration, and an exceptional agenesis of four lateral incisors. We also described the fourth case in the literature of a single solitary lower incisor on the midline, and the first case ever illustrated on CBCT.

    Conclusions: We proposed and illustrated the use of the system of progressive numbering of teeth on CBCT axial views to better understand complex dental clinical situations such as syndromic oligodontia.

  • Supernumerary teeth in premolar and molar area on CBCT: a pictorial review.
    Vol. 21 No 1 (2022)

    Objective: to build a descriptive classification of premolar and molar supernumerary teeth (ST) when preparing the cone beam computed tomography (CBCT) report. The aim is also to share wide range of CBCT images in the open access publishing model. Material and methods: For our review we systematically searched for articles from PubMed with 1) free full texts on ST in molar and premolar area and using CBCT, and 2) articles providing with information on complications related with the presence of ST in molar and premolar area. We also added to our review studies providing with classic ST classifications in premolar and molar area. Results: We found 29 cases of ST, and we freely illustrated them with 84 figures. We separated our pictorial review in: 1) unilateral ST in the mandible, 2) unilateral ST in the maxilla, 3) unilateral undersized ST, 4) bilateral ST, 5) ST with additional features, and 6) cases with major hyperdontia. Conclusions: we build up the classification matrix for premolar and molar ST with 11 descriptors and 50 boxes. The descriptors were: 1) location if the ST crown in axial view, 2) vertical location of the cusp tip in relation with closest erupted tooth in coronal view, 3) shape, 4) distribution, 5) Position (in relation to normal tooth eruption) in sagittal view, 6) State of eruption of the ST in the sagittal view, 7) Follicle size measurement in sagittal view, 8) External root resorption of adjacent teeth by ST and its location in relation to the long axis of the involved tooth, 9) Internal resorption of ST, 10) Adjacent tooth complication, and 11) Damage to surrounding structures if ST removal. The open access figures from the literature illustrated 11 boxes. With our pictorial review we were able to illustrate 45 out of 50 boxes, and freely provide the readership with the most complete description of ST in premolar and molar area on CBCT than in previously published studies.

  • Dental use of cone beam computed tomography in pediatric embolized arteriovenous maxillofacial malformation
    Vol. 20 No 1 (2021)

    Objective: Pediatric facial arteriovenous malformations (AVMs) are rare but can cause potentially fatal hemorrhages during dental procedures and oral surgery. In this article we present a systematic review of the medical open access literature on pediatric facial AVM.

    Case report: We illustrate our purpose with clinical dental use of cone beam computed tomography (CBCT) in pediatric embolized facial AVM to define the presence and the position of the right upper impacted canine.

    Conclusions: We advocate the use of CBCT as additional imaging tool in the follow-up of pediatric dentomaxillofacial AVM, and for depiction of dentoalveolar structures that are inaccessible by conventional dental radiography.

  • Mucosal necrosis of the palate after embolization for labial arterioveinous malformation
    Vol. 19 No 1 (2021)

    Objective: Cervico-facial arteriovenous malformations (AVMs) are complex and rare vascular lesions, and present in 0.1% of the population. Of traumatic or congenital origin, they are characterized by variable growth, and their complications can be disfiguring and potentially fatal. The treatment of choice is embolization followed by surgery if necessary. The main complications are recurrence and postoperative bleeding.

     Case report: We report the rare case of a 59-year-old female patient who underwent embolization of a right upper labial and jugal AVM, followed by complete necrosis of the right hemi-palatal mucosa associated with dental mobility and pain. Follow-up at 6 months showed complete reepithelialisation of the palate.

    Conclusions: Soft tissue necrosis after AVM embolization is a rare event and is more commonly described after embolization for epistaxis. The evolution is generally favourable within a few weeks.  

     

  • Cone beam computed tomography in the diagnosis of Stafne bone cavity: Report of seven cases and review of the open-access literature.
    Vol. 18 No 1 (2021)

    Stafne bone cavity (SBC) is a rare entity to find on panoramic radiography and on cone beam computed tomography. We reviewed in a systematic way the open-access literature from PubMed and DOAJ. We also proposed a new methodology consisting of collaboration with private practitioners, application of participative science approach, and open science practices, and using social media tool to obtain and describe seven different cases of SBC. We finally propose a new matrix table for classification of anatomical types of SBC already described and those yet to be described in open-access literature.

  • Medical and dental hidden treasures and secrets of 2700-year-old Egyptian mummy: Osirmose - the doorkeeper of the Temple of Re.
    Vol. 17 No 1 (2021)

    Objective: To perform a ‘virtual autopsy’ on the Egyptian mummy and to study, understand, and interpret three-dimensional (3D) high-resolution computed tomography (CT) scan images of Osirmose’s mummy with a multidisciplinary team composed of radiologists, archaeologists, and oral and maxillofacial surgeon.

    Material and methods: We studied the Osirmose’s mummy, the doorkeeper of the Temple of Re, who lived during the XXVth dynasty. His mummy belongs to the Royal Museum of Art and History (Inv. E.5889). We performed a high resolution CT scanning of Osirmose’s mummy. We also 3D printed the upper maxilla of the mummy and a tooth found in the oesophagus with a clinically validated low-cost 3D printer.

    Results: We confirmed the male sex of the mummy. We found the heart, aorta, and  kidneys inside the mummy’s body. Brain excerebration was performed through the right ethmoid bone pathway. A wood stick embedded in the dura mater tissue was found inside the skull. The orbicularis oculi muscle, internal canthus, optical nerves, and calcified eye were still present. Artificial eyes were added above the stuffing of eye globes. The skull and face were embalmed with multiple layers of inner bandages in a sophisticated manner. The wear of maxillary teeth was asymmetrical and more pronounced on the maxilla. We discovered three anomalies of the upper maxilla: 1) a rectangular hole on the palatine side of tooth n°26 (the palatine root of tooth n°26 was missing), 2) an indentation at a right angle palatine to tooth n°27, and 3) a semilunar shape of edges around the osteolytic lesion distal and palatine to tooth n°28.

    Conclusions: The present study provides the first evidence of a tooth removal site, and of oral surgery procedures previously conducted in a 2700-year-old Egyptian embalmed mummy. We found traces of dental root removal, and the opening of a tooth-related osteolytic lesion before the person’s death. The multidisciplinary team, the use of a high resolution 3D CT scan and a 3D-printed model of the upper maxilla helped in this discovery.

  • Déplacement accidentel de la dent de sagesse maxillaire dans le vestibule jugal antérieur
    Vol. 16 No 1 (2021)

    Les déplacements accidentels des dents de sagesse du maxillaire supérieur dans divers régions anatomiques sont rares. Nous avons effectué la recherche de littérature sur ce sujet de manière systématique en utilisant PubMed et DOAJ. Il n’existe pas d’illustration accessible gratuitement pour les voies de déplacements accidentels des dents de sagesse supérieurs imagées par le CT scan ou par le CBCT à part le déplacement vers la fosse infra-temporale et vers la fosse ptérygopalatine. Nous décrivons et illustrons par CBCT un cas unique dans la littérature médicale de déplacement accidentel du germe de la dent de sagesse du maxillaire supérieur dans l’espace jugal antérieur. Les raisons potentielles, les conséquences ainsi que les moyens de prévention de cette rare complication d’extraction de dents de sagesse sont aussi expliquées.

  • Open access resources on motion artifact in adult dentomaxillofacial CBCT: illustrated pictorial review of medical literature
    Vol. 15 No 1 (2021)

    Objective: to know how much open access/open knowledge reference figures were available on motion artifacts in CBCT dentomaxillofacial imaging, and to describe and to categorize clinical variation of motion artifacts related to diverse types of head motion retrospectively observed during CBCT scanning time.

    Material and methods: a search equation was performed on Pubmed database. We found 56 articles. The 45 articles were out of scope, and 7 articles were excluded after applying exclusion and inclusion criteria. Only 4 articles were finally freely accessible and selected for this review. Moreover, we retrospectively used our department CBCT database to search examinations with motion artifacts. We also checked retrospectively for radiological protocols as the type of motion artifact was described when occurred during the CBCT scanning time by the main observer. We had obtained the approval from the Ethical committee for this study.

    Results: The accessibility of free figures on motion artifact in dentomaxillofacial CBCT is limited to 13 figures not annotated, and to one annotated figure presenting a double contour around cortex of bony orbits. We proposed to categorize the motion artifacts into three levels: low, intermediary, and major. Each level was related to: 1) progressive image quality degradation, 2) distortion of anatomy, and 3) potential possibility of performing clinical diagnosis. All 45 figures were annotated.

    Conclusions: There exists a scarce open access literature on motion artifacts in CBCT. In our pictorial review we found that low level motion artifacts were more related to head rotation in axial plane (rolling). Rolling and lateral translation were responsible of intermediary level motion artifacts. Major level motion artifacts were created by complex motion with multiple rotation axes, multiple translation directions, and by anteroposterior translation. The main limitation of this study is related to retrospectively report empirical observation of patient motion during CBCT scanning and to compare these observations with motion artifacts found on clinical images. More robust methodology should be further developed using a virtual simulation of various types of head movements and associated parameters to consolidate the open knowledge on motion artifacts in dentomaxillofacial CBCT.

  • Contribution of dental private practitioners to publications on anatomical variations using cone beam computed tomography
    Vol. 14 No 1 (2020)

    Objective: To investigate the participation of citizens-dental private practitioner in scientific articles about anatomical variations on dentomaxillofacial CBCT. Our null hypothesis was that private practice practitioners are not involved in publications on anatomical variations using cone beam computed tomography.

    Material and methods: This study was performed from home without access to our university library. Only PubMed database was used to perform our study. We found 384 articles published among 1830 articles corresponding to our inclusion/exclusion criteria. For each selected article we searched for affiliation of all of the authors (university, private dental practice, students, other). We applied a co-creation approach to involve colleagues from private practice in analyzing results of this study.

     Results: A large majority of authors have university affiliation (96.5%). Only 3% of authors come from private practice. Most of articles belong to the group of 7 emergent economies (E7), and from Asia. 47.9% of 96 journals published only one article on anatomical variations discovered on CBCT. The higher number of articles (18.75%) were published by journals related to endodontics. The 84% of articles were dispersed among a vast span of general and specific dental, and maxillofacial journals. The 68.4% of articles on variations in CBCT were available in closed access and 31.6% of articles were available in open access. Only 6.7% of articles were published in open access without author publication charges (APC). The 31.6% of authors with university affiliation choose open access for their article. 7.8% of authors from private practice were involved in publishing in closed access journals and 2.34% in open access journals. Only 3 articles (0.78%) were published by authors affiliated to private practice without involvement of university authors. 2.6% of articles involved students as co-authors. Authors with other affiliation were involved only in one closed access publication. For the step of co-creation none of 183 private practitioners, and 3/33 (9%) university-affiliated members of Nemesis Facebook group actively participated in analyzing the results of this study.

    Conclusions: the null hypothesis was accepted: dentists from private practice are exceptionally involved in publications on anatomical variations using CBCT in dentomaxillofacial area.

  • Imprimantes tridimensionnelles grand public compatibles avec la dentisterie ?
    Vol. 13 No 1 (2020)

    The objective of this work was to define the different criteria that a general dentist will have to take into account to equip himself with a three-dimensional (3D) printer for dental use. We have identified a total of 1037 3D printers produced by 342 companies and 211 3D printers from 88 companies that can print with 25µm layers. To be able to compare them, we evaluated 16 different characteristics: 1) family of 3D printing process, 2) minimum layer thickness, 3) presence or absence of scientific study to validate the minimum layer thickness, 4) minimal resolution on XY axes, 5) type of calibration, 6) printing environment, 7) presence of a heated printing plate, 8) maximum printing speed (in mm/s) with a link giving details of the layer thickness used, the XY resolution used and the material used to determine this speed, 9) dimensions of printing capacity, 10) capacity to use materials not originating from the manufacturer, 11) capacity to use biocompatible materials, 12) weight (in kg) and printer dimensions (in cm), 13) compatible operating systems, 14) compatible 3D print file types, 15) after-sales service and warranty period, 16) price, including whether taxes are included s or not. We noted a great heterogeneity of the information present, and information often absent regarding: 1) the type of calibration, 2) the printing speed, 3) the price, 4) the after-sales service, 5) the guarantee as well as 6) the materials which are taken into account by the 3D printer. We described multiple communication difficulties with our contacts and a very dynamic development of the 3D printing world. Finally, we proposed the characteristics of an "ideal" dental 3D printer and of an "ideal" partner company for a dentist wishing to obtain the 3D printer of his choice.

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