There are several treatment options for hyperplastic gingival lesions. Among these, diode lasers have the advantages of less bleeding, which is an important characteristic in mucosal lesions, a shorter procedure time, better healing, and less complications. We present the case of a 48-year-old male patient with a history of cerebral palsy and a presumptive diagnosis of traumatic fibroma. The entire lesion was removed in one session with no complications. No recurrence was observed at 3 months follow up. This procedure can be considered a good modality especially for physically challenged patients.

Introduction: Atypical odontalgia (AO) is one of the most complicated challenges that a dentist can face for an adequate diagnosis and treatment plan. It can cause prolonged visits and costly overtreatments for the patient, increasing the time of resolution of the condition. Objective: To analyze the literature about AO, as well as its epidemiology, pathophysiology, predisposing factors, associated pathologies and treatment. Methodology: Information was searched in PubMed, SCOPUS and Google Scholar. Key words were used to search for information such as: atypical odontology, epidemiology, pathophysiology, related disease, treatment, among other relevant articles. Results: AO occurs in women (85%) and men (20%) between 50 -60 years old, hormonal or psychiatric disorders, related to local neuropathies due to problems in electrical conduction, and present or largely confused with trigeminal neuralgia and burning mouth syndrome mainly, sometimes it is possible to identify duct treatment or a history of aggressive therapy in the area, and can be treated with Amitriptyline, Imipramine, Aripiprazole, and locally with Botulinum Toxin A with favorable results found at 4 weeks. Conclusion: AO does not have specific characteristic criteria for its diagnosis, leaving a wide spectrum of possibilities that represent a complex pathology that needs further study.

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Introduction: Root therapy in primary teeth aims to remove the necrotic pulp, to prevent premature tooth loss, and to maintain the primary teeth until exfoliation. Rotary systems allow for more effective root canal treatments. Objective: To analyze the literature for the characteristics of the rotary systems such as root canal preparation, obturation time, post-operative pain and clinical success. Methodology: A exhaustive research was performed in PUBMED, to find relevant studies about the use of rotary systems in pediatric dentistry. Results: Rotary files provide a greater root canal preparation, show more conservation of tooth structure with less mistakes in comparison with other techniques. This technique simplifies the procedure, shows less post operative pain, and is reflected in the cooperation of the pediatric patient. Rotary files exhibit a significant cleaning efficacy and a greater bacterial removal that led to a significant clinical success. Conclusion: due to the complexity of the primary roots and how precise the root canal treatment must be. The use of rotary techniques can improve root canal treatment of primary teeth.

Background Pouchitis and Crohn′s-like disease of the pouch (CDP) can be refractory to conventional therapy. Evidence of biological therapy has been rarely reported in large patient cohorts. We explored the use and effectiveness of these therapies and compared the success of a second biologic after antiTNF failure. Methods This is a retrospective RESERVO study of the Spanish cohort of GETECCU, that included patients operated for ulcerative colitis, with pouch construction, and subsequent diagnosis of pouchitis, CDP or cuffitis second ECCO diagnostic criteria1. Patients treated with antiTNF, Vedolizumab and/or Ustekinumab were selected. Clinical effectiveness was evaluated at long-term. We defined clinical remission as returning to the previous stool frequency, no pain or defecatory urgency, clinical response as the improvement in these parameters without the achievement of remission and non-response as no change or worsening of these symptoms. We also compared the effectiveness of second biologic (antiTNF vs vedolizumab-ustekinumab) after antiTNF failure, using descriptive and comparative statistics. Results The cohort comprised 145 patients. Demographic and clinical characteristics are represented in Table 1. A total of 232 biologic therapies were indicated. Of the total cohort, 60 (41.3%), 21 (14.4%) and 6 (4.1%) used two, three and four lines, respectively. Biologics used were Infliximab (n=95), Adalimumab (n=69), Vedolizumab (n=35), Ustekinumab (n=26) and Golimumab (n=7). Therapy characteristics, clinical effectiveness, need for intensification, discontinuation, and therapy duration for each biological therapy are represented in Table 2. Global rates of clinical remission, response, non-response and loss of response to a first biologic were 21.8%, 27.5%, 21.1% and 29.6%. Female gender was the only factor associated with effectiveness to a first biologic in univariate analysis (OR 2.16, CI 1.08–4.32, p 0.027). There were no significant differences regarding efectiveness between type of pouch disorder (pouchitis vs CDP, 51.6 vs 47.6%, p 0.48) or biologic agents. Thirty-nine patients received a second biologic after prior antiTNF failure (28 a second antiTNF and 11 non-antiTNF: 6 Vedolizumab, 5 Ustekinumab). Basal characteristics in this subgroup showed no significant differences. Clinical response (21.4 vs 63.6%, p 0.02) and discontinuation therapy rates (82.2 vs 54.5 %, p 0.04) after 11 months showed a more favorable profile for non-antiTNF therapy. Conclusion Biologics represent an effective option in the management of pouchitis and Crohn′s like disease of the pouch. Despite our small sample size, non-antiTNF therapy could be the best option after antiTNF failure. 1Fernando Magro. J Crohns Colitis 2017; 11(6): 649–670.