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Patients Singleton–Merten syndrome is an extremely rare autosomal dominant condition with less than 10 reported cases in the literature. It is characterized by abnormal aortic calcifications and dental abnormalities. The goal of this case report is to discuss the abnormal oral clinical features and the modified treatment protocol that was used in order to achieve osseointegration of dental implants in a patient having abnormal bone density and bone turnover associated with Singleton–Merten Syndrome. Discussion Following extraction of the remaining teeth, titanium implants (Friadent GmbH, Mannheim, Germany and Straumann ® , Basel, Switzerland) were placed in the upper and lower jaw of the patient. The upper jaw which was treated with dental implants, received a bar supported implant retained prosthesis and the lower jaw an implant retained telescopic prosthesis. The patient was regularly followed up for the past 13 years during which, clinical and radiological evaluation of osseointegration was undertaken. All the loaded implants showed clinical and radiographic evidence of osseointegration. With a follow up of 13 years after insertion of the first implant, the patient reported functioning well with no complications. Conclusion The treatment with dental implants in the extremely rare Singleton–Merten syndrome patients is a reasonable treatment option to rehabilitate maxillofacial aesthetics and establish normal function of the jaws.

Background and objectives Aggressive Periodontitis is associated with higher risk of periimplantitis and lower implant survival. Glucose-6-phosphate dehydrogenase (G6pd) deficiency is an enzymatic disorder which may produce hemolytic anemia in red blood cells. Since G6pd helps to maintain intracellular redox potential, a deficiency produces a weak interface at the marginal gingiva and additionally a reduced wound healing due to hemolysis. This case report discusses the clinical features and treatment protocol used to achieve osseointegration of dental implants in grafted and non grafted regions in a patient having aggressive periodontitis, congenital G6pd deficiency, refractory to conventional periodontal therapy. Methods Following extraction of the remaining teeth, 10 titanium implants (Straumann AG) were placed, starting with 4 implants in the mandible. After 5 years, augmentation of the extremely atrophic maxilla was performed. On one side the augmentation failed, however a total of 6 implants could be placed in the maxilla. The patient was followed up regularly for 15 years. Results The long term follow up (9 years in the maxilla and 15 years in the mandible) of the inserted implants showed 100% success rate. Conclusion Rehabilitation with dental implants in patients having aggressive periodontitis is a reasonable treatment option to restore maxillo-mandibular function and esthetics.

Although empirical findings have indicated increase in bone fracture risk in type 2 diabetes patients, that has yet to be proven by results obtained at the material level. Here, we report evidence showing nanoscale time-dependent deformation/recovery of in vitro calcified nodules mimicking bone turnover in type 2 diabetes in respect to methylglyoxal (MG)-induced glycation. Nanoindentation test results revealed that calcified nodules cultured with MG did not show adequate dimensional recovery, despite a large creep rate during constant load indentation testing. This lesser recovery is likely based on the linear matrix polymerization network formed by advanced glycation end products (AGEs) as a secondary product of MG. Since elevated serum MG and abnormal bone turnover related to the amount of AGEs are observed in cases of type 2 diabetes, this time-dependent behavior may be one of the factors of the bone fracture mechanism at the material level in affected patients.

Background With increasing application of dental implants in poor-quality bones, the need for implant surfaces ensuring accelerated osseointegration and enhanced peri-implant bone regeneration is increased. Purpose A study was performed to evaluate the osseointegration and bone formation on novel simvastatin-loaded porous titanium oxide surface. Materials and Methods Titanium screws were treated by micro-arc oxidation to form porous oxide surface and 25 or 50 μg of simvastatin was loaded. The nontreated control, micro-arc oxidized, and simvastatin-loaded titanium screws were surgically implanted into the proximal tibia of 16-week-old male Wistar rats (n = 36). Peri-implant bone volume, bone-implant contact, and mineral apposition rates were measured at 2 and 4 weeks. Data were analyzed by one-way analysis of variance followed by Tukey's post hoc test. Results New bone was formed directly on the implant surface in the bone marrow cavity in simvastatin-loaded groups since 2 weeks. Bone-implant contact values were significantly higher in simvastatin-loaded groups than control and micro-arc oxidized groups at both time points (p

The use of dental implants for the rehabilitation of missing teeth has broadened the treatment options for patients and clinicians equally. As a result of advances in research in implant design, materials and techniques the use of dental implants has increased dramatically in the past two decades and is expected to expand further in the future. However the clinical complexity of the patient who present with limited bone volume often requires additional biomaterials and surgical procedures to ensure successful implant treatment. This review outlines the various biomaterials used in augmenting bone deficiencies encountered and the different surgical techniques that are used in order to achieve a predictable long term success of dental implants.

With increasing application of dental implants in poor-quality bones, the need for implant surfaces ensuring accelerated osseointegration and enhanced peri-implant bone regeneration is increased.A study was performed to evaluate the osseointegration and bone formation on novel simvastatin-loaded porous titanium oxide surface.Titanium screws were treated by micro-arc oxidation to form porous oxide surface and 25 or 50 μg of simvastatin was loaded. The nontreated control, micro-arc oxidized, and simvastatin-loaded titanium screws were surgically implanted into the proximal tibia of 16-week-old male Wistar rats (n = 36). Peri-implant bone volume, bone-implant contact, and mineral apposition rates were measured at 2 and 4 weeks. Data were analyzed by one-way analysis of variance followed by Tukey's post hoc test.New bone was formed directly on the implant surface in the bone marrow cavity in simvastatin-loaded groups since 2 weeks. Bone-implant contact values were significantly higher in simvastatin-loaded groups than control and micro-arc oxidized groups at both time points (p .05). Peri-implant bone volume and mineral apposition rate of simvastatin-loaded groups were significantly higher than control and micro-arc oxidized groups at 2 weeks (p .05).These data suggested that simvastatin-loaded porous titanium oxide surface provides faster osseointegration and peri-implant bone formation and it would be potentially applicable in poor-quality bones.

Aim Inadequate vertical bone compromises dental implant positioning and subsequent restoration. This study was carried out to investigate the feasibility of alpha tricalcium phosphate (α-TCP) for vertical bone augmentation. Methods Nine cortical perforations were made on each side of the parietal bone of rat calvaria under continuous saline coolant. Polytetrafluoroethylene cylinders were placed under the periosteum and α-TCP particles were applied in the cylinders in the TCP group while the cylinders were left empty in the control group. The animals were sacrificed at 4 and 8 weeks after surgery and analyzed radiologically and histologically. Results The augmented bone volumes in the control and TCP groups were 91.5 ± 25.6% and 76.5 ± 49.8% (mean ± SD) of the original bone at 4 weeks, and 136.3 ± 59.7% and 139 ± 62.4% at 8 weeks respectively. There was no significant difference between control and test groups. At 4 weeks the bone height was augmented by 168.8 ± 26.7% and 128.8 ± 62% in the control and TCP groups respectively (not significant), whereas significantly higher vertical bone was achieved in the TCP group than in the control group at 8 weeks (251 ± 32% vs 179.2 ± 30.3%, P

The purpose of the present study is to investigate effects of the combination of epigallocatechin-3-gallate (EGCG) and α-tricalcium phosphate (α-TCP) on bone regenerative capacity in a bilateral rat calvarial bone defect model. Materials and methods: Bilateral 5-mm-diameter calvarial defects were created in adult male Wistar rats and filled with preparations of EGCG (0, 0.1, 0.2, 0.4 mg) combined with α-TCP particles. This was done by dissolving EGCG in 100% ethanol (50 μL/14 mg) and dropping under sterile condition. The control group was left unfilled (n = 8). The animals were sacrificed at 2 and 4 weeks. Radiological images were taken, and histological analysis was done. Six animals from control (0 mg EGCG + α-TCP) group and (0.2 mg EGCG+ α-TCP) group were labeled with fluorescent dyes and histomorphometrically analyzed (n = 6) at 2 and 4 weeks. Results: Histomorphometric analysis revealed that the combination of EGCG and α-TCP at doses of 0.1 and 0.2 mg yielded significantly more new bone formation than untreated control group at 2 and 4 weeks (p > 0.05). Mineral apposition rate at 0.2-TCP group was enhanced compared with the one of the positive control α-TCP group at 4 weeks (p > 0.05). Conclusion: The combination of α-TCP particles and 0.2 mg EGCG stimulates maximum bone regeneration in rat calvarial defects, and this combination would be potentially effective as bone graft material. © 2011 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2011.

We have previously reported that healing of rat calvarial defects was enhanced by application of alpha tricalcium phosphate (alphaTCP) combined with simvastatin, a cholesterol synthesis inhibitor. The purpose of the present study was to investigate the cellular and molecular mechanisms in this phenomenon. Rat calvarial defects were grafted with alphaTCP with or without simvastatin or left untreated. Animals were sacrificed on 3, 7, 10, 14, and 21 days postoperatively and histological changes in the defect region were assessed. Gene expression patterns were examined by RT-PCR. Proliferation and migration of osteoprogenitor cells from the dura mater were increased in simvastatin group from day 3 to day 10 (p < 0.01). New bone formation was significantly increased in simvastatin group on day 14 and day 21 (p < 0.01). BMP-2 expression was significantly higher in simvastatin group on day 3 and day 14 (p < 0.05) and maintained until day 21. Increased upregulation of TGF-beta1 was also observed in the simvastatin group on day 7 (p < 0.05) which was maintained until day 14. These findings suggest that the proliferation and recruitment of osteoprogenitor cells were critical steps in early stage of bone healing and that these steps were enhanced by TGF-beta1 and BMP-2, which were stimulated by simvastatin.