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Background The exact mechanisms of bone resorption in periodontitis have not been fully elucidated. The aims of this study were to analyze the expression of Notch signaling molecules, bone remodeling mediators, and pro-inflammatory cytokines in periodontitis patients and to determine their potential correlations. Methods The study included 130 individuals: 40 with aggressive periodontitis (AP group), 40 with chronic periodontitis (CP group), and 50 periodontally healthy controls. Total RNA was extracted from gingival crevicular fluid samples and relative gene expression of investigated molecules (Notch 1, Notch 2, Jagged 1, Hes 1, Hey 1, TNF-alpha, IL-17, RANKL, and OPG) was determined by reverse transcriptase - real-time polymerase chain reaction (RT-qPCR). Results In AP group, a significant increase of Notch 2, TNF-alpha, IL-17 and RANKL and a significant decrease of Notch 1 and Jagged 1 expression were observed compared to control group (P = 0.023, P = 0.005, P = 0.030, and P = 0.001 P = 0.031 and P = 0.029, respectively). Notch 2 and RANKL were also overexpressed in CP group compared to controls (P = 0.001 and P = 0.011). Significant correlations were observed in AP group between expression levels of the analyzed genes. Conclusion The present findings implicate Notch 2 overexpression in the ethiopathogenesis of bone resorption in aggressive and chronic periodontitis. The down-regulation of Notch 1 and Jagged 1 and loss of their osteoprotective function might cause a more excessive osteoclast formation and contribute to greater osteolysis in aggressive periodontitis.

Background The exact mechanisms of bone resorption in periodontitis have not been fully elucidated. The aims of this study were to analyze the expression of Notch signaling molecules, bone remodeling mediators, and pro-inflammatory cytokines in periodontitis patients and to determine their potential correlations. Methods The study included 130 individuals: 40 with aggressive periodontitis (AP group), 40 with chronic periodontitis (CP group), and 50 periodontally healthy controls. Total RNA was extracted from gingival crevicular fluid samples and relative gene expression of investigated molecules (Notch 1, Notch 2, Jagged 1, Hes 1, Hey 1, TNF-alpha, IL-17, RANKL, and OPG) was determined by reverse transcriptase - real-time polymerase chain reaction (RT-qPCR). Results In AP group, a significant increase of Notch 2, TNF-alpha, IL-17 and RANKL and a significant decrease of Notch 1 and Jagged 1 expression were observed compared to control group (P = 0.023, P = 0.005, P = 0.030, and P = 0.001 P = 0.031 and P = 0.029, respectively). Notch 2 and RANKL were also overexpressed in CP group compared to controls (P = 0.001 and P = 0.011). Significant correlations were observed in AP group between expression levels of the analyzed genes. Conclusion The present findings implicate Notch 2 overexpression in the ethiopathogenesis of bone resorption in aggressive and chronic periodontitis. The down-regulation of Notch 1 and Jagged 1 and loss of their osteoprotective function might cause a more excessive osteoclast formation and contribute to greater osteolysis in aggressive periodontitis.

Background The exact mechanisms of bone resorption in periodontitis have not been fully elucidated. The aims of this study were to analyze the expression of Notch signaling molecules, bone remodeling mediators, and pro-inflammatory cytokines in periodontitis patients and to determine their potential correlations. Methods The study included 130 individuals: 40 with aggressive periodontitis (AP group), 40 with chronic periodontitis (CP group), and 50 periodontally healthy controls. Total RNA was extracted from gingival crevicular fluid samples and relative gene expression of investigated molecules (Notch 1, Notch 2, Jagged 1, Hes 1, Hey 1, TNF-alpha, IL-17, RANKL, and OPG) was determined by reverse transcriptase - real-time polymerase chain reaction (RT-qPCR). Results In AP group, a significant increase of Notch 2, TNF-alpha, IL-17 and RANKL and a significant decrease of Notch 1 and Jagged 1 expression were observed compared to control group (P = 0.023, P = 0.005, P = 0.030, and P = 0.001 P = 0.031 and P = 0.029, respectively). Notch 2 and RANKL were also overexpressed in CP group compared to controls (P = 0.001 and P = 0.011). Significant correlations were observed in AP group between expression levels of the analyzed genes. Conclusion The present findings implicate Notch 2 overexpression in the ethiopathogenesis of bone resorption in aggressive and chronic periodontitis. The down-regulation of Notch 1 and Jagged 1 and loss of their osteoprotective function might cause a more excessive osteoclast formation and contribute to greater osteolysis in aggressive periodontitis.

The scientific literature data have shown that dental implant placement is not contraindicated in patients on oral anticoagulant therapy (OAT). Anticoagulation therapy alters extrinsic and/or intrinsic coagulation pathways and therefore could affect plasma protein adsorption at implant surface and subsequent platelet adhesion and activation that may influence subsequent bone healing events in the peri-implant healing compartment. In healthy patients, the superior osteogenesis, angiogenesis and histo-morphometric characteristics of the chemically modified moderately rough, hydrophilic (SLActive) surface compared with moderately rough, hydrophobic (SLA) implant surface during the critical early period of osseointegration have been demonstrated. Numerous stuides have shown the comparable or better mechanical strength and improved biocompatibility of a new dental implant alloy, titanium–zirconium (TiZr) in comparison to existing titanium (Ti) alloys. In healthy patients, TiZr together with SLA or SLActive surface, is a suitable material for small-diameter implants. The scientific data offer opposite opinions regarding whether oral anticoagulation therapy should be uninterrupted prior to surgical procedures, or bridging with low-molecular heparin should be applied..., Naučna literatura je pokazala da ugradnja implantata pacijentima na oralnoj antikoagulantnoj terapiji (OAT) nije kontraindikovana. Antikoagulantna terapija utiče na spoljašnji i /ili unutrašnji put koagulacije krvi, stoga bi mogla da ima uticaj i na adsorpciju plazma proteina na površinu implantata, kao i na posledičnu adheziju i aktivaciju trombocita, što bi moglo imati posledice po periimplantantno zarastanje. Hemijski modifikovana, umereno hrapava, hidrofilna SLActive površina u odnosu na umereno hrapavu, hidrofobnu SLA površinu, utiče na bolju osteogenezu, angiogenezu i histomorfometrijske karakteristike u ranom periodu oseintegracije implantata ugrađenih zdravim pacijentima. Brojne studije su pokazale da nova legura titanijum-cirkonijum (TiZr) poseduje slična ili čak bolja mehanička svojstva, kao i unapređenu biokompatibilnost u odnosu na čisti titanijum (Ti). Kod zdravih pacijenata TiZr legura sa SLA ili SlActive površinom je pogodna za izradu implantata malog dijametra. U stručnoj literaturi prisutni su različiti stavovi po pitanju treba li uoči planirane hirurške intervencije prekinuti antikoagulantnu terapiju i premostiti je niskomolekularnim heparinom ili primeniti princip kontinuirane antikoagulantne terapije. Cilj: Poređenje koštanog i mekotkivnog zarastanja TiZr implantata sa hidrofilnom SlActive i hidrofobnom SLA površinom kod pacijenata na OAT, praćenje postoperativnih komplikacija, uticaja preoperativne pripreme pacijenta na visinu INR i nastanak postoperativnih komplikacija, kao i utvrđivanje stope opstanka i uspešnosti implantacije. Materijal i metode: Ukupno 84 TiZr implantata malog dijametra sa SLActive i SLA površinom ugrađeni su kod 20 pacijenata na OAT po split-mouth dizajnu studije...

The scientific literature data have shown that dental implant placement is not contraindicated in patients on oral anticoagulant therapy (OAT). Anticoagulation therapy alters extrinsic and/or intrinsic coagulation pathways and therefore could affect plasma protein adsorption at implant surface and subsequent platelet adhesion and activation that may influence subsequent bone healing events in the peri-implant healing compartment. In healthy patients, the superior osteogenesis, angiogenesis and histo-morphometric characteristics of the chemically modified moderately rough, hydrophilic (SLActive) surface compared with moderately rough, hydrophobic (SLA) implant surface during the critical early period of osseointegration have been demonstrated. Numerous stuides have shown the comparable or better mechanical strength and improved biocompatibility of a new dental implant alloy, titanium–zirconium (TiZr) in comparison to existing titanium (Ti) alloys. In healthy patients, TiZr together with SLA or SLActive surface, is a suitable material for small-diameter implants. The scientific data offer opposite opinions regarding whether oral anticoagulation therapy should be uninterrupted prior to surgical procedures, or bridging with low-molecular heparin should be applied..., Naučna literatura je pokazala da ugradnja implantata pacijentima na oralnoj antikoagulantnoj terapiji (OAT) nije kontraindikovana. Antikoagulantna terapija utiče na spoljašnji i /ili unutrašnji put koagulacije krvi, stoga bi mogla da ima uticaj i na adsorpciju plazma proteina na površinu implantata, kao i na posledičnu adheziju i aktivaciju trombocita, što bi moglo imati posledice po periimplantantno zarastanje. Hemijski modifikovana, umereno hrapava, hidrofilna SLActive površina u odnosu na umereno hrapavu, hidrofobnu SLA površinu, utiče na bolju osteogenezu, angiogenezu i histomorfometrijske karakteristike u ranom periodu oseintegracije implantata ugrađenih zdravim pacijentima. Brojne studije su pokazale da nova legura titanijum-cirkonijum (TiZr) poseduje slična ili čak bolja mehanička svojstva, kao i unapređenu biokompatibilnost u odnosu na čisti titanijum (Ti). Kod zdravih pacijenata TiZr legura sa SLA ili SlActive površinom je pogodna za izradu implantata malog dijametra. U stručnoj literaturi prisutni su različiti stavovi po pitanju treba li uoči planirane hirurške intervencije prekinuti antikoagulantnu terapiju i premostiti je niskomolekularnim heparinom ili primeniti princip kontinuirane antikoagulantne terapije. Cilj: Poređenje koštanog i mekotkivnog zarastanja TiZr implantata sa hidrofilnom SlActive i hidrofobnom SLA površinom kod pacijenata na OAT, praćenje postoperativnih komplikacija, uticaja preoperativne pripreme pacijenta na visinu INR i nastanak postoperativnih komplikacija, kao i utvrđivanje stope opstanka i uspešnosti implantacije. Materijal i metode: Ukupno 84 TiZr implantata malog dijametra sa SLActive i SLA površinom ugrađeni su kod 20 pacijenata na OAT po split-mouth dizajnu studije...

ObjectivesTo compare the peri-implant bone healing between TiZr implants with hydrophilic SLActive and hydrophobic SLA implant surface in patients receiving anticoagulants, to assess the implant survival and success rate, as well as to evaluate whether small-diameter TiZr implants could be used in patients on OAT in order to avoid augmentation procedures. Material and methodsA total of 80 small-diameter tissue-level TiZr implants with SLActive and SLA surfaces were placed in 20 anticoagulated patients, following the split-mouth study design. Implant stability was measured up to the third postoperative month by resonance frequency measurements (RFA). One-year implant survival and success rate were evaluated. ResultsAfter one year, 100% implant survival and success rate were observed. A significant decrease in ISQ comparing to baseline values was noted in the SLActive group from the first postoperative week, and in the SLA group, from the 3rdweek after the surgery. In both groups, a statistically significant decline in ISQ was observed between second and third postoperative week. No significant differences in ISQ values between SLActive and SLA implants were noted, at any time point. ConclusionsTitanium-zirconium small-diameter implants with SLActive and SLA surface predictably achieve and maintain adequate bone tissue integration in patients receiving anticoagulants. OAT appears to influence the bone healing events resulting in lower ISQ in the end of 3-month period in comparison with baseline values, although without compromising implant stability.

Naučna literatura je pokazala da ugradnja implantata pacijentima na oralnoj antikoagulantnoj terapiji (OAT) nije kontraindikovana. Antikoagulantna terapija utiče na spoljašnji i /ili unutrašnji put koagulacije krvi, stoga bi mogla da ima uticaj i na adsorpciju plazma proteina na površinu implantata, kao i na posledičnu adheziju i aktivaciju trombocita, što bi moglo imati posledice po periimplantantno zarastanje. Hemijski modifikovana, umereno hrapava, hidrofilna SLActive površina u odnosu na umereno hrapavu, hidrofobnu SLA površinu, utiče na bolju osteogenezu, angiogenezu i histomorfometrijske karakteristike u ranom periodu oseintegracije implantata ugrađenih zdravim pacijentima. Brojne studije su pokazale da nova legura titanijum-cirkonijum (TiZr) poseduje slična ili čak bolja mehanička svojstva, kao i unapređenu biokompatibilnost u odnosu na čisti titanijum (Ti). Kod zdravih pacijenata TiZr legura sa SLA ili SlActive površinom je pogodna za izradu implantata malog dijametra. U stručnoj literaturi prisutni su različiti stavovi po pitanju treba li uoči planirane hirurške intervencije prekinuti antikoagulantnu terapiju i premostiti je niskomolekularnim heparinom ili primeniti princip kontinuirane antikoagulantne terapije. Cilj: Poređenje koštanog i mekotkivnog zarastanja TiZr implantata sa hidrofilnom SlActive i hidrofobnom SLA površinom kod pacijenata na OAT, praćenje postoperativnih komplikacija, uticaja preoperativne pripreme pacijenta na visinu INR i nastanak postoperativnih komplikacija, kao i utvrđivanje stope opstanka i uspešnosti implantacije. Materijal i metode: Ukupno 84 TiZr implantata malog dijametra sa SLActive i SLA površinom ugrađeni su kod 20 pacijenata na OAT po split-mouth dizajnu studije..., The scientific literature data have shown that dental implant placement is not contraindicated in patients on oral anticoagulant therapy (OAT). Anticoagulation therapy alters extrinsic and/or intrinsic coagulation pathways and therefore could affect plasma protein adsorption at implant surface and subsequent platelet adhesion and activation that may influence subsequent bone healing events in the peri-implant healing compartment. In healthy patients, the superior osteogenesis, angiogenesis and histo-morphometric characteristics of the chemically modified moderately rough, hydrophilic (SLActive) surface compared with moderately rough, hydrophobic (SLA) implant surface during the critical early period of osseointegration have been demonstrated. Numerous stuides have shown the comparable or better mechanical strength and improved biocompatibility of a new dental implant alloy, titanium–zirconium (TiZr) in comparison to existing titanium (Ti) alloys. In healthy patients, TiZr together with SLA or SLActive surface, is a suitable material for small-diameter implants. The scientific data offer opposite opinions regarding whether oral anticoagulation therapy should be uninterrupted prior to surgical procedures, or bridging with low-molecular heparin should be applied...

ObjectivesTo compare the peri-implant bone healing between TiZr implants with hydrophilic SLActive and hydrophobic SLA implant surface in patients receiving anticoagulants, to assess the implant survival and success rate, as well as to evaluate whether small-diameter TiZr implants could be used in patients on OAT in order to avoid augmentation procedures. Material and methodsA total of 80 small-diameter tissue-level TiZr implants with SLActive and SLA surfaces were placed in 20 anticoagulated patients, following the split-mouth study design. Implant stability was measured up to the third postoperative month by resonance frequency measurements (RFA). One-year implant survival and success rate were evaluated. ResultsAfter one year, 100% implant survival and success rate were observed. A significant decrease in ISQ comparing to baseline values was noted in the SLActive group from the first postoperative week, and in the SLA group, from the 3rdweek after the surgery. In both groups, a statistically significant decline in ISQ was observed between second and third postoperative week. No significant differences in ISQ values between SLActive and SLA implants were noted, at any time point. ConclusionsTitanium-zirconium small-diameter implants with SLActive and SLA surface predictably achieve and maintain adequate bone tissue integration in patients receiving anticoagulants. OAT appears to influence the bone healing events resulting in lower ISQ in the end of 3-month period in comparison with baseline values, although without compromising implant stability.

AimTo evaluate by histopathological analysis the peri-implant bone inflammation degree, in certain time intervals (7, 14, 21 and 28days), following mini-incision flapless and flap implant placement. Material and methodsThe experiment was conducted on four domestic pigs. Nine weeks prior to implant insertion, second and third mandibular premolars were extracted. Each animal received six implants in lower jaw. On one randomly chosen side of jaw flapless technique using mini-incision was performed, while on the other side implants were inserted after flap raising. After 7, 14, 21, and 28days, the experimental animals were sacrificed. Following mandibular resection and decalcification, the samples for histopathological analysis of the peri-implant bone were obtained in the empty implant bed area, from the buccal side of the mandible, adjacent to implant neck region and parallel to crestal edge of implant bed. The degree of inflammatory response of the peri-implant bone was estimated through ordinal scores from 0 to 2. ResultsSeven days after the surgery all samples in the flap group had score 2 indicating high inflammation degree, in contrast to lower inflammatory reaction in flapless group. On the 14th and 21st postoperative day decreasing of inflammation degree was noted in all samples of the flapless group (score 1), while in flap group samples presented scores 1 and 2. Twenty-eight days after the implant placement, further reduction of inflammation in the flapless group (33% of samples had score 0) was observed. ConclusionFlapless technique in comparison to conventional flap procedure minimizes postoperative bone inflammatory reactions.

PurposesThe primary aim of the study was to investigate a 1-year success rate of early-loaded bone level implants with a chemically modified sand-blasted, large grit, acid-etched surface (SLActive (R), Institut Straumann AG, Basel, Switzerland) in the posterior maxilla. Secondary objectives included stability of these implants and peri-implant bone level. Materials and MethodsBone level (R) implants (Institut Straumann AG) inserted into premolar and/or molar maxillary sites were loaded after 6 weeks of healing. The implants were monitored for 1 year using the following outcome measures: implant success, primary and secondary stability, and peri-implant bone level. ResultsOut of 37 implants placed in 13 patients, 36 reached sufficient stability and were early loaded, whereas one underwent a delayed loading protocol. One-year success rate of early-loaded implants was 100%. Implant stability at baseline was 71.75. 6 to be steadily increased thereafter up to 1 year (80.3 +/- 3.3), except at 2 weeks when a nonsignificant decrease was noticed (71.9 +/- 3.9). Continuous and significant bone loss was observed, reaching 0.4 +/- 0.1mm in the first postoperative year. ConclusionBone level implants with the SLActive surface placed into low-density bone and loaded after 6 weeks of healing can predictably achieve and maintain a successful tissue integration.

Background/Aim. Low-level laser therapy (LLLT) has been proven to stimulate bone repair, affecting cellular proliferation, differentiation and adhesion, and has shown a potential to reduce the healing time following implant placement. The aim of this clinical study was to investigate the influence of postoperative LLLT osseointegration and early success of self-tapping implants placed into low-density bone. Methods. Following the split-mouth design, self-tapping implants (n = 44) were inserted in the posterior maxilla of 12 patients. One jaw side randomly received LLLT (test group), while the other side was placebo (control group). For LLLT, a 637 nm gallium-aluminum-arsenide (GaAlAs) laser (Medicolaser 637, Technoline, Belgrade, Serbia) with an output power of 40 mW and continuous wave was used. Low-level laser treatment was performed immediately after the surgery and then repeated every day in the following 7 days. The total irradiation dose per treatment was 6.26 J/cm² per implant. The study outcomes were: implant stability, alkaline-phosphatase (ALP) activity and early implant success rate. The follow-up took 6 weeks. Results. Irradiated implants achieved a higher stability compared with controls during the entire follow-up and the difference reached significance in the 5th postoperative week (paired t-test, p = 0.030). The difference in ALP activ- ity between the groups was insignificant in any observation point (paired t-test, p > 0.05). The early implant success rate was 100%, regardless of LLLT usage. Conclusion. LLLT applied daily during the first postoperative week expressed no significant influence on the osseointegration of self- tapping implants placed into low density bone of the posterior maxilla. Placement of self-tapping macro-designed implants into low density bone could be a predictable therapeutic procedure with a high early success rate regardless of LLLT usage., Uvod/Cilj. Terapija laserom male snage (TLMS) stimuliše reparatorne sposobnosti kosti utičući na ćelijsku proliferaciju, diferencijaciju i adheziju, i ima potencijal da skrati vreme zarastanja kosti nakon ugradnje implantata. Cilj ove kliničke studije bio je da se ispita uticaj postoperativne primene TLMS na oseointegraciju i rani uspeh ugradnje samourezujućih implantata u kost male gustine. Metode. Prateći split- mouth dizajn, samourezujući implantati (n = 44) ugrađeni su u posteriorne regije gornje vilice 12 pacijenata. Slučajnim izborom, jednoj od strana vilice je dodeljena TLMS (test grupa), dok je druga strana bila placebo (kontrolna grupa). Za TLMS korišćen je galijum-aluminijum-arsenid (GaAlAs) laser (Medicolaser 637, Technoline, Beograd, Srbija) talasne dužine 637 nm, snage 40 mW, neprekidnog režima rada. Tretman laserom male snage sprovodio se neposredno po ugradnji, a zatim svakodnevno, tokom narednih sedam dana. Ukupna zračna doza po tretmanu bila je 6,26 J/cm² po implantatu. Praćeni su stabilnost implantata, aktivnost alkalne fosfataze (ALP) i procenat rane uspešnosti implantatne terapije. Period praćenja bio je šest nedelja. Rezultati. Zračeni implantati imali su veću stabilnost u odnosu na kontrolne tokom celog perioda praćenja, a statistički značajno veća stabilnost bila je u petoj postoperativnoj nedelji (t-test za vezane uzorke, p = 0.030). Razlika u aktivnosti ALP između grupa nije bila statistički značajna ni u jednoj tački posmatranja (t-test za vezane uzorke, p > 0.05). Procenat rane uspešnosti terapije implantatima bio je 100%, bez obzira na primenjenu TLMS. Zaključak. Svakodnevna primena TLMS u prvoj postoperativnoj nedelji nije pokazala značajan uticaj na oseointegraciju samourezujućih implantata u kost male gustine bočne regije gornje vilice. Primena implantata samourezujućeg makrodizajna u kosti male gustine mogla bi predstavljati predvidljivu terapijsku proceduru sa visokim procentom rane uspešnosti, bez obzira na primenjenu TLMS.

AimThe aim of this study was comparing the effect of flapless vs. flap technique of implant placement on inflammation degree of peri-implant soft tissue, through histopathological analysis. MethodThe experiment was conducted on five domestic pigs. Nine weeks after tooth extraction, implants were installed. Each animal received six implants in mandible. According to split-mouth design, randomly one side was used for flapless technique using mini-incision, while on the other side, flap was raised. After 7, 14, 21, 28, and 90days, the experimental animals were sacrificed. Samples for histopathological analyzes were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The degree of inflammatory response in the peri-implant soft tissue was estimated through ordinal scores from 0 to 3. ResultsIn the flap group Score 3 indicating high degree of inflammation was present from day 7 to day 21, in contrast to flapless group where Score 3 was not recorded during the entire follow-up. Three months after implantation, there were no signs of inflammation neither around flap nor around flapless implants. ConclusionFlapless surgical implantation technique using mini-incision decreases peri-implant soft tissue inflammatory reaction compared with flap surgery.

Normal bone healing after tooth extraction includes the following steps: blood clot forming, granulation, bone forming and final bone reorganization. In clinical settings connective tissue infiltration of extraction socket can result in fibrous scar formation rather than bone healing. Local and systemic factors seem to be major contributors to the occurrence of erratic socket healing. The aim of this case report was to describe oral-surgery treatment of a patient with inadequate bone and soft supportive tissue for prosthetic rehabilitation. Surgical procedure and recovery are presented, including final complete denture rehabilitation., Nakon vađenja zuba obično slede brza organizacija koaguluma, formiranje granulacionog tkiva, osteoida, a zatim i zrele lamelarne kosti. Međutim, klinički se neretko može sresti infiltracija ekstrakcione alveole vezivnim tkivom, uz stvaranje fibroznog ožiljka umesto novostvoren kosti. Za to su odgovorni brojni lokalni i sistemski faktori koji doprinose nepravilnom zarastanju ekstrakcione alveole. Cilj ovog rada je bio da se opiše oralnohirurško lečenje pacijenta s neodgovarajućim stanjem koštanog i mekog nosećeg tkiva gornje totalne proteze. Prikazani su hirurški postupak i postoperacioni tok, zaključno s konačnim odgovarajućim protetičkim zbrinjavanjem pacijenta, koji je doveo do pravilnog zarastanja rane i time zadovoljavajuće protetičke rehabilitacije.

Background/Aim. Low-level laser therapy (LLLT) has been proven to stimulate bone repair, affecting cellular proliferation, differentiation and adhesion, and has shown a potential to reduce the healing time following implant placement. The aim of this clinical study was to investigate the influence of postoperative LLLT osseointegration and early success of self-tapping implants placed into low-density bone. Methods. Following the split-mouth design, self-tapping implants (n = 44) were inserted in the posterior maxilla of 12 patients. One jaw side randomly received LLLT (test group), while the other side was placebo (control group). For LLLT, a 637 nm gallium-aluminum-arsenide (GaAlAs) laser (Medicolaser 637, Technoline, Belgrade, Serbia) with an output power of 40 mW and continuous wave was used. Low-level laser treatment was performed immediately after the surgery and then repeated every day in the following 7 days. The total irradiation dose per treatment was 6.26 J/cm² per implant. The study outcomes were: implant stability, alkaline-phosphatase (ALP) activity and early implant success rate. The follow-up took 6 weeks. Results. Irradiated implants achieved a higher stability compared with controls during the entire follow-up and the difference reached significance in the 5th postoperative week (paired t-test, p = 0.030). The difference in ALP activ- ity between the groups was insignificant in any observation point (paired t-test, p > 0.05). The early implant success rate was 100%, regardless of LLLT usage. Conclusion. LLLT applied daily during the first postoperative week expressed no significant influence on the osseointegration of self- tapping implants placed into low density bone of the posterior maxilla. Placement of self-tapping macro-designed implants into low density bone could be a predictable therapeutic procedure with a high early success rate regardless of LLLT usage., Uvod/Cilj. Terapija laserom male snage (TLMS) stimuliše reparatorne sposobnosti kosti utičući na ćelijsku proliferaciju, diferencijaciju i adheziju, i ima potencijal da skrati vreme zarastanja kosti nakon ugradnje implantata. Cilj ove kliničke studije bio je da se ispita uticaj postoperativne primene TLMS na oseointegraciju i rani uspeh ugradnje samourezujućih implantata u kost male gustine. Metode. Prateći split- mouth dizajn, samourezujući implantati (n = 44) ugrađeni su u posteriorne regije gornje vilice 12 pacijenata. Slučajnim izborom, jednoj od strana vilice je dodeljena TLMS (test grupa), dok je druga strana bila placebo (kontrolna grupa). Za TLMS korišćen je galijum-aluminijum-arsenid (GaAlAs) laser (Medicolaser 637, Technoline, Beograd, Srbija) talasne dužine 637 nm, snage 40 mW, neprekidnog režima rada. Tretman laserom male snage sprovodio se neposredno po ugradnji, a zatim svakodnevno, tokom narednih sedam dana. Ukupna zračna doza po tretmanu bila je 6,26 J/cm² po implantatu. Praćeni su stabilnost implantata, aktivnost alkalne fosfataze (ALP) i procenat rane uspešnosti implantatne terapije. Period praćenja bio je šest nedelja. Rezultati. Zračeni implantati imali su veću stabilnost u odnosu na kontrolne tokom celog perioda praćenja, a statistički značajno veća stabilnost bila je u petoj postoperativnoj nedelji (t-test za vezane uzorke, p = 0.030). Razlika u aktivnosti ALP između grupa nije bila statistički značajna ni u jednoj tački posmatranja (t-test za vezane uzorke, p > 0.05). Procenat rane uspešnosti terapije implantatima bio je 100%, bez obzira na primenjenu TLMS. Zaključak. Svakodnevna primena TLMS u prvoj postoperativnoj nedelji nije pokazala značajan uticaj na oseointegraciju samourezujućih implantata u kost male gustine bočne regije gornje vilice. Primena implantata samourezujućeg makrodizajna u kosti male gustine mogla bi predstavljati predvidljivu terapijsku proceduru sa visokim procentom rane uspešnosti, bez obzira na primenjenu TLMS.

PurposesThe primary aim of the study was to investigate a 1-year success rate of early-loaded bone level implants with a chemically modified sand-blasted, large grit, acid-etched surface (SLActive (R), Institut Straumann AG, Basel, Switzerland) in the posterior maxilla. Secondary objectives included stability of these implants and peri-implant bone level. Materials and MethodsBone level (R) implants (Institut Straumann AG) inserted into premolar and/or molar maxillary sites were loaded after 6 weeks of healing. The implants were monitored for 1 year using the following outcome measures: implant success, primary and secondary stability, and peri-implant bone level. ResultsOut of 37 implants placed in 13 patients, 36 reached sufficient stability and were early loaded, whereas one underwent a delayed loading protocol. One-year success rate of early-loaded implants was 100%. Implant stability at baseline was 71.75. 6 to be steadily increased thereafter up to 1 year (80.3 +/- 3.3), except at 2 weeks when a nonsignificant decrease was noticed (71.9 +/- 3.9). Continuous and significant bone loss was observed, reaching 0.4 +/- 0.1mm in the first postoperative year. ConclusionBone level implants with the SLActive surface placed into low-density bone and loaded after 6 weeks of healing can predictably achieve and maintain a successful tissue integration.

AimThe aim of this study was comparing the effect of flapless vs. flap technique of implant placement on inflammation degree of peri-implant soft tissue, through histopathological analysis. MethodThe experiment was conducted on five domestic pigs. Nine weeks after tooth extraction, implants were installed. Each animal received six implants in mandible. According to split-mouth design, randomly one side was used for flapless technique using mini-incision, while on the other side, flap was raised. After 7, 14, 21, 28, and 90days, the experimental animals were sacrificed. Samples for histopathological analyzes were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The degree of inflammatory response in the peri-implant soft tissue was estimated through ordinal scores from 0 to 3. ResultsIn the flap group Score 3 indicating high degree of inflammation was present from day 7 to day 21, in contrast to flapless group where Score 3 was not recorded during the entire follow-up. Three months after implantation, there were no signs of inflammation neither around flap nor around flapless implants. ConclusionFlapless surgical implantation technique using mini-incision decreases peri-implant soft tissue inflammatory reaction compared with flap surgery.

Objectives The study aimed to investigate the effect of surgical technique, implant macrodesign and insertion torque on bone temperature changes during implant placement. Material and methods In the in vitro study, 144 self-tapping (blueSKY (R) 4x10mm; Bredent) and 144 non-self-tapping (Standard implant (R) 4.1x10mm; Straumann) were placed in osteotomies prepared in pig ribs by lateral bone condensing or bone drilling techniques. The maximum insertion torque values of 30, 35 and 40Ncm were used. Real-time bone temperature measurement during implant placement was performed by three thermocouples positioned vertically, in tripod configuration around every osteotomy, at a distance of 5mm from it and at depths of 1, 5 and 10mm. Data were analysed using Kruskal-Wallis, Mann-Whitney U-tests and Regression analysis. Results Significant predictor of bone temperature at the osteotomy depth of 1mm was insertion torque (P=0.003) and at the depth of 10-mm implant macrodesign (P=0.029), while no significant predictor at depth of 5mm was identified (0.05). Higher insertion torque values as well as non-self-tapping implant macrodesign were related to higher temperatures. Implant placement in sites prepared by bone drilling induced significantly higher temperature increase (P=0.021) compared with bone condensing sites at the depth of 5mm, while no significant difference was recorded at other depths. Compared with 30Ncm, insertion torque values of 35 and 40Ncm produced significantly higher temperature increase (P=0.005; P=0.003, respectively) at the depth of 1mm. There was no significant difference in temperature change induced by 35 and 40Ncm, neither by implant macrodesign at all investigated depths (0.05). Conclusions Placement of self-tapping implants with low insertion torque into sites prepared by lateral bone condensing technique might be advantageous in terms of thermal effect on bone.

Objectives The study aimed to investigate the effect of surgical technique, implant macrodesign and insertion torque on bone temperature changes during implant placement. Material and methods In the in vitro study, 144 self-tapping (blueSKY (R) 4x10mm; Bredent) and 144 non-self-tapping (Standard implant (R) 4.1x10mm; Straumann) were placed in osteotomies prepared in pig ribs by lateral bone condensing or bone drilling techniques. The maximum insertion torque values of 30, 35 and 40Ncm were used. Real-time bone temperature measurement during implant placement was performed by three thermocouples positioned vertically, in tripod configuration around every osteotomy, at a distance of 5mm from it and at depths of 1, 5 and 10mm. Data were analysed using Kruskal-Wallis, Mann-Whitney U-tests and Regression analysis. Results Significant predictor of bone temperature at the osteotomy depth of 1mm was insertion torque (P=0.003) and at the depth of 10-mm implant macrodesign (P=0.029), while no significant predictor at depth of 5mm was identified (0.05). Higher insertion torque values as well as non-self-tapping implant macrodesign were related to higher temperatures. Implant placement in sites prepared by bone drilling induced significantly higher temperature increase (P=0.021) compared with bone condensing sites at the depth of 5mm, while no significant difference was recorded at other depths. Compared with 30Ncm, insertion torque values of 35 and 40Ncm produced significantly higher temperature increase (P=0.005; P=0.003, respectively) at the depth of 1mm. There was no significant difference in temperature change induced by 35 and 40Ncm, neither by implant macrodesign at all investigated depths (0.05). Conclusions Placement of self-tapping implants with low insertion torque into sites prepared by lateral bone condensing technique might be advantageous in terms of thermal effect on bone.