Search

ObjectivesThe aim of this study was to compare clinical results of immediate and early loading (EL) self-tapping implants placed in posterior mandibles. Material and methodsTwelve patients with bilateral edentulous posterior mandibular were randomly assigned to treatment either with immediate (test) or early loaded implants (control). Seventy-two self-tapping implants with SLA surface (O 4, 1/4, 8mm; length 8 and 10mm) were analyzed in this study. Test implants (36) were loaded on the day of surgery and control implants 6weeks later. The measuring of implant stability quotient (ISQ) was performed on 0, 6th, 12th, and 52nd week after implant insertion. The bone resorption, modified plaque, and bleeding index were notified at 1 and 5years later. ResultsAfter 5years, survival in the both groups was 100%. The mean value of primary implant stability was 76.920.79 ISQ. In the first 6weeks, ISQ values significantly increased in the test group (77.92 +/- 1.16 vs. 79.61 +/- 0.90) as well as in the control group (7.92 +/- 1.05 vs. 77.55 +/- 0.99). A significant longitudinal increase in ISQ value was recorded in test and control group. The differences between immediate and early loaded implants were statistically insignificant (P>0.05). At the 5years, no statistically significant differences were found between immediate and early loaded implants with respect to mean crestal bone loss measurements (0.4 +/- 0.24 vs. 0.8 +/- 0.15mm), mean bleeding index (0.22 +/- 0.11 vs. 0.25 +/- 0.11), and mean plaque index (0.17 +/- 0.15 vs. 0.19 +/- 0.20). ConclusionBased on these results, the self-tapping implants inserted in posterior mandible can provide adequate primary stability value as the main factor for immediate and EL protocol.

Objectives:Bone vascularity is an important factor in process of osseointegration. The aim of this study was to find whether or not blood perfusion of the bone around the prepared implant sites influences subsequent implant stability.Methods:Patients with bilaterally edentulous mandible were treated with dental implants. Bone vascularity in implant sites was previously noted using Laser Doppler Flowmetry (LDF). Implant stability quotient (ISQ) was measured during follow-up period of 26th week. Statistical distribution and correlation between LDF and ISQ values were presented. Other variables (type of implant loading; sex and distance from the apical part of implant sites to the roof of the mandibular canal) were collected and correlated with LDF values.Results:The mean recorded LDF value was 53.05 perfusion unit. Eighteen implants were immediately loaded, and the other 18 were early loaded. In the group of early loaded implants, a statistically significant correlation between mean value of LDF and changing value of resonance frequency analysis (P lt 0.05) was noted at 5th, 6th, 12th, and 26th weeks. Using Pearson coefficient of correlation, there was no statistically significant relationship between other variables and LDF values.Conclusion:LDF values of implant sites might determine future implant stability.

Background/Aim. The use of autogenous bone grafts for augmentation of the resorbed alveolar ridge is still considered the gold standard in implant dentistry. The aim of this study was to analyze the resorption rate of autogenous bone block grafts from the retromolar region placed in the frontal segment of the upper jaw unprotected by barrier membranes, to assess the stability of implants placed into the grafted bone, as well as to monitor its changes during the healing period. Methods. The study included 18 patients with a total of 20 grafted sites. The residual alveolar ridge was measured before and after the augmentation and prior to implant placement. All implants were restored with provisional crowns within 48 hours after the placement. Implant stability was assessed using resonance frequency analysis. Results. The average period from ridge augmentation to reentry was 5.4 months (range 4-6 months) . At reentry the healed alveolar ridge had a mean width of 6.1 ± 1.27 mm. The mean calculated width gain was 3.04 ± 1.22 mm. The overall surface resorption of block grafts was 0.68 ± 0.69 mm (18.85%). At the time of implant placement the mean value of implant stability quotient (ISQ) was 71.25 ± 5.77. The lowest ISQ values were noted after three weeks of healing, followed by a gradual increase until week 12. After 12 weeks implants showed significantly higher ISQ values compared to primary stability (p lt 0.05 Wilcoxon signed ranks test). During the 3-years followup period no cases of implant loss were recorded. Conclusion. Despite a significant resorption of bone grafts, it was possible to place implants in all the cases and to use the immediate loading protocol without affecting implant survival rate., Uvod/cilj. Primena autogenih koštanih graftova (implantata) za uvećavanje smanjenog (resorbovanog) alvelarnog grebena još uvek se smatra zlatnim standardom u implantologiji. Cilj ove studije bio je analiza stepena resorpcije autolognih koštanih blok transplantata nezaštićenih barijernim mebranama, uzetih iz retromolarnog predela mandibule i postavljenih u frontalni segment gornje vilice, procena stabilnosti implantata ugrađenih u povećanu regiju, kao i praćenje promene implantne stabilnosti tokom perioda oseointegracije. Metode. U studiju je bilo uključeno 18 pacijenata sa ukupno 20 autotransplantata. Širina rezidualnog alveolarnog grebena merena je pre i posle postavljanja transplantata, kao i neposredno pre ugradnje implantata. Svi implantati su opterećeni privremenim nadoknadama 48 sati nakon ugradnje. Stabilnost implantata procenjivana je primenom analize rezonantne frekvencije. Rezultati. Srednje vreme između uvećavanja grebena i ugradnje implantata iznosilo je 5,4 (4-6) meseci. Pre ugradnje implantata srednja vrednost širine grebena iznosila je 6,1 ± 1,27 mm, a povećanja širine grebena u odnosu na vrednosti pre uvećanja 3,04 ± 1,22 mm. Površinska resoprcija grafta iznosila je 18,85% (0,68 ± 0,69 mm). Srednja vrednost koeficijenta implantne stabilnosti (ISQ) u momentu ugradnje iznosila je 71,25 ± 5,77. Najniže vrednosti ISQ zabeležene su u trećoj nedelji nakon ugradnje, što je bilo praćeno postepenim porastom do dvanaeste nedelje zarastanja. Nakon dvanaest nedelja vrednosti ISQ bile su statitički značajno više od vrednosti u momentu ugradnje (p lt 0,05 Wilcoxon test). Tokom trogodišnjeg perioda praćenja nije bilo izgubljenih implantata. Zaključak. Bez obzira na značajan stepen resorpcije autotransplantata, kod svih pacijenata bilo je moguće ugraditi implantate u uvećani greben, kao i primeniti protokol ranog opterećenja bez uticaja na stepen preživljavanja implantata.

Bone quality is an important factor that may determine implant success. In addition to the other parameters that define bone quality, vascularity plays a vital role in the process of osseointegration of dental implants. Laser Doppler flowmetry (LDF) is an appropriate method for assessment of tissue vascularity at the level of microcirculation. It is non-invasive, painless and well accepted by the patients. The results are expressed in Perfusion Units (PU). The aim of this study was to estimate bone vascularity in the human posterior maxilla during implant insertion using LDF. Nine patients, three females and six males, mean age 57.56 +/- 8.83 years, consecutively treated with 54 implants were enrolled in this study. Implants were inserted in the posterior maxilla, in positions of first premolar, second premolar and first molar bilaterally in each patient. After implant site preparation with a drill of diameter 2.8 mm, bone vascularity was measured using LDF. Mean LDF value for 54 osteotomy sites was 43.39 +/- 14.65 PU. Results of the present study showed there wasn't statistically significant difference in LDF values between implant site positions and genders. It was also revealed that the proximity from the apical part of the implant site to the maxillary sinus floor had no influence on LDF values. Therefore, bone vascularity in the posterior maxilla could be measured by LDF during implant insertion, and those results might be considered as a standard data for this part of the upper jaw.

Background: Surgical removal of impacted lower third molars is a common oral surgical procedure, generally followed by moderate to severe postoperative pain. Transdermal drug delivery as a concept offers interesting possibilities for postoperative pain control. The aim of this study was to evaluate the efficacy of transdermal system with fentanyl in relieving pain following impacted lower third molar surgery. Material and Methods: Seventeen patients with bilateral impacted lower third molars were included in this preliminary study. For postoperative pain control, patients randomly received a fentanyl patch plus placebo tablet after the first operation and regular (placebo) patch and an analgesic, after the second operation. Analgesia was evaluated during first 24 hours postoperatively according to patients' reports about time of first pain appearance and additional analgesic consumption. Pain severity was rated using a 10 cm long visual analogue scale (VAS). Results: Intensity of postoperative pain and postoperative analgesic consumption were significantly lower after the Fentanyl Transdermal System (FTS) was applied (p lt 0.05). Duration of postoperative analgesia was significantly higher with FTS when compared to control treatment (p lt 0.05). Conclusions: Based on the results of this preliminary study, transdermal system with fentanyl significantly reduced postoperative pain after third molar surgery.

Biphasic calcium phosphates (BCP) are widely used in alveolar ridge regeneration as a porous scaffold for new bone formation. The aim of this case series was to evaluate the regenerative effect of the combination of BCP and polylactide-co-glycolide (PLGA) which can serve as a barrier membrane during bone regeneration. The study included five patients. Four months into the healing period, bone samples were collected for histological and morphometric analyses. The results of morphometric analysis showed that newly formed bone represented 32.2 ± 6.8% of the tissue, 31.9 ± 8.9% was occupied by residual graft and 35.9 ± 13.5% by soft tissue. Active osteogenesis was seen around the particles of the graft. The particles were occupied mostly by immature woven bone and connective tissue. The quality and quantity of newly formed bone, after the use of BCP/PLGA for ridge preservation, can be adequate for successful implant therapy after tooth extraction.

Objectives: The aim of the present study was to compare a newly developed biodegradable polylactide/polyglycolide/N-methyl-2-pyrrolidone (PLGA/NMP) membrane with a standard resorbable collagen membrane (RCM) in combination with and without the use of a bone substitute material (deproteinized bovine bone mineral [DBBM]) looking at the proposed tenting effect and bone regeneration. Materials and methods: In five adult German sheepdogs, the mandibular premolars P2, P3, P4, and the molar M1 were bilaterally extracted creating two bony defects on each site. A total of 20 dental implants were inserted and allocated to four different treatment modalities within each dog: PLGA/NMP membrane only (Test 1), PLGA/NMP membrane with DBBM (Test 2), RCM only (negative control), and RCM with DBBM (positive control). A histomorphometric analysis was performed 12 weeks after implantation. For statistical analysis, a Friedman test and subsequently a Wilcoxon signed ranks test were applied. Results: In four out of five PLGA/NMP membrane-treated defects, the membranes had broken into pieces without the support of DBBM. This led to a worse outcome than in the RCM group. In combination with DBBM, both membranes revealed similar amounts of area of bone regeneration and bone-to-implant contact without significant differences. On the level of the third implant thread, the PLGA/NMP membrane induced more horizontal bone formation beyond the graft than the RCM. Conclusion: The newly developed PLGA/NMP membrane performs equally well as the RCM when applied in combination with DBBM. Without bone substitute material, the PLGA/NMP membrane performed worse than the RCM in challenging defects, and therefore, a combination with a bone substitute material is recommended.

Objective. The aim of this study was to compare the treatment of oroantral communications (OACs) with bioresorbable root analogs made of poly(lactide-co-glycolide) (PLGA)-coated beta-tricalcium phosphate (beta-TCP), hemostatic gauze or a buccal flap technique. Study design. In this prospective clinical study, 30 patients with oroantral communications were randomly assigned to a treatment. Clinical success, vestibular depth at the defect site, pain, and swelling were monitored. Results. The OAC closure was successful in all cases. The vestibular depth stayed constant in the groups treated with the PLGA-beta-TCP composite or hemostatic gauze. In contrast, a vestibular depth reduction of 1.2 +/- 0.2 mm was observed in the buccal flap group, indicating atrophy of the alveolar ridge in these patients. Furthermore, pain and swelling were more pronounced in this group. Conclusion. Closures of OACs with PLGA-beta-TCP composite or hemostatic gauze are reliable minimally invasive methods that minimize atrophy of the alveolar ridge, swelling, and pain compared with a buccal flap technique. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 844-850)

Cytotoxicity testing, as a standard assay for toxicity of dental materials, is useful for initial biocompatibility evaluations. In vitro test of calcium hydroxyapatite (CHA) with established laboratory cell line showed multiple partitions of cells proving good biocompatibility properties of this new material. Further research should be directed towards simulation of in vivo conditions and animal experimentation to obtain sufficient data before its clinical application in humans.