Effects of collagen membrane on bone level and periodontal status of adjacent tooth after third molar surgery: a randomized controlled trial.

BACKGROUND: The periodontal status and distal bone level of the adjacent second molar can be negatively affected by the surgical extraction of an impacted lower third molar. Absorbable materials have some benefits, including enhancing primary wound coverage and promoting wound healing through isolation, clotting, wound stabilization and haemostasis. This study set out to compare primary and secondary healing and collagen-membrane-based primary healing after surgical removal of partially erupted impacted third molars (3Ms), evaluating the distal alveolar bone level (ABL) and periodontal status of the adjacent second molars (2Ms). METHODS: Patients who met the inclusion criteria were randomized into three groups: secondary healing (n = 28), primary healing (n = 27) and membrane-based primary healing (n = 29). Digital panoramic radiographs were obtained preoperatively (T1) and three months postoperatively (T2). The distances between the cemento-enamel junctions and the alveolar bone crests on the distal aspects of the adjacent 2Ms were measured using calibrated radiograph measurement software. The pocket depth and plaque index measurements were performed preoperatively and three months postoperatively. The periodontal plaque index (PPI) scores were registered on the distal aspects of the 2Ms, and the mean values were used. RESULTS: Three of the applied healing types positively affected periodontal pocket depth (PPD) and periodontal index values (p < 0.05). In terms of the ABL of the adjacent 2Ms, primary healing (p < 0.05) and membrane-based primary healing (p < 0.05) had superior results to secondary healing. CONCLUSION: Membrane use is promising for the distal bone gain and periodontal status of the adjacent 2M. TRIAL REGISTRATION: This clinical study was registered by the Australian New Zealand Clinical Trials Registry, with the trial number ACTRN12618001551280.

Trace elements released from dental implants with periimplantitis: a cohort study.

BACKGROUND: Pure titanium and Ti6Al4V alloy have been in use as dental implant contemporarily. Trace element release from implant bodies is a possible health problem. Well-healed and osseointegrated intrabony implants are only in contact with bone and blood, but in the case of periimplantitis, the possibility of corrosion and the release of trace elements from dental implant surfaces increases due to contact with external factors. AIMS: The aim of this study is to evaluate the trace element levels in the blood serum and saliva of patients who have dental implants with periimplantitis compared with the control group. METHODS: This study included 25 patients diagnosed with periimplantitis and 25 participants with healthy osseointegrated implants as the control group. The trace element levels in blood serum and saliva were measured by inductively coupled plasma-mass spectrometry (ICP-MS) and results were analyzed statistically. RESULTS: There is no statistically significant difference between groups for saliva samples except the aluminum (Al) levels of the study group are significantly lower than the control group (p < 0.05) and the mercury (Hg) levels of the study group are significantly higher than the control group (p < 0.05). On the other hand, there is a significant decrease in titanium (Ti), chromium (Cr), and iodine (I) in the blood serum samples of the study group (p < 0.05). There is no significant difference between the groups for other measured trace elements in the blood serum (p > 0.05). CONCLUSION: There is no statistically significant increase in titanium or aluminum levels in the study group compared with the control group.

Evaluation of nasal airflow resistance of operated unilateral cleft lip and palate surgery patients compared with skeletal class III individuals.

OBJECTIVE: The purpose of this study was to measure the nasal airflow resistance of operated unilateral cleft lip and palate (UCLP) patients using the anterior rhinomanometry method compared with non-cleft skeletal class III individuals with isolated maxillary hypoplasia serving as the control group. MATERIAL&METHODS: Sixteen UCLP patients who have undergone lip and palate reconstructions and alveolar cleft grafting but not advanced surgeries as the study group and 16 non-cleft skeletal class III participants as the control group (corresponded for age and sex to the study group) were included in this prospective study. All of the patients had class III occlusion due to isolated maxillary hypoplasia. Nasal airflow was measured with anterior rhinomanometry (in ml/sec) for each nostril separately. For evaluation of nasal side subgroups of the UCLP group for nasal resistance, the cleft sides and non-cleft sides of individuals were examined in two separate groups. The nasal side resistance of the control group was evaluated as the average of both nasal side resistances. The nasal resistances for nasal sides and total nasal resistance were measured in Pa/L/sec. The observed data were analyzed using Kolmogorov-Smirnov test used for normality, and the Student t-test and Mann Whitney U test used to determine the differences between the groups. P values of <0.05 were considered statistically significant. RESULTS: As the primary outcome of this study, it was found that both the cleft sides and non-cleft sides of the UCLP individuals had statistically significantly higher nasal resistance than the healthy skeletal class III control group (p < 0.05). It was revealed that the cleft side had more nasal resistance than the non-cleft side for both inspiration and expiration, but the results were not statistically significant (p = 0.41/p = 0.28). CONCLUSION: The results showed that operated UCLP patients have nasal resistance and breathing problems, even when lip, palate, and alveolar cleft operations have been performed.

Evaluation of Nasal Airway Volume of Operated Unilateral Cleft Lip and Palate Patients Compared With Skeletal Class III Individuals.

Cleft lip and palate (CLP) patients have various problems with nasal anatomy beyond just oronasal separation. The alar base, concha, and septum are over impressed in these individuals. Additionally, skeletal class III deformity is seen. These conditions may limit nasal function. In our study, 15 unilateral patients with CLP older than 15 years (10 females, 5 males; mean age: 19.13) who had received surgery were included as the study group, and 15 participants with noncleft skeletal class III deformities were included as the control group (10 females, 5 males; mean age: 19.20). The individuals' nasal airway volumes (total/cleft side/noncleft side/control/ nasal passages) were examined and compared statistically. The results showed that the study group had significantly higher values in terms of total airway volume ( P < .05). Additionally, there were significant differences between the cleft side and noncleft side volumes, between the cleft side volumes and the volumes of the control group participants, and between the noncleft side volumes and the volumes of the control group participants ( P < .05). There was no difference between the groups in terms of nasopharyngeal ( P = .39) and nasal passage volumes ( P = .73). The results show there are some problems regarding nasal airway volume in patients with CLP, even when lip, palate, and alveolar cleft operations have been performed. The aim of this study was to evaluate differentiation of nasal airway volumes between unilateral patients with CLP and individuals with noncleft skeletal class III serving as the control group.

Determining the Margin of Safety for Damaging the Sphenoid Sinus with Nasal Septum Osteotome during Le Fort I Surgery in Young Adults.

Nasal septum (Obwegeser) osteotome is a basic instrument used for separating the nasal septum and maxilla during Le Fort I osteotomy. If this instrument is placed too high or tilted into the nasal cavity, sphenoid sinus and various adjacent vital structures may be damaged and serious bleeding, neurological complications, or blindness or even death may occur. The aim of this study is to determine the margin of safety for damaging the sphenoid sinus and the adjacent structures with nasal septum osteotome in the young adults: 49 male and 51 female patients between 15 and 25 ages who required a Cone Beam Computed Tomography (CBCT) examination as part of their routine examination. In the study sample consisting of CBCT images, the aimed surgical line, the line between spina nasalis anterior and vomer and the base of sphenoid sinus (undesired line), and tilt angle between surgical and undesirable lines were measured. As the primary outcome of this study, margin of safety for damaging the sphenoid sinus and adjacent vital structures with nasal septum osteotome during Le Fort surgeries in young adults recommended as 5 mm and 120. For this reason the importance of planning with preoperative CBCT before Le Fort I osteotomies has been revealed.

How effective is collagen resorbable membrane placement after partially impacted mandibular third molar surgery on postoperative morbidity? A prospective randomized comparative study.

BACKGROUND: Collagen membranes have some benefits include promoting wound healing through isolation, clot stabilization, wound stability, and hemostasis, enhancing primary wound coverage through its chemotactic ability to attract fibroblasts, and augmenting flap thickness by providing a collagenous scaffold. The purpose of this study was to compare primary and secondary healing and collagen membrane-based primary healing after surgical removal of partial impacted mandibular third molars, evaluating the incidence of postoperative complications and analyzing the swelling, mouth opening, and pain. METHODS: This was a prospective, randomized controlled study. Patients were randomly assigned to three groups: the SC (Secondary closure) group, the PC (Primary closure) group, and the MBPC (membrane based primary closure) group. Data were collected on pain, mouth opening, swelling, and complications experienced by the patients. RESULTS: There was no statistically significant difference between the groups for the pain (p > 0.05), relatively. The swelling recorded on postoperative days 2 and 7 was lower in the SC group than in the PC (p = 0.046 and 0.00) and in MBPC (p = 0.005 and 0.002) groups, respectively. Mouth opening showed a statistically significant difference between the three groups at day 2 (p = 0.00). Wound dehiscence was shown in 6 patients in the PC (20%) group and 2 patients in the MBPC (6.7%) group. Dry socket was observed 3 patients in the SC group (10%), 2 patients in the PC group (6.7%), and no dry socket in the MBPC group. No cases of infection or postoperative bleeding were encountered. CONCLUSIONS: The secondary closure provides a marked advantage over the primary closure in terms of swelling and mouth opening. However, the absence of alveolitis in the primary closure using the collagen membrane and minimal wound dehiscence, suggests that membrane use may support primary healing in terms of wound healing.