Vertical Bone Augmentation With Customized CAD/CAM Titanium Mesh for Severe Alveolar Ridge Defect in the Posterior Mandible: A Case Letter.

Implant rehabilitation after implant removal is a major challenge, especially in mandibular posterior arches. This case report describes the reconstruction of a severe vertical bone defect using customized titanium mesh covered by collagen membrane and solid advanced platelet-rich fibrin, combined with autogenous bone, deproteinized bovine bone mineral, and injectable platelet-rich fibrin after implant removal caused by advanced peri-implantitis. This individualized titanium mesh may be a reliable technique for severe alveolar ridge reconstruction, with the additional benefits of reduced surgery time and a simplified operation.

Effect of topical ozonetherapy on gingival wound healing in pigs: histological and immuno-histochemical analysis

Abstract In this study, the effects of ozonetherapy on secondary wound healing were evaluated histologically and immuno-histochemically. Material and Methods: 8 healthy pigs were used in this study. Six wounds with 10 mm in diameter were created through the punch technique on the palatinal gingiva of each pig. Ozone gas was applied on only 3 wounds (test group) and the remaining 3 were left to natural healing (control group). Biopsy samples were taken from one of the wounds in each group on the third day, from another wound of each group on the seventh day, and from another one on the tenth day. Routine histological analysis and immuno-histochemical staining were performed to investigate transforming growth factor-beta (TGF-β) and (VEGF) expressions. Results: No statistical difference was found between the test and control groups in terms of collagen fibers, epithelial formation and inflammation scores. A VEGF expression found in the test group was statistically higher than control group samples taken on the 3rd and 7th day. There was no statistical difference between the test and control groups in terms of TGF-β expression on any of the sampling days. Conclusion: The topical application of ozone gas could be effective in the early stages of wound healing by increasing the amount of VEGF expression. Clinical Relevance: Topical application of ozone gas may be effective in the early stages of oral wound healing.

Effect of topical ozonetherapy on gingival wound healing in pigs: histological and immuno-histochemical analysis.

OBJECTIVES: In this study, the effects of ozonetherapy on secondary wound healing were evaluated histologically and immuno-histochemically. MATERIAL AND METHODS: Material and Methods: 8 healthy pigs were used in this study. Six wounds with 10 mm in diameter were created through the punch technique on the palatinal gingiva of each pig. Ozone gas was applied on only 3 wounds (test group) and the remaining 3 were left to natural healing (control group). Biopsy samples were taken from one of the wounds in each group on the third day, from another wound of each group on the seventh day, and from another one on the tenth day. Routine histological analysis and immuno-histochemical staining were performed to investigate transforming growth factor-beta (TGF-ß) and (VEGF) expressions. RESULTS: Results: No statistical difference was found between the test and control groups in terms of collagen fibers, epithelial formation and inflammation scores. A VEGF expression found in the test group was statistically higher than control group samples taken on the 3rd and 7th day. There was no statistical difference between the test and control groups in terms of TGF-ß expression on any of the sampling days. CONCLUSIONS: Conclusion: The topical application of ozone gas could be effective in the early stages of wound healing by increasing the amount of VEGF expression. Clinical Relevance: Topical application of ozone gas may be effective in the early stages of oral wound healing.

Histological Characteristics of Ligaments between Middle Ear and Temporomandibular Joint.

OBJECTIVES: To examine histological aspects of the ligaments between the middle ear and temporomandibular joint and suppose a theoretical role of their structural characteristics on mobility of mallear ossicle. METHODS: The ligaments were obtained by microdissection of middle cranial fossa on both sites of 15 cadavers fixed in formalin solution and were sectioned longitudinally (7-10 mum thickness). The sections were stained with Verhoff's Van Gieson's stain (VVG) for demonstration of elastic fibers and visualized at X2.5 and X10 magnifications under light microscopy. RESULTS: Anterior mallear ligament (AML) and sphenomandibular ligaments (SML) were consisted of collagen fibres in analyzed specimens. The discomallear ligament (DML) was constituted of rich collagenous fibres. One specimen of DML harvested between petrotympanic fissure and retrodiscal-capsular intersection site contained elastic fibers dispersed in cotton-bowl appearance between collagen fibers. In the light of functional tests performed in previous studies, it could be extrapolated that presence of elastic fibers in the DML may prevent excessive forces conducted to mallear head by elongation of elastic fibers. CONCLUSIONS: Collagenous fibres have no ability to stretch along their axis which may lack compensatory mechanism to prevent mallear head mobility.

Non-infiltrating angiolipoma of the cheek: a case report and review of the literature.

Angiolipoma, spindle cell lipoma, mylelolipoma, chondrolipoma and myxolipoma are histologic variants of lipomas arising from fat tissue. Although angiolipoma is the most common tumor in the trunk and extremities of young people, it occurs infrequently in the head and neck region. The authors present the clinical and histological features of a non-infiltrating angiolipoma excised from the cheek of a 22-year old man. Clinical examination showed a soft, mobile, approximately 4 x 3 cm mass that could be palpated anterior to the masseter muscle. The mass was removed by an intraoral approach. Angiolipoma was confirmed on histopathologic evaluation. Lipomas represent about 1 to 5% of all neoplasms of the oral cavity. They are usually painless, soft, round and mobile. The diagnosis is based on both clinical and histologic characteristics. The treatment is surgical excision.

Extraction of upper first molar resulting in fracture of maxillary tuberosity.

Fracture of the maxillary tuberosity sometimes can happen when pneumatization of the maxillary sinus extends between the roots of upper molars. Some factors may lead to this complication including prominent or curved roots, chronic periapical infection, hypercementosis, root ankylosis and tooth fusion. This paper reports a case with fracture of the maxillary tuberosity following extraction of an upper first molar in general dental practice. Prevention from any complication during extractions of maxillary molars with large antral enlargement is possible with careful preoperative examination and accurate surgical planning. The general dentist should be prepared to refer such cases to an oral surgeon when facing difficulties like the presented case.

Retrospective radiographic evaluation of the anterior loop of the mental nerve: comparison between panoramic radiography and spiral computerized tomography.

PURPOSE: This study compares the prevalence and the length of mental loops, which were measured with panoramic radiographs and spiral computerized tomographs (SCT). MATERIALS AND METHODS: Seventy-three panoramic radiographs and 73 SCTs were taken for preoperative planning of implant placement in the interforaminal region of the anterior mandible. The bone quality of both mental regions in each patient was determined by 1 experienced calibrated clinician, and the cross-sectional images of the SCTs were evaluted for bone quality according to the Lekholm and Zarb classification. Panoramic radiographs and cross-sectional SCT images were examined carefully by the same calibrated clinician to determine the presence and to measure the length of the mental loop in each patient. The relationship between these radiographs was also examined and correlated with bone quality. Paired samples t test and Pearson's correlations were used to examine the agreement between 2 radiographic methods at each bone quality. A 5% level of significance was chosen. RESULTS: The prevalence of the mental loop in panoramic radiographs and spiral CT images was 28% and 34%, respectively. The mental loop was identified more frequently in spiral CT images regardless of bone quality. The demonstration of the mental loop between radiographic methods was more pronounced in poor bone quality. The mean length of the mental loop in panoramic radiographs was 3.71 +/- 1.35 mm and 3.00 +/- 1.41 mm in SCT. Measurements for panoramic radiographs were higher than those for spiral CT images. There was a correlation of r = 0.66 (P = .01) between the 2 radiographic methods, indicating agreement. CONCLUSIONS: SCT demonstrated a higher prevalence of mental loops than panoramic radiographs. SCT can be more useful to visualize and measure the mental loop in low bone qualities. Panoramic radiographs significantly overestimate (P = .02 in type 3, P = .01 in type 4) mental loop length, which were measured in spiral CT images in poor bone quality, but there is a close correspondence between these 2 radiographs in higher quality bone.

Treatment of complex dentoalveolar injury--avulsion and loss of periodontal tissue: a case report.

Dental avulsion is a common and complex injury which affects multiple oral tissues. In this case report, a 9-year-old girl patient with two traumatically avulsed maxillary central incisors with loss of periodontal tissue was presented. Treatment guidelines for avulsed permanent teeth with open apex were carried out. Bilateral laterally sliding flap procedure was performed, to repair loss of gingival soft tissue. Conventional immobilization was carried out for 6 weeks. Five months follow-up of the patient in whom replantation was performed resulted in positive sensitivity test, no symptoms of infection, pain or any discomfort and good periodontal wound healing. In conclusion, this report presents successful replantation and periodontal treatment of a patient with complex dentoalveolar injury.

Prevalence of human herpesviruses in patients with aggressive periodontitis.

BACKGROUND: Recent studies have demonstrated that various human viruses, especially cytomegalovirus (HCMV) and Epstein-Barr virus type-1 (EBV-1), seem to play a part in the pathogenesis of human periodontitis. The aim of this investigation was to evaluate the subgingival presence of HCMV and EBV in patients with aggressive periodontitis (AgP) and healthy subjects and to examine the effect of treatment on the incidence of these viruses 3 months following surgery. METHODS: A polymerase chain reaction (PCR) method determined the presence of HCMV and EBV-1. Subgingival plaque samples from 17 consecutive AgP patients and 16 healthy controls were collected. The following indices were measured: plaque index (PI), gingival index (GI), probing depths (PD), and clinical attachment loss (CAL). Clinical parameters were assessed pretherapy and at 3 months following surgical and antimicrobial therapy. RESULTS: HCMV was detected in 64.7% of AgP patients but not detected in healthy subjects (P < 0.001) and EBV-1 in 70.6% of AgP patients and 6.3% of the healthy controls (P < 0.001). HCMV and EBV-1 coinfection was detected in 41.7% of AgP patients. A statistically significant decrease was found in all clinical parameters 3 months after treatment. There was a statistically significant decrease in HCMV and EBV-1 following therapy (P < 0.001; no HCMV; 1 patient with EBV-1). CONCLUSIONS: These findings indicate that subgingival presence of EBV-1 HCMV is strongly associated with aggressive periodontitis, and coinfection with HCMV and EBV-1 appears to be particularly deleterious to periodontal health.

Detection of human viruses in patients with chronic periodontitis and the relationship between viruses and clinical parameters.

BACKGROUND: Recent studies have demonstrated that various human viruses, especially cytomegalovirus (HCMV), Epstein-Barr virus type-1 (EBV-1), and herpes simplex virus (HSV), seem to play a part in the pathogenesis of human periodontitis. Little information is available on the relationship between these viruses and clinical periodontal parameters in patients with chronic periodontitis. This study examined the occurrence of HCMV, EBV-1, and HSV in patients with chronic periodontitis and the relationship between these viruses and clinical parameters. METHODS: A nested polymerase chain reaction (PCR) method determined the presence of HCMV, EBV-1, and HSV. Subgingival plaque samples from 30 patients with chronic periodontitis and 21 randomly selected healthy controls were collected by paper points, and clinical measurements were recorded from both sampling sites and entire dentition. The following indices were measured: plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (CAL). RESULTS: HCMV was detected in 44.3% of chronic periodontitis patients and 14.3% of healthy persons (P < 0.05); EBV-1 in 16.7% of chronic periodontitis patients and 14.3% of healthy persons (P = 1.00); and HSV in 6.7% of chronic periodontitis patients and in no healthy persons. HCMV and EBV-1 detected and undetected sites in patients with periodontitis showed statistically significant differences in sampling clinical depth (SPD) and sampling clinical attachment loss (SCAL). Differences in the measurements of PI of entire dentition and GI of entire dentition between HSV detected and undetected sites were statistically significant. CONCLUSIONS: Findings of the present study confirm the frequent presence of HCMV in crevicular samples of chronic periodontitis lesions, and suggest a strong relationship between the presence of HCMV and EBV-1 in subgingival areas and the measurements of probing depth and probing attachment loss.