Can Our Blood Help Ensure Antimicrobial and Anti-Inflammatory Properties in Oral and Maxillofacial Surgery?

In recent decades, the potential of PRF has been extensively studied. The number of studies about PRF has increased three times since the year 2012, but the full spectrum of its fundamental properties, such as antimicrobial and anti-inflammatory activity, is not clearly described. In oral and maxillofacial surgery, PRF is described in alveolar ridge preservation, orthognathic surgery, cleft lip and palate surgery, maxillary sinus augmentation, and dental implant placement as demonstrating favorable results and its clinical advantages. The structural complexity, inhomogeneous nature, and clotting ability of PRF make its antimicrobial effect evaluation complicated. Nevertheless, most of the used antimicrobial testing methods are based on antibacterial agent diffusion ability in culture media. Because the oral and maxillofacial region is the most frequent area of PRF application, its antimicrobial activity evaluation also prevails in the oral microbiome. PRF's biological potential is highly dependent on the specific preparation protocol and methodology used; it should be carefully prepared and kept under proper conditions to keep cellular content alive. PRF's influence on living cells demonstrates a stimulating effect on bone regeneration, and an angiogenetic effect, and it provides anti-inflammatory activity. According to analyzed studies, PRF demonstrated success in oral and maxillofacial surgery in various methods of application. Antibacterial and anti-inflammatory properties were proven by antibacterial activity against different bacterial species, sustained growth factor, sustained release, and cell activity on the material application. Accurately and correctly prepared PRF can ensure antibacterial and anti-inflammatory properties, and it can be a beneficial clinical tool in oral and maxillofacial surgery.

Evaluation of Condylar Positional, Structural, and Volumetric Status in Class III Orthognathic Surgery Patients.

BACKGROUND AND OBJECTIVES: The need to evaluate the condylar remodeling after orthognathic surgery, using three-dimensional (3D) images and volume rendering techniques in skeletal Class III patients has been emphasized. The study examined condylar positional, structural, and volumetric changes after bimaxillary or single-jaw maxillary orthognathic surgeries in skeletal Class III patients using the cone-beam computed tomography. MATERIALS AND METHODS: Presurgical, postsurgical, and one-year post-surgical full field of view (FOV) cone-beam computed tomography (CBCT) images of 44 patients with skeletal Class III deformities were obtained. Group 1 underwent a bimaxillary surgery (28 patients: 24 females and 4 males), with mean age at the time of surgery being 23.8 ± 6.0 years, and Group 2 underwent maxillary single-jaw surgery (16 patients: 8 females and 8 males), with mean age at the time of surgery being 23.7 ± 5.1 years. After the orthognathic surgery, the CBCT images of 88 condyles were evaluated to assess their displacement and radiological signs of bone degeneration. Three-dimensional (3D) condylar models were constructed and superimposed pre- and postoperatively to compare changes in condylar volume. RESULTS: Condylar position was found to be immediately altered after surgery in the maxillary single-jaw surgery group, but at the one-year follow-up, the condyles returned to their pre-surgical position. There was no significant difference in condylar position when comparing between pre-surgery and one-year follow-up in any of the study groups. Condylar rotations in the axial and coronal planes were significant in the bimaxillary surgery group. No radiological signs of condylar bone degeneration were detected one year after the surgery. Changes in condylar volume after surgery were found to be insignificant in both study groups. CONCLUSIONS: At one year after orthognathic surgery, there were no significant changes in positional, structural, or volumetric statuses of condyles.

Long-Term Volumetric Stability of Maxillary Sinus Floor Augmentation Using a Xenograft Bone Substitute and Its Combination with Autologous Bone: A 6+ Year Retrospective Follow-Up Study Using Cone Beam Computed Tomography.

Deproteinised bovine bone (DBB) is widely used as bone substitute in maxillary sinus floor augmentation (MSFA) surgery. No previous studies have shown the long-term volumetric changes in the augmented bone when using DBB. The selected patients had MFSA performed using a lateral window technique and a xenograft, alone or in combination with the patient's autologous bone from the mandible. Cone beam computed tomography (CBCT) images were used to compare the volumetric changes in the augmented bone for patients over a period of 6 or more years. No significant bone reduction was seen in the augmented bone region when comparing MSFA after 7 months and 6 or more years after dental implantation.

The Facial Characteristics of Individuals with Posterior Crossbite: A Cross-Sectional Study.

Facial morphology is known to be influenced by genetic and environmental factors. Scientific evidence regarding facial parameters in patients with posterior crossbite is lacking. This study aimed to investigate the association between posterior crossbite and facial parameters. This cross-sectional study included 34 adolescents with and 34 adolescents without posterior crossbite in the age range from 13 to 15 years. Facial surface scans were acquired with a 3dMD imaging system, and landmark-based analysis was performed. Data were analyzed using the Mann-Whitney U test and Spearman's correlations. Individuals in the control group had lower face heights (females: p = 0.003, r = 0.45; males: p = 0.005, r = 0.57). The control group females presented with smaller intercanthal width (p = 0.04; r = 0.31) and anatomical nose width (p = 0.004; r = 0.43) compared with the crossbite group females. The males in the control group had wider nostrils. In the control group, significant correlations among different facial parameters were more common, including the correlations between eye width and other transversal face measurements. On the contrary, the facial width was correlated with nasal protrusion (r = 0.657; p < 0.01) and the morphological width of the nose (r = 0.505; p < 0.05) in the crossbite group alone. In both groups, the philtrum width was linked with the anatomical and morphological widths of the nose. Conclusions: Patients with posterior crossbites have increased face height and different patterns of facial proportions compared with individuals without crossbites.

An in vitro and in vivo study on the intensity of adhesion and colonization by Staphylococcus epidermidis and Pseudomonas aeruginosa on originally synthesized biomaterials with different chemical composition and modified surfaces and their effect on expression of TNF-α, ß-defensin 2 and IL-10 in tissues.

UNLABELLED: The aim of this study was to determine adhesion and colonization of bacteria on the surface of originally synthesized glass-ceramic biomaterials and their effect on inflammation reactions in tissues surrounding the implant. MATERIALS AND METHODS: Biomaterial discs were contaminated with bacterial suspensions of 10, 10(2), and 10(3) colony forming units (CFU)/mL (P. aeruginosa ATCC 27853 and S. epidermidis ATCC 12228), and after 2 hours of cultivation, the intensity of bacterial adhesion was determined. For in vivo tests, the samples were contaminated with 102 and 103 CFU/mL cultivated at 37°C for 2 h to ensure bacterial adhesion. Contaminated biomaterial samples were implanted in the interscapular area of chinchilla rabbits for 2 and 4 weeks. The biomaterials were removed, and using plate count and sonification methods, bacterial colonization on the surface of biomaterials was determined. Moreover, the expression of TNF-α, ß-defensin 2, and IL-10 in the surrounding tissues was assessed by using immunohistochemistry methods. RESULTS: P. aeruginosa more intensively colonized biomaterials in the in vivo study as compared with S. epidermidis. Il-10 is a regulatory cytokine, which reduces the intensity of inflammatory cell activity, thus reducing nonspecific resistance of the organism. CONCLUSIONS: The expression of TNF-α and IL-10 was not affected by short (2 and 4 weeks) biomaterial implantation. Pronounced cytokine expression in tissues around implanted biomaterials contaminated with P. aeruginosa was observed.

Basal Cell Carcinoma. Analysis of 395 cases localized in the neck, ear and nose region.

BACKGROUND AND OBJECTIVES: To test if there are different outcomes in basal cell carcinoma for lesion size, histopathology, localization, and recurrence rates. MATERIALS AND METHODS: A total of 395 patients with BCC localized in the neck, nose and ear regions who were surgically treated in Latvian Oncology Centre between 2006-2011 were analyzed retrospectively. The data were analyzed using modified classification based on Clarks et al. (2014) and McKenzie et al. (2016). RESULTS: Three hundred and ninety-five cases of BCC that were surgically treated in head and neck region were reviewed. Results were tabulated in four categories: anatomical region, histopathology, lesion size, and recurrence rates. Classification by anatomical region: 228 cases in the nose region, 82 cases in the neck region, 82 cases in the ear region. Classification by histopathology: 259 cases presented as low risk BCC [nodular, pigmented, adenoid, keratotic and cystic], 21 cases presented as superficial, 94 cases presented as mixed, and 21 cases presented as high-risk BCC (metatypical, morphea form). Mann-Whitney U test was used to compare recurrent BCC cases to non-recurrent cases. Significantly higher recurrence rates were observed if BCC at the time of the excision was ≥10 mm (p<0.001). Significance was also noted in cases where histopathology was mixed BCC and in cases where mixed BCC was localized to the nose region (p<0.001). CONCLUSION: More attention should be brought to assessing classification and clinical treatment synergy. Higher recurrence rates are observed when lesions occur in high risk anatomical region (H zone), when lesion size reaches or exceeds 20 mm in diameter, and when lesion is subtyped as mixed BCC. It is crucial to evaluate risk factors such as BCC subtype and localization, as these are associated with a higher rate of recurrence when present in a single lesion. These risk factors, together with pre-treatment lesion evaluation will enable formulation of better treatment plan and prognostic aspects in each case.

Early morphofunctional response of contact tissue after intraosal implantation in rabbit jaw of pure synthetic hydroxyapatite (HAp) bioceramic materials and HAp saturated with lidocaine.

PURPOSE: The aim of this study was to evaluate early morphofunctional response of contact tissue to pure and saturated with lidocaine porous synthetic HAp ceramic implants inserted in holes of rabbit upper jaw. MATERIALS AND METHODS: Pure and saturated with lidocaine cylinders of porous HAp ceramics produced at Biomaterials R&D Laboratory of Riga Technical University were inserted into edentulous part of the upper jaw of 12 New Zealand male rabbits. After two weeks, blocks of soft tissue and bone were taken out. The sections done with EXACT Grunding system and from paraffin blocks were stained with haematoxylin/eosin and by use of biotin-streptavidin immunohistochemistry for transforming growth factor beta1 (TGFbeta1), fibroblast growth factor receptor 1 (FGFR1), interleukin 10 (IL10). Apoptosis was detected by TUNEL method. RESULTS: TGFbeta1 was equally expressed in the bone around HAp implants saturated with lidocaine and without lidocaine, while control sections did not show any expression of TGFbeta. In contacting bone tissue to pure HAp and HAp saturated with lidocaine as well in controls rich expression of FGFR1 was observed. In soft tissue of experimental samples also rich expression of FGFR1 was observed, although it was weak in control samples. IL10 had rich expression in all samples. The mean number of apoptotic cells was higher in samples with pure HAp, slightly decreased in samples HAp with lidocaine and significantly lower in controls. CONCLUSIONS: The expression of TGF beta1 confirms osteoinductive activity of HAp. Contact soft tissue to HAp showed rich FGFR1 expression, and weak in controls suggesting higher plasticity of connective tissue to implants in comparison with supportive tissue. Slightly lower apoptosis in samples of HAp with lidocaine gives evidence of indistinct influence of saturated with lidocaine HAp implants on development of programmed cell death.

Growth factors, apoptotic cells and barx1 gene in bone and soft tissue of skeletal class III patients.

UNLABELLED: Growth factors and growth stimulating genes are main signaling molecules for growth and development in ante- and postnatal period involved in cellular proliferation, differentiation and morphogenesis of tissues and organs during embryogenesis, postnatal growth and adulthood. The aim of this study was to evaluate TGF-beta (transforming growth factor-beta), BMP2/4 (bone morphogenetic protein 2/4), FGFR1 (fibroblast growth factor receptor one), barx1 gene and apoptosis from tissue samples of oro-maxillo-facial region in skeletal class III patients to reveal possible morphopathogenesis of severe skeletal anomalies. The study group included 9 patients with skeletal class III malocclusion. During orthognatic surgery tissue samples from tuber maxillae, ramus mandibulae anterior and posterior part, as well as gingiva from the lower jaw in region of second molar have been taken. Samples were stained with immunohistochemistry for TGF-beta, BMP2/4, FGFR1, apoptosis and barx1 gene. We used also the routine histological staining with haematoxyline and eosine. In tuber maxillae, ramus mandibulae anterior and posterior part staining for TGF-beta was the most relevant. Also BMP2/4, FGFR1 and barx1 showed the highest mean number of positive cells in tuber maxillae. Barx1 was equally expressed in ramus mandibulae, but BMP2/4 and FGFR1 mainly stained its posterior part cells. Apoptosis mostly affected ramus mandibulae anterior part. CONCLUSIONS: We suggest about more active stimulation of bone growth in tuber maxilla whereas ramus mandibulae. Apoptosis mainly affects ramus mandibulae anterior part that possibly connects to the lower expression of growth stimulating factors and may indicate lower bone remodelation ability.

Volumetric analysis of implanted biphasic calcium phosphate/collagen composite by three-dimensional cone beam computed tomography head model superimposition.

Facial onlay augmentation is often performed as an ancillary procedure simultaneously with orthognathic surgery to improve facial appearance, with hydroxyapatite (HAp) and HAp-based composites often used as the materials of choice. The ability to apply HAp in a granular rather than solid shape form may be responsible for its comparatively reduced rate of complications. However, a known complication of HAp and HAp composites is reduction of implant volume over time associated with resorption of the material. Evaluation of the volumetric changes of implanted biphasic calcium phosphate (HAp/ß-TCP)/collagen composite in the malar areas from baseline to 4 months, 9-12 months, and 18-24 months after surgery using cone beam computed tomography (CBCT) surface superimposition and volumetric subtraction was done. The average decrease of volume of implanted HAp/ß-TCP 4 months after surgery was 18.6%. Further volumetric decreases were negligible and a mean total volume loss of 21.65% was found at 18-24 months postoperatively.