Topical applications of vitamin D on implant surface for bone-to-implant contact enhance: a pilot study in dogs part II.

OBJECTIVE: The aim of this study was to evaluate the effect of topical application of vitamin D over implant surface, placed immediately to the extraction, throughout histological and histomorphometric analysis of peri-implant tissue. MATERIAL AND METHODS: Six American foxhound dogs were used in the study. Mandibular premolar distal roots were extracted. Twenty-four immediate conical C1 implants (MIS, Barlev, Israel) were randomly assigned to the distal site on each site of the mandible in three groups: (Group CI) 12 titanium implants alone; (Test Group DI) 12 titanium implants supplemented with vitamin D. Prior to implanting, test implants (DI) were submerged in vitamin D 10% solution. No treatment was applied at control implants (CI). After 12 weeks, animals were sacrificed. Block sections were obtained and processed for mineralized ground sectioning. Bone-to-implant contact (Total BIC and BIC%), new bone formation (NBF), interthread bone (ITB), and histological linear measurements (HLM) were analyzed. RESULTS: At 12 weeks, all implants were clinically stable and histologically osseointegrated. BIC evaluation showed Total BIC mean and SD values for DI (48.96 ± 2.14), CI (44.56 ± 1.75) (P < 0.05), BIC% DI (43.59 ± 0.98), and CI (42.67 ± 9.26) (P > 0.05). For interthread bone formation, values were as follows: DI (15.21 ± 3.87), CI (14.79 ± 1.45) (P > 0.05), no statistically differences. Regarding peri-implant new bone formation, no statistically differences could be found between the two groups DI (31.87 ± 1.23), CI (27.18 ± 2.38) (P > 0.05). For linear measurements, test group (DI) showed statistically significant less buccal crestal bone loss (CBL) DI (0.37 ± 0.12)*, CI (1.26 ± 0.8) (P < 0.05), and vitamin D implants showed less lingual junctional epithelium DI (1.58 ± 0.43)*, CI (2.18 ± 0.48) (P < 0.05). No differences were observed in the buccal mucosa. CONCLUSION: With the limitation of animal studies, topical application of vitamin D on dental implants could reduce crestal bone loss and increase 10% more bone-to-implant contact at 12-week follow-up period.

Xenografts Supplemented with Pamindronate placed in postextraction sockets to avoid crestal bone resorption. Experimental study in Fox hound dogs.

OBJECTIVES: The aim of the study was to compare the effects of porcine xenografts (MP3(®)) with or without pamindronate for the healing of small and large defects of postextraction sockets. MATERIALS AND METHODS: Six beagle dogs were used in the study; second premolars and first molars of the mandible were extracted, small defects (SD) and large defects (LD) were identified. Each defect was measured and randomly filled as follows: SC (small control defects filled with MP3(®) alone), ST (small test defects filled with MP3(®) modified with pamindronate), LC (large control defects filled with MP3(®) alone), LT (large test defects filled with MP3(®) modified with pamindronate). After 4 and 8 weeks, the animals were euthanized and the percentages of new bone formation (NB), residual graft (RG) and connective tissue (CT) were analysed by histology and histomorphometry of undecalcified samples. RESULTS: After 4 weeks, NB formation was higher for ST compared to all groups and for LT compared to LC (P < 0.05); RG was significantly higher in both control groups compared to tests (P < 0.05); and CT was higher in large defects (LC and LT) compared to small defects. After 8 weeks, NB formation was higher for test groups (ST and LT) compared to controls (P < 0.05); RG was significantly higher in both control groups compared to tests (P < 0.05); and CT was higher in large defects (LC and LT) compared to small defects (P < 0.05). CONCLUSIONS: Within the limitations of this experimental study, the findings suggest that porcine xenografts modified with pamindronate favours the new bone formation and increased the porcine xenograft substitution/replacement after 4 and 8 weeks of healing.

Zirconia with laser-modified microgrooved surface vs. titanium implants covered with melatonin stimulates bone formation. Experimental study in tibia rabbits.

OBJECTIVES: The aim of the study was to evaluate if zirconia implants with micro-grooved surfaces supplemented with melatonin enhance the bone-to-implant contact (BIC) vs. titanium implants with the same coating. MATERIALS AND METHODS: Eighty implants divided in four groups were inserted in the tibia of 20 New Zealand rabbits as follows: (group A) 20 titanium implants; (group B) 20 micro-grooved zirconia implants; (group C) 20 titanium implants supplemented with melatonin and (group D) 20 micro-grooved zirconia implants supplemented with melatonin. Histometric and SEM evaluation of BIC were evaluated after 1 and 4 weeks. RESULTS: At 1 week, group C (29.7 ± 2.4%) and group D (28.9 ± 1.3%) implants showed higher BIC% compared with group A and B (P < 0.05). After 4 weeks, group D showed higher BIC compared with all the groups (47.5 ± 2.2%) (P < 0.05). Also Connective tissue was higher in groups B (78.9 ± 2.1%) and D (88.7 ± 1.2%) related to titanium and zirconia melatonin untreated at 4 weeks (P < 0.05). CONCLUSIONS: Within the limitations of this pilot study in rabbits, we can conclude that the local application of melatonin increases the BIC values in titanium and in zirconia implants at 1 week.

Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction. A preliminary study.

Pain, swelling, and trismus are the most common complications after surgical removal of impacted lower third molars. The aim of this study was to evaluate the analgesic and anti-inflammatory effects of a low-level laser therapy (Laser Smile™, Biolase®, San Clemente, USA) applied to the wound appeared after the surgical removal of impacted lower third molars. A prospective, randomized, and double-blind study was undertaken in 20 healthy patients with two symmetrically impacted lower third molars. The application of a low-level laser was made randomly on one of the two sides after surgery. The experimental side received 5 J/cm(2) of energy density, a wavelength of 810 nm, and an output power of 0.5 W. On the control side, a handpiece was applied intraorally, but the laser was not activated. Evaluations of postoperative pain, trismus, and swelling were made. The sample consisted of 11 women and nine men, and mean age was 23.35 years (18-37). The pain level in the first hours after surgery was lower in the experimental side than in the placebo side, although without statistically significant differences (p = 0.258). Swelling and trismus at the 2nd and 7th postoperative days were slightly higher in the control side, although not statistically significant differences were detected (p > 0.05). The application of a low-level laser with the parameters used in this study did not show beneficial affects in reducing pain, swelling, and trismus after removal of impacted lower third molars.

Necrosis of the skin of the chin: a possible complication of inferior alveolar nerve block injection.

BACKGROUND: The literature describes different local complications derived from a local anesthetic. The authors present a report of a case of such a complication-a complication of which they have identified only one other similar case in the literature. CASE DESCRIPTION: A 10-year-old girl received an inferior alveolar nerve block injection for a dental restoration on the right side. After the procedure, she developed pallor of the right side of the lower lip and chin that subsequently evolved into a surface ulceration. The lesion suddenly healed 15 days later. The authors ruled out self-inflicted injury, intra-operative injury and skin infection as causes. CONCLUSIONS: and CLINICAL IMPLICATIONS: On the basis of the clinical manifestations and affected anatomical structures, the authors postulated skin necrosis secondary to vascular spasm of the terminal branches of the inferior alveolar artery. Even when clinicians use the utmost care, this kind of complication can occur as a result of an inferior alveolar nerve block injection. The practitioner should diagnose the problem appropriately and reassure the patient.