Surgical ciliated cyst of the maxilla. Clinical case.

Surgical ciliated cyst is uncommon in Western countries but frequently reported in Asian populations as a delayed complication of surgery, with inclusion in the bone of nasal or sinus mucosa. Isolated cases have also been reported in the mandible after orthognathic surgery. We report a case in the maxillary region three years after radical sinus surgery for chronic sinusitis. Intraoral examination revealed a small painless tumefaction with no color change in the surrounding tissues. Computed tomography demonstrated a well-defined intraosseous lesion lateral to the maxillary sinus. The lesion was completely excised, when histology demonstrated a pseudostratified ciliated epithelial lining. Differential diagnosis from other lesions such as an odontogenic keratocyst or inflammatory cyst were also made. This case report,uncommon in Western countries, of a surgical ciliated cyst illustrates the need for a meticulous surgical technique, proper management of complications, and routine, long-term follow-up of patients undergoing any type of sinus surgery.

Osseointegration of TI6Al4V dental implants modified by thermal oxidation in osteoporotic rabbits.

BACKGROUND: In this work, the effect of the heat treatment on Ti6Al4V implants and topical administration of growth hormone to address a better osseointegration in osteoporotic patients has been analysed. METHODS: The osseointegration process of Ti6Al4V implants modified by oxidation treatment at 700 °C for 1 h and the influence of local administration of growth hormone (GH) in osteoporotic female rabbits after 15 and 30 days of implantation have been studied. Bone response was analysed through densitometric and histomorphometric studies. Characterization of the surface was provided by scanning electron microscopy. RESULTS: The oxidation treatment promotes the formation of an oxide scale grown on the Ti6Al4V implants that alters the nanoroughness of the surface. Bone mineral density (BMD) increases from 0.347 ± 0.014 (commercial) to 0.383 ± 0.012 g cm-2 (modified), and bone-to-implant contact (BIC) goes from 48.01 ± 14.78 (commercial) to 55.37 ± 15.31 (modified) after 30 days of implantation. CONCLUSIONS: The oxidation treatment on the Ti6Al4V dental implants enhances the early bone formation at the longest periods of implantation. No significant differences in the BMD and BIC results in healthy and osteoporotic rabbits were revealed with respect to the local administration of GH in the implantation site.

Determination of metallic traces in kidneys, livers, lungs and spleens of rats with metallic implants after a long implantation time.

Metallic transfer from implants does not stop at surrounding tissues, and metallic elements may be transferred by proteins to become lodged in organs far from the implant. This work presents an in vivo study of metallic implant corrosion to measure metallic element accumulation in organs located far from the implant, such as kidneys, livers, lungs and spleens. The studied metallic implant materials were CoCr alloy, Ti, and the experimental alloy MA956 coated with alpha-alumina. The implants were inserted in the hind legs of Wistar rats. Analysis for Co, Cr, Ti and Al metallic traces was performed after a long exposure time of 12 months by Inductively Coupled Plasma (ICP) with Mass Spectrometry (MS). According to the results, the highest Cr and Ti concentrations were detected in spleens. Co is mainly found in kidneys, since this element is eliminated via urine. Cr and Ti traces increased significantly in rat organs after the long implantation time. The organs of rats implanted with the alpha-alumina coated experimental MA956 did not present any variation in Al content after 12 months, which means there was no degradation of the alumina layer surface.

Local administration of growth hormone enhances periimplant bone reaction in an osteoporotic rabbit model.

OBJECTIVE: The purpose of this study was to determine whether rhGH administered locally during the surgical placement of an implant, in the tibia of an osteoporotic rabbit model, would induce qualitative and quantitative differences in peri-implant bone reaction. MATERIALS AND METHODS: Eight New Zealand rabbits were ovariectomized and fed with a low-calcium diet (with 0.07% of calcium) to induce osteoporosis. After 6 weeks, an experimental titanium sheet was inserted into the rabbit tibiae. The rabbits were randomly divided into two groups. The experimental group was treated with 4 IU of rhGH added locally into the ostectomy as a lyophilized powder and the control group was left without any treatment. After 2 weeks, animals were sacrificed, tibial sections were prepared and bone-titanium interface was examined at light microscopy, using Masson, hematoxylin-eosin and Pichrosirius stains. Light microscopic morphometry and densitometry were used to comparatively quantitate bone reaction. RESULTS/CONCLUSION: Local administration of rhGH during the surgical placement of titanium sheets on the tibiae of an osteoporotic rabbit model enhances periosteal and transcortical reaction and mineralization of osteoid 14 days later around titanium sheets, without increasing bone resorption.

Surgical ciliated cyst of the maxilla. Clinical case

Surgical ciliated cyst is uncommon in Western countries but frequently reported in Asian populations as a delayed complication of surgery, with inclusion in the bone of nasal or sinus mucosa. Isolated cases have also been reported in the mandible after orthognathic surgery. We report a case in the maxillary region three years after radical sinus surgery for chronic sinusitis. Intraoral examination revealed a small painless tumefaction with no color change in the surrounding tissues. Computed tomography demonstrated a well-defined intraosseous lesion lateral to the maxillary sinus. The lesion was completely excised, when histology demonstrated a pseudostratified ciliated epithelial lining. Differential diagnosis from other lesions such as an odontogenic keratocyst or inflammatory cyst were also made. This case report,uncommon in Western countries, of a surgical ciliated cyst illustrates the need for a meticulous surgical technique, proper management of complications, and routine, long-term follow-up of patients undergoing any type of sinus surgery (AU)