Antibacterial properties of marine algae incorporated polylactide acid membranes as an alternative to clinically applied different collagen membranes.

The reconstruction of bony defects in the alveolar crest poses challenges in dental practice. Guided tissue regeneration (GTR) and guided bone regeneration (GBR) procedures utilize barriers to promote bone regeneration and prevent epithelial growth. This study focuses on evaluating the antibacterial properties of marine algae-polylactic acid (PLA) composite membranes compared to commercially available collagen membranes. Marine algae (Corallina elongata, Galaxaura oblongata, Cystoseira compressa, Saragassum vulgare, and Stypopodium schimperi) were processed into powders and blended with PLA to fabricate composite membranes. Cytocompatibility assays using human periodontal ligament fibroblasts (n = 3) were performed to evaluate biocompatibility. Antibacterial effects were assessed through colony-forming units (CFU) and scanning electron microscopy (SEM) analysis of bacterial colonization on the membranes. The cytocompatibility assays demonstrated suitable biocompatibility of all marine algae-PLA composite membranes with human periodontal ligament fibroblasts. Antibacterial assessment revealed that Sargassum vulgare-PLA membranes exhibited the highest resistance to bacterial colonization, followed by Galaxaura oblongata-PLA and Cystoseira compressa-PLA membranes. SEM analysis confirmed these findings and revealed smooth surface textures for the marine algae-PLA membranes compared to the fibrous and porous structures of collagen membranes. Marine algae-PLA composite membranes show promising antibacterial properties and cytocompatibility for guided bone and tissue regeneration applications. Sargassum vulgare-PLA membranes demonstrated the highest resistance against bacterial colonization. These findings suggest that marine algae-PLA composite membranes could serve as effective biomaterials for infection control and tissue regeneration. Further in vivo validation and investigation of biodegradation properties are necessary to explore their clinical potential.

Training in the use of the water jet and cold atmospheric plasma jet for the decontamination of dental implants.

OBJECTIVES: Clinical trials testing new devices require prior training on dummies to minimize the "learning curve" for patients. Dentists were trained using a novel water jet device for mechanical cleaning of dental implants and with a novel cold plasma device for surface functionalisation during a simulated open flap peri-implantitis therapy. The hypothesis was that there would be a learning curve for both devices. MATERIALS AND METHODS: 11 dentists instrumented 44 implants in a dummy-fixed jaw model. The effect of the water jet treatment was assessed as stain removal and the effect of cold plasma treatment as surface wettability. Both results were analysed using photographs. To improve treatment skills, each dentist treated four implants and checked the results immediately after the treatment as feedback. RESULTS: Water jet treatment significantly improved from the first to the second implant from 62.7% to 75.3% stain removal, with no further improvement up to the fourth implant. The wettability with cold plasma application reached immediately a high level at the first implant and was unchanged to the 4th implant (mean scores 2.7 out of 3). CONCLUSION: A moderate learning curve was found for handling of the water jet but none for handling of the cold plasma. CLINICAL RELEVANCE: Scientific rational for study: Two new devices were developed for peri-implantitis treatment (Dental water jet, cold plasma). Dentists were trained in the use of these devices prior to the trial to minimize learning effects. PRINCIPAL FINDINGS: Experienced dentists learn the handling of the water jet very rapidly and for cold plasma they do not need much training. PRACTICAL IMPLICATIONS: A clinical study is in process. When the planned clinical study will be finished, we will find out, if this dummy head exercise really minimised the learning curve for these devices.

Reliability of probing depth assessments at healthy implant sites and natural teeth.

AIM: To evaluate the intra- and inter-examiner reliability in the assessment of probing depth (PD) measurements at healthy dental implant sites and periodontally healthy natural teeth. MATERIALS AND METHODS: Five patients exhibiting 21 dental implants were enrolled in the study. Eight experienced examiners performed duplicate PD measurements at six sites of all implants and of preselected natural teeth. Intra-examiner accuracy was estimated using intra-examiner correlation coefficients (ICCs) with 95% confidence intervals (CI). A gold standard (GS) examiner was set. Inter-examiner accuracy compared to the GS examiner was assessed using pairwise inter-examiner ICCs. RESULTS: The intra-examiner ICC ranged from 0.759 (95% CI, 0.692-0.812) to 0.863 (95% CI, 0.826-0.892) for the measurements at teeth and from 0.712 (95% CI, 0.580-0.800) to 0.841 (95% CI, 0.774-0.888) for the PDs assessed at implants. The inter-examiner ICCs for tooth measurements varied from 0.197 (95% CI, - 0.280 to 0.511) to 0.791 (95% CI, 0.560-0.892). The corresponding values for the assessments at implants varied from 0.576 (95% CI, 0.286-0.734) to 0.794 (95% CI, 0.708-0.855). CONCLUSIONS: The intra- and inter-examiner reproducibility of repeated PD measurements assessed by experienced examiners tended to be higher for the measurements at periodontally healthy teeth compared to healthy dental implant sites. CLINICAL RELEVANCE: Experienced examiners demonstrated a higher degree of reliability of probing measurements around teeth compared to dental implants.

Organic Bone Matrix Component Type I and V Collagen Are Not Destructed in Bisphosphonate-Associated Osteonecrosis of the Jaws.

Background and objectives: The investigation of the pathophysiology behind medication-related osteonecrosis (MRONJ) of the jaw mostly focuses on alterations in osteoclast and osteoblast cell activity, but changes in the organic and inorganic bone matrix have rarely been studied. The aim of this study was to investigate whether collagen, the main organic component of extracellular bone matrix, is destructed in osteonecrosis of the jaw secondary to antiresorptive medication. Material and methods: Bone samples of patients with MRONJ (n = 15, control group n = 3) were demineralized, and collagen fragments were separated from intact collagen pellets by ultrafiltration. The quantification of mature collagen cross-links hydroxylysylpyridinoline (HP) and lysylpyridinoline (LP) in pellets and ultrafiltrates was performed by high-performance liquid chromatography (HPLC). The detection of hydroxyproline (Hyp) was carried out using a spectrophotometric assay. In addition, collagen chains were analyzed by sodium dodecylsulfate-polyacrylamide gel (SDS-PAGE). Results: The results revealed significantly higher concentrations of HP, LP and Hyp in pellet samples. In addition, there were no significant differences between samples from MRONJ patients and those of the control group. These results were paralleled by SDS- PAGE. Conclusion: These findings suggest that MRONJ does not involve the destruction of type I and V collagen molecules, in contrast to previously reported destruction by osteoradionecrosis.

A clinical study on the 6-year outcomes of immediately loaded three implants for completely edentulous mandibles: "the all-on-3 concept".

The objective of the current study was to demonstrate the 6-year clinical and radiological treatment outcomes of the technique performed by immediately loading of three implants (single straight in the mid-line and two tilted distal implants) for the management of total edentulous mandibles and introduce a simple decision matrix for selection of the most appropriate protocol in cases with insufficient length of the interforaminal area. Re-assessments were performed over a total observation period of 6 years after surgery via measurement of bone resorption around implants, bleeding on probing, plaque accumulation, periodontal probing depth, bite force measurements and oral health impact profile. A total of 29 patients (45% women and 55% men) with a mean age of 65 ± 6 years enrolled in the study. 14 patients received an acryl-based bridge as definitive prosthetic restoration and 15 patients received a ceramic-based restoration. Both during the immediate loading phase and during the 6-year follow-up, there was no implantation loss. Regardless of the implant position, all implants showed continuous bone loss over the observation time. The bone loss around dental implants during observation period was only maximum 1.0 ± 1 mm and it remained well within the limits for 'success' according to the 2007 Pisa consensus (< 2 mm). The plaque index showed no significant fluctuations between the implant positions and the individual examination times. The approach described herein might help the surgeon by avoiding unnecessary loss of bone strength, selecting implant sites, and establishing the biomechanical advantage of increased A-P spread for immediate function.

The influence of diagnoses on patient satisfaction during inpatient stays: A prospective study.

The aim of this study was to assess patient satisfaction relating to inpatient stays. In this prospective observational study, adult patients with oncological (oral cancer, medication-related osteonecrosis of the jaw) and non-oncological (mandibular fracture) diagnoses, and who had undergone surgery, were contacted 4 weeks after discharge. Two validated questionnaires were used: EORTC QLQ-C30 for quality of life and IN-PATSAT32 for patient satisfaction. For quality of life, the mandibular fracture group had a lower impairment of physical functioning (M = 83.59, SD = 24.44; p = 0.029) in comparison with both other groups (M = 68.84, SD = 26.24; M = 59.33, SD = 24.43, for oral cancer and osteonecrosis, respectively). Regarding patient satisfaction, patients with oral cancer were slightly more satisfied with doctors' availability (M = 48.91, SD = 24.11; p = 0.583) compared with the other groups (M = 36.54, SD = 19.11; M = 46.67, SD = 20.86, for mandibular fracture and ostenecrosis, respectively). Patients with an unplanned inpatient stay following an acute event tended to be less satisfied than patients with a planned inpatient stay. Within the limitations of the study it seems that knowledge of these influencing external factors and their effects can support physicians and nursing staff in providing improved patient care.

Decontaminative Properties of Cold Atmospheric Plasma Treatment on Collagen Membranes Used for Guided Bone Regeneration.

Background cold atmospheric plasma (CAP) is known to be a surface-friendly yet antimicrobial and activating process for surfaces such as titanium. The aim of the present study was to describe the decontaminating effects of CAP on contaminated collagen membranes and their influence on the properties of this biomaterial in vitro. Material and Methods: A total of n = 18 Bio-Gide® (Geistlich Biomaterials, Baden-Baden, Germany) membranes were examined. The intervention group was divided as follows: n = 6 membranes were treated for one minute, and n = 6 membranes were treated for five minutes with CAP using kINPen® MED (neoplas tools GmbH, Greifswald, Germany) with an output of 5 W, respectively. A non-CAP-treated group (n = 6) served as the control. The topographic alterations were evaluated via X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM). Afterward, the samples were contaminated with E. faecalis for 6 days, and colony-forming unit (CFU) counts and additional SEM analyses were performed. The CFUs increased with CAP treatment time in our analyses, but SEM showed that the surface of the membranes was essentially free from bacteria. However, the deeper layers showed remaining microbial conglomerates. Furthermore, we showed, via XPS analysis, that increasing the CAP time significantly enhances the carbon (carbonyl group) concentration, which also correlates negatively with the decontaminating effects of CAP. Conclusions: Reactive carbonyl groups offer a potential mechanism for inhibiting the growth of E. faecalis on collagen membranes after cold atmospheric plasma treatment.

Effect of enriched bone-marrow aspirates on the dimensional stability of cortico-cancellous iliac bone grafts in alveolar ridge augmentation.

BACKGROUND: The objective of the current study was to assess the clinical and radiological outcomes following autologous grafting from the iliac crest treated with autologous stem cells in-situ to reduce the postoperative bone graft resorption rate. MATERIALS AND METHODS: The study group consisted of patients who underwent vertical augmentation of the jaws via bone grafts harvested from the iliac crest enriched with bone-marrow aspirate concentrates (stem cell group). The first control group (control) included 40 patients underwent a vertical augmentation with autologous bone grafts from the iliac crest. In the second control group, 40 patients received identical surgical procedure, whereas the autologous bone graft was covered with a thin layer of deproteinized bovine bone matrix and a collagen membrane (DBBM group). Clinical complications, implant survival, radiological assessment of the stability of the vertical height and histological evaluation at the recipient site have been followed up for 24 months postoperatively. RESULTS: No differences in terms of implant survival were observed in the groups. In the stem cell group, the resorption after 4-6 months was 1.2 ± 1.3 mm and significantly lower than the resorption of the control group with 1.9 ± 1.6 mm (P = 0.029) (DBBM group: 1.4 ± 1.2 mm). After 12 months, the resorption of the stem cell group was 2.1 ± 1.6 mm and significantly lower compared to the control group (4.2 ± 3.0 mm, P = 0.001) and DBBM group (resorption 2.7 ± 0.9 mm, P = 0.012). The resorption rate in the second year was lower compared to the first year and was measured as 2.7 ± 1.7 mm in the stem cell group (1-year bone loss in the time period of 12-24 months of 0.6 mm compared to 2.1 mm in the first 12 months). The resorption was significantly lower compared to the control group (4.7 ± 2.9 mm; P = 0.003, DBBM group: 3.1 ± 0.5 mm, P = 0.075). CONCLUSIONS: Autologous bone-marrow aspirate concentrate could enhance the dimensional stability of the bone grafts and improve the clinical standard of complex reconstruction of the alveolar ridge. Even though the intraoperative cell enrichment requires an additional equipment and technical specification, it represents an alternative method for in-situ regeneration by osteogenic induction with a contribution of a manageable cost factor.

In-vitro assessment of the efficiency of cold atmospheric plasma on decontamination of titanium dental implants.

BACKGROUND: The aim of the current study was to comparatively assess the efficiency of three different adjunctive therapy options (cold atmospheric plasma, [CAP], photodynamic therapy [PDT] and chemical decontamination via 35% phosphoric acid gel [PAG]) on decontamination of titanium implant surfaces in-vitro. MATERIALS AND METHODS: Implants were inserted in concavities of four mm in depth mimicking a bone defect at the implant recipient site. In each model, two implants were inserted in the fourth and one implant in the third quadrants. After contamination with E. faecalis, the first group has been treated with CAP for 3 min, the second group with 35% PAG (and the third group with PDT. After treatment, quantification of bacterial colonization was assessed by quantification via colony forming units and qualitatively by fluorescence microscopy and scanning electron microscopy. RESULTS: With a mean value of 1.24 × 105 CFU/ml, the CAP treated implants have showed the least microorganisms. The highest number of CFU was found after PDT with mean value of 8.28 × 106 CFU/ml. For the implants that were processed with phosphoric acid, a mean value of 3.14 × 106 CFU/ml could be detected. When the groups were compared, only the CAP and PDT groups differed significantly from each other (p = 0.005). CONCLUSION: A complete cleaning of the micro-textured implant surface or the killing of the bacteria could not be achieved by any of the investigated treatment options, thus bacteria in the microstructure of the titanium surface cannot be completely reached by mechanical and physico-chemical processes. CLINICAL RELEVANCE: The main goal of the adjunctive peri-implantitis treatment is the decontamination of the implant surface. However, there is still an ongoing need to define the most appropriate adjunctive therapy method. Due to its antimicrobial effects, CAP combined with mechanical debridement could be a feasible treatment modality in the management of peri-implantitis.

Learning Curve and Comparison of Dynamic Implant Placement Accuracy Using a Navigation System in Young Professionals.

The aim of the current study was to evaluate the learning curve and accuracy of implant placement by young professionals using a dynamic computer-assisted surgical system for dental implant placement. Ten students tried to place eight implants with a dynamic surgical system in predefined positions on two consecutive weekends, resulting in 160 implant placements in total. Postoperatively, the positions of the implants were scanned with an intraoral scanner and compared for deviations at the entry point, the apex, as well as angular deviations to the master model. The mean values of all measurements improved; statistical significance was found for the changes in the angle as well as for the position of the implants to the apex (p < 0.001). Furthermore, the young professionals indicated subjective improvement in handling the dynamic surgery system. Navigated surgical dental implant placement can be learned quickly and can support young professionals in everyday clinical practice, especially in difficult anatomic situations.

Introducing a Novel Experimental Model for Osseo-Disintegration of Titanium Dental Implants Induced by Monobacterial Contamination: An In-Vivo Feasibility Study.

Background and Objectives: The aim of the current study was to establish an osseo-disintegration model initiated with a single microorganism in mini-pigs. Materials and Methods: A total of 36 titanium dental implants (3.5 mm in diameter, 9.5 mm in length) was inserted into frontal bone (n: 12) and the basis of the corpus mandible (n: 24). Eighteen implants were contaminated via inoculation of Enterococcus faecalis. Six weeks after implant insertion, bone-to-implant contact (BIC) ratio, interthread bone density (ITBD), and peri-implant bone density (PIBD) were examined. In addition to that, new bone formation was assessed via fluorescence microscopy, histomorphometry, and light microscopical examinations. Results: Compared to the sterile implants, the contaminated implants showed significantly reduced BIC (p < 0.001), ITBD (p < 0.001), and PBD (p < 0.001) values. Around the sterile implants, the green and red fluorophores were overlapping and surrounding the implant without gaps, indicating healthy bone growth on the implant surface, whereas contaminated implants were surrounded by connective tissue. Conclusions: The current experimental model could be a feasible option to realize a significant alteration of dental-implant osseointegration and examine novel surface decontamination techniques without impairing local and systemic inflammatory complications.

Clinicopathological Risk Factors for Contralateral Lymph Node Metastases in Intraoral Squamous Cell Carcinoma: A Study of 331 Cases.

The current study aimed to examine the effects of clinicopathological factors, including the region, midline involvement, T classification, histological grade, and differentiation of the tumor on the rate of contralateral lymph node metastasis for oral squamous cell carcinoma and to assess their effects on survival rates. A total of 331 patients with intraoral squamous cell carcinomas were included. The influence of tumor location, T status, midline involvement, tumor grading, and the infiltration depth of the tumor on the pattern of metastasis was evaluated. Additionally, the effect of contralateral metastases on the prognosis was examined. Metastases of the contralateral side occurred most frequently in squamous cell carcinomas of the palate and floor of the mouth. Furthermore, tumors with a high T status resulted in significantly higher rates of contralateral metastases. Similarly, the midline involvement, tumor grading, existing ipsilateral metastases, and the infiltration depth of the tumor had a highly significant influence on the development of lymph node metastases on the opposite side. Oral squamous cell carcinomas require a patient-specific decision. There is an ongoing need for further prospective studies to confirm the validity of the prognostic factors described herein.

A retrospective analysis of the surgical outcomes of different free vascularized flaps used for the reconstruction of the maxillofacial region: Hand-sewn microvascular anastomosis vs anastomotic coupler device.

The aim of the study was to assess the surgical outcomes following venous anastomosis with a coupling device and hand-sewn anastomosis in the reconstruction of the maxillofacial region. The study sample was recruited from patients who underwent reconstructive surgeries between January 2011 and November 2016. Tumor type, recipient veins, distribution of flap type, flap survival rates and anastomosis associated complications requiring a flap revision were documented. The follow-up period was four years. In total, 236 patients were included in this study, in which 201 reconstructions were performed via microsurgical venous coupling device (82.04%), whereas hand sewn anastomosis was used in 44 patients (17.96%). Postoperative complications regarding the anastomosis technique revealed that venous coupler devices showed significantly lower complications (4,97%) compared to hand sewn anastomosis (11,36%) (p < 0.05). Within the limitations of the current study, it can be concluded that the coupler system does appear to have advantages over conventional hand-sewn venous anastomosis and should be preferred when possible.

A Bacteria and Cell Repellent Zwitterionic Polymer Coating on Titanium Base Substrates towards Smart Implant Devices.

Biofouling and biofilm formation on implant surfaces are serious issues that more than often lead to inflammatory reactions and the necessity of lengthy post-operation treatments or the removal of the implant, thus entailing a protracted healing process. This issue may be tackled with a biocompatible polymeric coating that at the same time prevents biofouling. In this work, oxygen plasma-activated silanized titanium substrates are coated with poly(sulfobetaine methacrylate), a zwitterionic antibiofouling polymer, using photopolymerization. The characterization of polymer films includes FT-IR, AFM, and adhesion strength measurements, where adhesion strength is analyzed using a cylindrical flat punch indenter and water contact angle (WCA) measurements. Both cytotoxicity analysis with primary human fibroblasts and fluorescence microscopy with fibroblasts and plaque bacteria are also performed is this work, with each procedure including seeding on coated and control surfaces. The film morphology obtained by the AFM shows a fine structure akin to nanoropes. The coatings can resist ultrasonic and sterilization treatments. The adhesion strength properties substantially increase when the films are soaked in 0.51 M of NaCl prior to testing when compared to deionized water. The coatings are superhydrophilic with a WCA of 10° that increases to 15° after dry aging. The viability of fibroblasts in the presence of coated substrates is comparable to that of bare titanium. When in direct contact with fibroblasts or bacteria, marginal adhesion for both species occurs on coating imperfections. Because photopolymerization can easily be adapted to surface patterning, smart devices that promote both osseointegration (in non-coated areas) and prevent cell overgrowth and biofilm formation (in coated areas) demonstrate practical potential.

Comparison of implant placement accuracy in two different preoperative digital workflows: navigated vs. pilot-drill-guided surgery.

BACKGROUND: The aim of the study is to evaluate the accuracy of a new implant navigation system on two different digital workflows. METHODS: A total of 18 phantom jaws consisting of hard and non-warping plastic and resembling edentulous jaws were used to stimulate a clinical circumstance. A conventional pilot-drill guide was conducted by a technician, and a master model was set by using this laboratory-produced guide. After cone beam computed tomography (CBCT) and 3D scanning of the master models, two different digital workflows (marker tray in CBCT and 3D-printed tray) were performed based on the Digital Imaging Communication in Medicine files and standard tessellation language files. Eight Straumann implants (4.1 mm × 10 mm) were placed in each model, six models for each group, resulting in 144 implant placements in total. Postoperative CBCT were taken, and deviations at the entry point and apex as well as angular deviations were measured compared to the master model. RESULTS: The mean total deviations at the implant entry point for MTC (marker tray in CBCT), 3dPT (3d-printed tray), and PDG (pilot-drill guide) were 1.024 ± 0.446 mm, 1.027 ± 0.455 mm, and 1.009 ± 0.415 mm, respectively, and the mean total deviations at the implant apex were 1.026 ± 0.383 mm, 1.116 ± 0.530 mm, and 1.068 ± 0.384 mm. The angular deviation for the MTC group was 2.22 ± 1.54°. The 3dPT group revealed an angular deviation of 1.95 ± 1.35°, whereas the PDG group showed a mean angular deviation of 2.67 ± 1.58°. Although there were no significant differences among the three groups (P > 0.05), the navigation groups showed lesser angular deviations compared to the pilot-drill-guide (PDG) group. Implants in the 3D-printed tray navigation group showed higher deviations at both entry point and apex. CONCLUSIONS: The accuracy of the evaluated navigation system was similar with the accuracy of a pilot-drill guide. Accuracy of both preoperative workflows (marker tray in CBCT or 3D-printed tray) was reliable for clinical use.

A Novel Surface Modification Strategy via Photopolymerized Poly-Sulfobetaine Methacrylate Coating to Prevent Bacterial Adhesion on Titanium Surfaces.

Recent investigations on the anti-adhesive properties of polysulfobetaine methacrylate (pSBMA) coatings had shown promising potential as antifouling surfaces and have given the impetus for the present paper, where a pSBMA coating is applied via photopolymerization on a macro-roughened, sandblasted, and acid-etched titanium implant surface in order to assess its antifouling properties. Current emphasis is placed on how the coating is efficient against the adhesion of Enterococcus faecalis by quantitative assessment of colony forming units and qualitative investigation of fluorescence imaging and scanning electron microscopy. pSBMA coatings via photopolymerization of titanium surfaces seems to be a promising antiadhesion strategy, which should bring substantial benefits once certain aspects such as biodegradation and osseointegration were addressed. Additionally, commercial SAL-titanium substrates may be coated with the super-hydrophilic coating, appearing resistant to physiological salt concentrations and most importantly lowering E. faecalis colonization significantly, compared to titanium substrates in the as-received state. It is very likely that pSBMA coatings may also prevent the adhesion of other germs.

Early osteoblastic activity on TiO2 thin films decorated with flower-like hierarchical Au structures.

Titanium alloys are the most commonly used dental and orthopedic implant materials due to their proven biocompatibility and mechanical properties. The native oxide layer (TiO2 layer) formed on such Ti-based implants acts as the self-protecting layer against possible ion release. Increasing the oxide layer thickness further on such TiO2 implants even opens the triggering of the osseointegration process if the oxide layer is having a certain degree of roughness, preferably higher. This work reports a novel photocatalytic patterning of sputter deposited TiO2 layers with flower-like Au structures to enhance the early osteoblastic activity. The prepared hierarchical Au structures, composed of micro- and nanoscale features on the top, lead to improved number of filopodia formation. This suggest that proposed Au-TiO2 surface may foster the cell attachment and as well as cell proliferation.

Surface conditioning with cold argon plasma and its effect on the osseointegration of dental implants in miniature pigs.

PURPOSE: Successful implant therapy is based on fast, safe, and predictable osseointegration. Several surface modifications have been introduced to improve the bone-to-implant interaction. This in vivo study evaluates the impact of plasma surface conditioning on early wound healing and osseointegration. MATERIALS AND METHODS: A total of 16 dental implants with a sand-blasted and acid-etched surface were conditioned with cold atmospheric plasma prior to insertion in the frontal bone of four miniature pigs. Sequential fluorescence labeling was administered to label bone metabolism, and after 8 weeks, bone blocks were harvested for radiological, histological, and histomorphometrical evaluation. RESULTS: The plasma conditioning had no impact on the morphology of the implant surface. The bone-to-implant contact ratio was 90.4% and 86.5%, the interthread bone density 72.5% and 63.4%, and the periimplant bone density 60.5% and 61.1%, in the plasma conditioned group and control group, respectively. Concentric bands of fluorescence enrichment indicated a chronological and homogenous mineralization of newly formed bone. No unwanted periimplant side effects were detected. CONCLUSION: The increased parameters for osseointegration in this in vivo study merit further investigation in prospective clinical trials.

The correlation between periodontal health status and suspectibility to infections associated with craniomaxillofacial osteosynthesis plates.

AIM: The aim of the present study was to demonstrate the possible relation between periodontal health status and infections associated with osteosynthesis materials (OMs) used in the oral and maxillofacial reconstruction. MATERIAL AND METHODS: The study group consisted of 32 individuals which were subdivided into two groups regarding their PSI scores. After the removal of the osteosynthesis plates, microbial colonization was assessed via microbiological cultivation, fluorescence microscopy and scanning electron microscopy. In addition, samples obtained from gingival crevicular fluids were investigated by fluorescence microscopy. RESULTS: A total of 118 osteosynthesis plates were examined. 8.5% (n = 10) of the plates were associated at least one of the clinical signs of infection. There was a positive correlation between periodontal disease and clinical signs of infection (p = 0.022). Patients with infection signs also had a higher number of smoking history (pack years, p = 0.010). Intraorally placed osteosynthesis plates showed wide range of bacterial colonizations compared to extraorally inserted osteosynthesis materials (p = 0.004). CONCLUSION: Patients with poor periodontal health might be potential candidates for OM related infections. Early removal of OMs in patients with poor periodontal health status and/or heavy smokers would have clinical benefits. In addition, preferation of extraoral access to the fracture line might decrease the possibility of plate related infections.