Randomized and Controlled Clinical Trial of Bone Healing After Alveolar Ridge Preservation Using Xenografts and Allografts Versus Plasma Rich in Growth Factors.

The aim of this study was to compare bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation. Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the following 4 treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM), and plasma rich in growth factors (PRGF) alone. Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, newly formed nonmineralized tissue, and residual bone-grafting material (if applicable). Statistical analysis was performed to provide descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in the PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4% ± 15.2% vs 75.5% ± 16.3%), control/(BBM/CM) (46.4% ± 15.2% vs 20.3% ± 21.9%), control/(FDBA/CM) (46.4% ± 15.2% vs 7.2% ± 8.6%), PRGF/(BBM/CM) (75.5% ± 16.3% vs 20.3% ± 21.9%), and PRGF/(FDBA/CM) (75.5% ± 16.3% vs 7.2% ± 8.6%) groups. The new mineralized tissue formation was in the following order: PRGF > control > BBM > FDBA. Alveolar ridge preservation in the esthetic zone with PRGF was the most effective for bone regeneration of the alveolar ridge.

Effect of leukocytes included in platelet concentrates on cell behaviour.

This literature review's aim is to evaluate the function of white blood cells (WBCs) and to conclude whether leukocyte's inclusion in platelet concentrates promotes or inhibits tissue regeneration. An electronic literature search was performed on MEDLINE through its online site (PubMed) and on the EMBASE database for articles published between 1986 and 2019. Consecutive screenings at the title/abstract and full-text levels were performed. All in vitro studies that reported the comparison of leukocyte-rich and leukocyte-poor platelet concentrates were included. The search included 14 articles that matched the inclusion criteria. A systematic review shows that leukocytes are responsible for less promoted migration and osteogenic differentiation of human bone marrow stem cells (HBMSCs), lesser cartilage cell, gingival fibroblast and osteoblast proliferation. Decreased tendon cell metabolism and a cytotoxic effect of leukocytes on synoviocytes have also been identified. Additionally, leukocytes were accountable for a cytokine (IL-1ß, IL-8, TNF-α, MMP-1 and MMP-9) increase and NF­κB signaling pathway initiation. WBCs were also linked to growth factors (VEGF, PDGF-AA/BB). Leukocyte and platelet functions are alike when considering growth factor release. Nevertheless, in the presence of WBCs, platelet concentrates promote cell migration, proliferation, and differentiation less effectively and are responsible for a potentially prolonged inflammation phase due to cytokine release.

Scientific Publications in Dentistry in Lithuania, Latvia, and Estonia Between 1996 and 2018: A Bibliometric Analysis.

This study aimed to determine the number and quality of scientific publications in dentistry from the Baltic countries of Lithuania, Latvia, and Estonia between 1996 and 2018 using bibliometric analysis. Web of Science and Scopus were searched to identify scientific publications in dentistry between 1996 and 2018 by authors from centers in Lithuania, Latvia, and Estonia. The annual number of scientific publications, citation rate, and h-index for each publication, and trends in international co-authorship were investigated by country and institution. There were 651 scientific publications in dentistry between 1996 and 2018, by authors from Lithuania (280 publications), Latvia (210 publications), and Estonia (161 publications). Publications from Estonia were ranked highest in qualitative terms (citation rate and h-index), followed by Lithuania, and Latvia. Of 28 authors with at least ten publications, 54% were Lithuanian (15 authors), 25% were Estonian (7 authors), and 21% were Latvian (6 authors). Estonian authors collaborated mainly with Finland (27 publications), Latvian authors with the USA (16 publications), and Lithuanian authors with Canada (26 publications). Most publications came from the academic institutions of the Lithuanian University of Health Sciences (136 publications), the University of Tartu (109 publications), Vilnius University (101 publications), and Riga Stradins University (28 publications). During the past 22 years, authors from Lithuania had the most publications in the field of dentistry, and authors from Estonia had the most cited publications. Authors mainly published in native journals and collaborated with authors in Scandinavia and North America.

Maxillary Sinus and Surrounding Bone Anatomy With Cone Beam Computed Tomography After Multiple Teeth Loss: A Retrospective Multicenter Clinical Study.

PURPOSE: The aim of this multicenter study was to examine the residual alveolar bone anatomy and sinus mucosa pattern at maxillary sinus regions in multiple teeth loss. MATERIALS AND METHODS: This study was conducted with cone beam computed tomography images of 518 patients (267 females and 251 males) with multiple posterior maxillary teeth loss. Variables associated with sinus membrane (SM), sinus dimensions, ostium, septa, sinus neighborhood, alveolar bone height and ridge width, posterior superior alveolar artery, and adjacent roots were evaluated. RESULTS: No (58.2%) or flat (19.3%) thickening morphology was detected at most of the SMs. Membrane thickening and mucosal-like morphology was more prevalent for male patients (P = 0.005). The mean sinus width was relatively low (3.64 ± 3.33 mm) at the 5-mm level and showed an expected increase toward upper levels. Most of the sinus spaces were dimensionally average (39.5%) or wide (44.7%), and no effect of gender was observed in terms of sinus dimensions (P > 0.05). CONCLUSION: Multiple teeth loss plays a role in creating an imaginary sinus anatomy constituted of a relatively narrow space compared with single-tooth loss cases, from 3.6-mm mean coronal width to 11.3 mm in the apical portion.

Dimensional soft tissue changes following soft tissue grafting in conjunction with implant placement or around present dental implants: a systematic review.

OBJECTIVES: To systematically review changes in mucosal soft tissue thickness and keratinised mucosa width after soft tissue grafting around dental implants. MATERIALS AND METHODS: An electronic literature search was conducted of the MEDLINE database published between 2009 and 2014. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported changes in soft tissue thickness or keratinised mucosa width after soft tissue grafting at implant placement or around a present implant at 6-month follow-up or longer were included. RESULTS: The search resulted in fourteen articles meeting the inclusion criteria: Six of them reported connective tissue grafting around present dental implants, compared to eight at the time of implant placement. Better long-term soft tissue thickness outcomes were reported for soft tissue augmentation around dental implants (0.8-1.4 mm), compared with augmentation at implant placement (-0.25-1.43 mm). Both techniques were effective in increasing keratinised tissue width: at implant placement (2.5 mm) or around present dental implants (2.33-2.57 mm). CONCLUSIONS: The present systematic review discovered that connective tissue grafts enhanced keratinised mucosa width and soft tissue thickness for an observation period of up to 48 months. However, some shrinkage may occur, resulting in decreases in soft tissue, mostly for the first three months. Further investigations using accurate evaluation methods need to be done to evaluate the appropriate time for grafting.

Validation of Therapeutic Anatomy-Oriented Classification in Endosseous Dental Implant Treatment: A Pilot Study.

BACKGROUND: The purpose of the study was to validate a newly proposed therapeutic anatomically based clinical and radiological classification for dental implant treatment. METHODS: Eighty-one patients with at least 1 edentulous jaw segment (EJS) from 2 dental clinics were included in this study. Both clinical and radiological parameters were assessed in aesthetic and nonaesthetic zones. The data were then compared at preoperative, intraoperative, and postoperative (subdivided into early and late stage) study stages. RESULTS: Based on the hard and soft tissue support, EJSs were divided into 3 types. The outcomes were then validated at preoperative, intraoperative, and early postoperative stages. Data were then analyzed using paired sample t test and the Wilcoxon signed ranks test. No statistically significant difference (P > 0.05) was identified between any the measurements. CONCLUSIONS: The proposed therapeutic anatomically based clinical and radiological classification for the dental implant treatment seems to be reproducible, objective, and helpful in planning dental implant treatment. Future studies with a larger sample size are needed to further validate the outcome obtained in this pilot study.

Evaluation of Single Tooth Loss to Maxillary Sinus and Surrounding Bone Anatomy With Cone-Beam Computed Tomography: A Multicenter Study.

BACKGROUND: Posterior maxillary tooth loss may complicate the implant treatment due to the alterations in alveolar anatomy and maxillary sinus pneumatization. This study aimed to comprehensively examine the anatomical structure of this region from cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: The posterior maxilla regions with single tooth loss were analyzed by dividing the variables into 3 subgroups from images of 597 patients chosen from 1160 CBCTs. Variables associated with sinus membrane (SM), sinus dimensions, ostium, septa, sinus neighborhood, alveolar bone height (ABH) and width (RW), posterior superior alveolar artery (PSAA), and adjacent roots were evaluated. RESULTS: The majority of the patients demonstrated 0 to 5 mm membrane thickness. Irregular SM thickening was lower for female patients. While females showed higher number of narrow sinus, males had higher RW than females. Sinus augmentation classification showed negative correlation with ABH, root-tip sinus floor and edentulous site classification. Posterior septa height was correlated with number of septa and ABH. PSAA diameter and location were also correlated between each other. CONCLUSION: The present results define formation of a sinus space with 11 mm coronal and 16 mm apical width after single tooth loss. A flat or semispherical thickening around 4 mm is usual in most cases with 51% possibility of anterior septum existence. A ridge anatomy, around 7.5 mm ABH and 7.2 to 9.3 RW from coronal to apical, complements this anatomy. Further studies are needed to clarify the reasons behind the SM and crestal anatomy variations between genders.

Apical/Retrograde Periimplantitis/Implant Periapical Lesion: Etiology, Risk Factors, and Treatment Options: A Systematic Review.

OBJECTIVES: To review the literature on retrograde periimplantitis symptoms, risk factors, and treatment methods and to propose a decision-making tree of retrograde periimplantitis management. MATERIALS AND METHODS: An electronic literature search was conducted on the MEDLINE and EMBASE databases for articles published between 1990 and 2015. Clinical human studies in the English language were included. RESULTS: The search resulted in 44 case reports published by 27 authors. The average time of the diagnosis of the pathology was found to be 26.07 weeks after implant placement (SD ± 39.7). Fistula formation was found to be the most common clinical symptom, statistically significantly more often occurring in the maxilla (P = 0.04). A negative correlation was found between pain and the adjacent tooth with incomplete endodontic treatment/endodontic pathology (r = -0.4; P = 0.009) and a positive correlation between the later risk factor and implant removal (r = 0.3; P = 0.028). Regenerative treatment (45.2% of the cases) or implant removal (35.7% of the cases) was the most common treatment techniques used. A decision-making tree of retrograde periimplantitis management is suggested. CONCLUSIONS: The etiology of retrograde periimplantitis is most often infectious. A decision-making tree aimed at managing patients with retrograde periimplantitis according to the possible etiology and symptoms of the disease can be a useful tool in the treatment of the pathology.

Canines mesiodistal measures as the key to sex prediction: a systematic review and meta-analysis.

INTRODUCTION: The purpose of this study was to systematically review the literature about canine measures to determine whether their variations had any role in sex determination. EVIDENCE ACQUISITION: The study searched MEDLINE database from 2004-2014 according PRISMA guidelines. Search terms included "canine teeth," "dental crowns," "dentition," "permanent," "sex dimorphism," "forensic anthropology," "review literature." EVIDENCE SYNTHESIS: Four hundred forty-three studies were identified in the search strategy and 11 were included. Eight analysed mean differences of maxillary right canines' mesiodistal (MD) measures between male and female. There was no significant mean difference in two studies of eight (standardised mean difference [SMD]=0.150 and 0.268, respectively). According to all eight studies that reviewed them, maxillary right canines MD measures mean difference was significantly different (SMD=0.479). All five studies, which described maxillary left canines MD measures, found the mean, were significantly different (SMD=0.424). Ten studies found the same result for mandibular right canines (SMD=0.696). Eight studies found mandibular left canines MD measures and mean significantly different (SMD=0.685). CONCLUSIONS: The most significant SMD was between male and female mandibular canines (right and left), mesiodistal width 0.696 and 0.685 respectively. Consequently, these canines are the most important to the sex prediction.

The prevalence of malocclusion and oral habits among 5-7-year-old children.

BACKGROUND: Digit sucking, tongue thrust swallowing, and mouth breathing are potential risk factors for development of malocclusion. The purpose of this study was to verify the prevalence of different occlusal traits among 5-7-year-old children and assess their relationship with oral habits. MATERIAL AND METHODS: The study included 503 pre-school children (260 boys and 243 girls) with a mean age of 5.95 years. Different occlusal traits were verified by intraoral examination. Oral habits were diagnosed using data gathered from clinical examination of occlusion and extra-oral assessment of the face, combined with a questionnaire for parents. RESULTS: The study demonstrated that 71.4% of the children presented with 1 or more attributes of malocclusion and 16.9% had oral habits. The vertical and sagittal malrelation of incisors, as well as spacing, were the predominant features. This study showed that digit suckers have higher incidence of anterior open bite (P=0.013) and posterior crossbite (P=0.005). The infantile type of swallowing demonstrated strong association (P=0.001) with anterior open bite. CONCLUSIONS: Non-nutritive sucking habits and tongue thrust swallowing are significant risk factors for the development of anterior open bite and posterior crossbite in pre-school children.

Evaluation of mandibular lingual foramina related to dental implant treatment with computerized tomography: a multicenter clinical study.

BACKGROUND: Bleeding can be one of the severe complications during implant placement or other surgeries. Presurgical assessment of the area should be performed precisely. Thus, we examined lingual vascular canals of the mandible using dental computerized tomography (CT); define the anatomical characteristics of canals and the relationship with mandibular bone. METHODS: One thousand sixty-one foramina in 639 patients, in 5 dental clinics, were included in this multicenter study. Distance between crest and lingual foramen, tooth apex and lingual foramen, distance from mandibular border, diameter of lingual foramen, canal type, anastomosis, and location of foramen were examined. RESULTS: Foramen was 18.33 ± 5.45 mm below the bony crest and 17.40 ± 7.52 mm from the mandibular border, with men showing larger measurements. The mean diameter of lingual foramina was 0.89 ± 0.40 mm; 76.8% canal type was mono; 51.8% patients presented with median lingual canal-foramen (MLC) and 21.1% with lateral lingual foramen. Diameter of MLC was statistically larger. CONCLUSIONS: With a large sample group, results represented that lingual foramina could be visualized with dental CT, providing useful data for mandibular implant surgeries. Findings suggest that vascular canals and several anastomoses exist in the anterior mandible extending through premolar and molar regions as well. It is imperative to consider these vessels with the dental CT before and during the mandibular surgery to prevent threatening hemorrhage.

Green pigmentation in human teeth. A stereomicroscopic study.

Green pigmentation in teeth is an uncommon condition associated with bilirubin deposits in hard dental tissues. Its occurrence can cause anxiety to both the child and parents and is not diagnosed easily by clinicians. The aim of this study is to analyze the current knowledge about the etiology, the intraoral alterations, and the macroscopic and microscopic features of green teeth pigmentation related to a high bilirubin levels. A primary tooth was extracted and manually sliced into 600 microns thin sections. The slenderized slices were examined with a light microscope AxioImager M1 to evaluate the microscopic teeth structure. The clinical characteristics of teeth may help in the diagnosis of current or past systemic diseases. Pediatricians should be able to quickly note the signs in order to perform the proper diagnosis. This study may help clinicians gain more knowledge about the current status of this uncommon pathology.

Attitudes of Oral Surgeons and Periodontists towards Immediate Dental Implant Placement.

Objectives: This cross-sectional study aimed to evaluate the factors that determine the choice of oral surgeons and periodontists to perform immediate dental implant placement. Material and Methods: An anonymous survey was carried out from January 6, 2024 to February 29, 2024. The questionnaire was distributed online to Lithuanian specialists - oral surgeons and periodontists, who perform implantation procedures. A total of 186 professionals were included in this survey. Chi-square test, its degrees of freedom was used for the analysis of variables. Results: The main reason for refusing immediate implant placement is a periapical lesion greater than 5 mm, reported by 91.7% of oral surgeons and 96.9% of periodontists. Good aesthetics and preservation of anatomical structures are identified as an advantage by 99.2% of oral surgeons and 92.3% of periodontists. In the aesthetic zone, for periodontists, the main criterion for choosing a method is the quantitative and qualitative indicators of the soft tissue of the extraction socket 96.9%, and for oral surgeons - the morphology of the bone walls of the socket 87.6%. Only 43.1% of periodontists and 33.9% of oral surgeons are familiar with and use extraction socket morphology assessment classifications for immediate dental implant placement. Conclusions: Taking into account study's results, it is recommended to adjust the teaching programs at Universities and to increase the knowledge of specialists performing dental implantation procedures, by carrying out continuous educational programs.

The Use of Platelet-Rich Fibrin in Sinus Floor Augmentation Surgery: a Systematic Review.

Objectives: This systematic review aims to critically assess the impact of platelet-rich fibrin on maxillary sinus floor augmentation and outline the specific aspects of new bone formation, bone height, implant stability quotient, and Schneiderian membrane thickness. Material and Methods: A systematic review and meta-analysis were conducted, analysing studies from MEDLINE (PubMed), the Cochrane Library, and ScienceDirect databases, published from January 29, 2018 until January 29, 2024 that compared maxillary sinus floor augmentation (MSFA) using bone graft material with and without platelet-rich fibrin (PRF). This review focused on patients 18 years and older who undergone MSFA before the dental implant placement. It systematically examined five studies, encompassing randomized controlled trials, and reported on 112 MSFA procedures conducted in 84 patients. Results: The meta-analysis reveals a marginal significance in new bone formation with PRF, suggesting a trend towards beneficial outcomes that were not statistically significant. No significant impact on bone height was observed. However, a notable improvement in implant stability quotient (ISQ) was recorded, indicating enhanced implant stability with PRF. The Schneiderian membrane thickness did not show significant changes post-treatment with PRF. Conclusions: While platelet-rich fibrin shows promise in enhancing implant stability, its effects on new bone formation and Schneiderian membrane thickness are inconclusive, highlighting the need for further research. Platelet-rich fibrin did not significantly affect bone height. The findings support platelet-rich fibrin's potential as a beneficial adjunct in maxillary sinus floor augmentation, particularly for implant stability.

Outcome Difference between Short and Longer Dental Implants Placed Simultaneously with Alveolar Bone Augmentation: a Systematic Review and Meta-Analysis.

Objectives: This systematic review and meta-analysis aim to provide detailed insights into the clinical performance of short and longer dental implants placed simultaneously with bone augmentation. Material and Methods: The search for literature was performed across MEDLINE (PubMed), ScienceDirect and the Cochrane Library databases, adhering to specific selection criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only articles published in English between 2014 and 2024 were considered for data collection. Primary outcomes were survival rate (SR), marginal bone loss (MBL) and complications. Clinical outcomes were as follows: bleeding on probing (BOP), periodontal pocket depth (PPD), and implant stability quotient (ISQ). Quality and risk of bias assessment were evaluated by the Critical Appraisal Checklist tool for randomized controlled trials developed by the Joanna Briggs Institute. Results: A total of 14678 articles were screened, with 9 meeting the inclusion criteria and being utilized for this systematic review and meta-analysis. A total of 495 patients with 984 implants (491 short and 493 longer implants) showing a SR of 93.91% for the short implants and 91.83% for the longer implants. Meta-analysis revealed statistically significant difference between short implants and longer implants simultaneously placed with alveolar bone augmentation in relation to MBL (-0.513 mm, 95% CI = -0.93 to -0.096; P = 0.02), and in PPD (-0.247, 95% CI = -0.515 to 0.022; P = 0.07). Conclusions: When comparing the results of treatment with short and longer dental implants combined with alveolar bone augmentation, short implants showed better clinical results regarding the parameters of survival rate, marginal bone loss and complications.

Inferior alveolar nerve injury associated with implant surgery.

OBJECTIVES: Inferior alveolar nerve (IAN) is the most commonly injured nerve (64.4%) during implant treatment. At present, no standardized protocol exists for clinicians to manage IAN injury related with implant surgery. Therefore, the purposes of the present article were to analyze the reasons for nerve injury and to propose guidelines in managing IAN injury. MATERIAL AND METHODS: Patients with IAN sensory disturbances after implant treatment were recruited for the study. Sixteen patients, eight men and eight women, with a mean age of 52.2 ± 8.1 years participated in this study. Patient examination, treatment, and IAN sensory function recovery monitoring were performed following six-step IAN injury during dental implant surgery (IANIDIS) protocol. The control group was composed of 25 healthy volunteers who never had IAN sensory disturbances or any trauma in the maxillofacial region. RESULTS: The IAN sensory disturbances were scored as following: 5 (31.25%) had hyperalgesia and 11 (68.75%) expressed hypoalgesia. The mean asymmetry index (AI) was calculated for each patient and varied from 0.6 to 3.2. Overall, 31.3% of nerve injury patients were classified as mild, 31.3% as moderate, and remaining 37.5% as severe injury. All patients were successfully treated with proposed IANIDIS protocol. CONCLUSION: The most frequent (50%) risk factor for IAN injury was intraoperative bleeding during bone preparation. The most common (56.3%) etiological risk factor of nerve injury was dental implant. A six-step protocol aimed at managing patients with IAN injury, during dental implant surgery, was a useful tool that could provide successful treatment outcome.

The Use of Autogenous Teeth Tissues Grafts for Alveolar Bone Reconstruction: a Systematic Review.

Objectives: Enough bone around the implant is an important factor in ensuring the stability and longevity of the implant. Therefore, alveolar bone regeneration procedures are often required. A relatively new bone substitute is made from autogenous teeth. There are more and more studies in the scientific literature that perform regenerative alveolar bone procedures using autogenous tissues substitutes made from extracted teeth. The objective of this systematic literature review is to systematize information and present conclusions about the effectiveness of this regenerative material. Material and Methods: Scientific articles were selected using the PRISMA recommendations. Publications have been carried out since January 1, 2012 to January 1, 2022. The review includes articles in English, clinical studies in humans who underwent bone augmentation prior to or during dental implantation using an autogenous teeth tissues substitute. Results: A total of 7 publications were included in this systematic literature review. Summarizing the data of the publications, 258 patients participated in the studies, 240 subjects were included in the results for various reasons, and a total of 298 implants were inserted. No statistically significant results were found in the five studies. Two studies comparing autogenous tooth graft with xenogeneic bone graft and autogenous teeth tissues showed statistically significant positive results in autogenous tooth group. Conclusions: Within the limitations of this study, autogenous tissues graft derived from teeth are an effective material and can be used as an alternative to other bone grafts existing on the market. Further studies with a longer follow-up period are needed to validate these findings.

Differences in Titanium, Titanium-Zirconium, Zirconia Implants Treatment Outcomes: a Systematic Literature Review and Meta-Analysis.

Objectives: The objective of this systematic review is to test the hypothesis that treatment with titanium, titanium-zirconium and zirconia dental implants has different clinical outcomes in survival rate, marginal bone loss, bleeding on probing, plaque control record, and probing depth. Material and Methods: A systematic electronic search through the PubMed (MEDLINE) and Cochrane Library databases was performed to identify studies published between January 1, 2013 and January 1, 2023 containing a minimum of 10 patients per study comparing titanium (Ti), titanium-zirconium (Ti-Zr), and zirconia (Zr) dental implants. Ti, Ti-Zr, and Zr dental implant clinical outcomes were determined by evaluating survival rate, marginal bone level, bleeding on probing, probing depth, plaque control record. Quality and risk-of-bias assessment were evaluated by Cochrane risk of bias tool. Results: A total of 1361 articles were screened, with 10 meeting the inclusion criteria and being utilized for this systematic review and meta-analysis. A total of 301 patients with 637 implants (304 Ti, 134 Ti-Zr, and 199 Zr) were evaluated, showing a survival rate of 97.7% for Ti, 98.6% for Ti-Zr, and 93.8% for Zr implants respectively. In a meta-analysis, no difference in marginal bone level was found between Ti, Ti-Zr, and Zr implants (P = 0.84). Conclusions: Dental implant survival rate was lower in zirconia group. Assessment of marginal bone loss and bleeding on probing showed better results with titanium-zirconium dental implants. Plaque control result was similar in all groups. Due to limited sample size assessed it was not possible to obtain conclusion on probing depth parameter.

Peri-implantitis Diagnosis and Prognosis Using Biomarkers: A Systematic Literature Review.

PURPOSE: To summarize the latest scientific literature regarding the concentrations of biomarkers in saliva and peri-implant crevicular fluid (PICF) of healthy implant (HI) patients and patients with peri-implant mucositis (PIM) and peri-implantitis (PI). MATERIALS AND METHODS: The literature review was performed according to PRISMA guidelines. The databases used were PubMed MEDLINE, ScienceDirect, and Cochrane Library. A combination of keywords was used, and selection criteria were applied. Selected articles were published between February 1, 2017, and February 1, 2022, written in English, conducted in humans, and examined the levels of saliva and PICF biomarkers in PI patients and compared them to HI/PIM patients. RESULTS: A total of 16 publications were selected, involving a total of 1,117 patients with 1,346 implants. Qualitative analysis revealed 49 different biomarkers, the levels of which were compared between groups. After evaluating the most frequently studied biomarkers, significantly higher values of IL-1ß, RANKL, sRANKL, IL-6, TNF-α, TNFSF12, MMP2, and MMP8 levels were observed in the PI group than in the HI group. CONCLUSIONS: Of all 49 biomarkers evaluated, IL-1ß and RANKL have potentially the highest diagnostic significance in the assessment of peri-implant inflammatory conditions, as differences were observed between all three groups (HI < PIM < PI), but data from current publications were not fully sufficient to provide strong evidence.

Assessment Results of Dental Students' Knowledge about Bisphosphonates and Bisphosphonate-Related Osteonecrosis of the Jaw.

Objectives: The aim of this cross-sectional study is to evaluate Lithuanian fourth- and fifth-year dental students' knowledge about bisphosphonates and bisphosphonate-related osteonecrosis of the jaw. Material and Methods: The anonymous survey using a questionnaire was conducted from February to March 2022. The survey was sent to 173 students at Lithuanian University of Health Sciences (LSMU) and 107 of them were completed. It consisted of student data, questions about the main properties of bisphosphonates, bisphosphonate-related osteonecrosis of the jaw (BRONJ), and the necessity of additional studies for students. Chi-square test and Cramér's V coefficient were used for the analysis of variables. Results: Most of the fifth-year students knew the main properties of bisphosphonates and what diseases they are used to treat. Twenty fifth-year students (33.9%) knew the accurate definition of BRONJ, while only 11 fourth-year students (22.9%) chose the same correct answer. Statistically significant (P < 0.05) data were found about the knowledge of main properties of bisphosphonates. The vast majority of fourth- and fifth-year students (39 [81.3%] and 45 [76.3%]), agreed that the University should provide more information about bisphosphonates. Conclusions: The study revealed that fifth-year students demonstrated better knowledge about bisphosphonates compared to fourth-year students and this was due to a curriculum supplemented with information about this pathology. The overall findings of this research suggest that Universities need to expand their student curricula by providing more knowledge about bisphosphonates and its relation to bisphosphonate-related osteonecrosis of the jaw.