Ozone therapy effect in medication-related osteonecrosis of the jaw as prevention or treatment: microtomographic, confocal laser microscopy and histomorphometric analysis.

OBJECTIVE: This study aimed to evaluate the efficacy of ozone therapy in the preoperative (prevention) and/or postoperative (treatment) of MRONJ. MATERIAL AND METHODS: Forty male Wistar rats were caudally treated with zoledronic acid (ZOL) and to ozone therapy before extraction (prevention, POG), after extraction (treatment, TOG), or both (prevention and treatment, TPOG), and treated with saline (SAL). The animals received intramuscular fluorochrome (calcein and alizarin), and 28 days postoperatively, they were euthanized, and the tissues were subjected to microtomographic computed tomography (microCT), LASER confocal, and histomorphometric analyses. RESULTS: Micro-CT showed a higher bone volume fraction average in all groups than that in the ZOL group (P < 0.001), the ZOL group showed high porosity (P = 0.03), and trabecular separation was greater in the TOG group than in the POG group (P < 0.05). The mineral apposition rate of the POG group was high (20.46 ± 6.31) (P < 0.001), followed by the TOG group (20.32 ± 7.4). The TOG group presented the highest mean newly formed bone area (68.322 ± 25.296) compared with the ZOL group (P < 0.05), followed by the SAL group (66.039 ± 28.379) and ZOL groups (60.856 ± 28.425). CONCLUSIONS: Ozone therapy modulated alveolar bone repair in animals treated with ZOL, mainly after surgery trauma, leading to bone formation as healing tissue. CLINICAL RELEVANCE: Osteonecrosis has been a challenge in dentistry, and owing to the lack of a consensus regarding therapy, studies presenting new therapies are important, and ozone has been one of the therapies explored empirically.

A regenerative approach for temporomandibular joint repair: An in vitro and ex vivo study.

BACKGROUND: Current clinical approaches to regenerate temporomandibular joint (TMJ) articulating cartilage defects only treat the symptoms (i.e. pain and dysfunction) and do not seek to restore joint integrity for long-term relief. Therefore, we investigated a novel self-assembling tissue-engineered cartilage to overcome this significant clinical issue for TMJ regenerative purposes. OBJECTIVES: Examine the maturation of dynamic self-regenerating cartilage (dSRC) using auricular chondrocytes and evaluate a novel combinatorial approach with fractional laser treatment and dSRC implantation for TMJ cartilage repair. MATERIALS AND METHODS: A suspension of 107 freshly harvested rabbit ear chondrocytes was cultured under a continuous reciprocating motion to form the dSRC. After 2, 4 and 8 weeks of culture, dSRC samples were stained with H&E, Safranin-O and Toluidine Blue. Immunohistochemistry (IHC) was performed for collagens type I and II. Channels (300-500 µm diameter and 1.2-1.5 mm depth) were created in six freshly harvested condyles using a fractional Erbium laser. Two groups were tested: dSRC in a laser-ablated lesion (experimental) and an empty laser-ablated channel (control). TMJ condyles were cultured for up to 8 weeks and analysed as described above. RESULTS: H&E staining showed a high cell density in dSRC compared to native cartilage. All dSRC groups demonstrated intense Safranin-O staining, indicating high glycosaminoglycan (GAG) production and intense Toluidine Blue staining showed high proteoglycan content. IHC confirmed that dSRC consisted predominantly of collagen type II. The experimental group showed improved cartilage repair at both time points compared to the empty channels. CONCLUSION: dSRC viability and successful matrix formation were demonstrated in vitro. The combination of fractional laser ablation and dSRC implantation enhanced cartilage repair.

Photobiomodulation Therapy Improves Postoperative Pain and Edema in Third Molar Surgeries: A Randomized, Comparative, Double-Blind, and Prospective Clinical Trial.

PURPOSE: Laser light has biological effects that can modulate inflammatory processes. Thus, this study aimed to evaluate the effects of photobiomodulation (PBM) therapy on pain, edema, and trismus after the extraction of retained third molars. METHODS: A split-mouth, double-blind, randomized clinical trial (RCT) was conducted in 13 patients with similar bilateral third molars who received intraoral application PBM therapy at 4 points with a diode laser at 810 nm wavelength, 6 J (100 mW, 60 seconds/point) on 1 side (the PBM side); and laser irradiation simulation on the other side (SHAM side). The pain was assessed through visual analog scale (VAS) at 0, 12, 24, 48, and 72 hours, number of analgesic-relief (NAR), and mean time of first analgesic use; edema, through VAS, and linear facial measurements at 0, 24, 48, and 72 hours; and trismus, through the mouth opening measurements at 0, 24, 48, and 72 hours. The repeated-measures analysis was applied to assess the effect of the treatment, followed by Tukey's post hoc test for multiple comparisons (P < .05). RESULTS: Thirteen patients (61.77% male and 38.63% female) with age of 24.16 ± 2.06 participated in this research. VAS showed that PBM controlled pain better (7.56 ± 6.25) than SHAM (32.25 ± 22.78) at 24 hours (P < .001) and 48 hours (19.47 ± 9.27 and 39.87 ± 4.21, respectively) (P = .011). VAS also showed that PBM controlled edema better (19.7 ± 13.27) than SHAM (32.38 ± 15.28) at 24 hours (P = .037) and 48 hours (19.47 ± 13.11 and 39.87 ± 22.77, respectively) (P = .002). CONCLUSION: The PBM therapy in this study resulted in pain and edema reduction after third molar surgery and may be considered as adjuvant therapy after the surgical procedure.

Mechanical Comparison of Four Different Types of Osteosynthesis in a 11-mm Advancement Le Fort I Osteotomy.

OBJECTIVE: This study aimed to evaluate 4 methods of osteosynthesis in the maxilla after a linear advance of 11 mm. METHODOLOGY: Le Fort I osteotomies were performed on 24 resin models and different osteosynthesis were applied in the anterior region. Group I received Lindorf plates; group II, modified Lindorf plates; group III, inverted "T" plates; and group IV, "L" plates. All groups received "L" plates in the posterior region. Analysis were performed through universal mechanical testing machine with an axial linear load until 5-mm displacement. The data obtained about the force and the amount of deformation were computed, thus the energy required for displacement and stiffness was calculated. Statistical analysis was performed using 2-way analysis (Shapiro-Wilk, followed by Holm-Sidak) (P  < 0.05). RESULTS: Groups I and II showed greater resistance to displacement (P < 0.05) than the other groups. The largest amount of maximum force exerted for the 5-mm displacement was in group II (91.73 N), followed by group I (87.46 N), presenting the best values in comparison with the other groups (P < 0.001). Group III had less stiffness (P < 0.001) than the other groups. CONCLUSIONS: The use of preclinical methodologies to verify the mechanical stability of fixation models allows a prediction in the choice of greater resistance systems. The fixation type with greater resistance to deformation was achieved with modified Linford plates followed by Linford plates in the anterior region and plate "L" bilaterally in the posterior region.

Post-legalization Consumption of Cannabis at Massachusetts General Hospital Dental Group.

AIM: The aim of this study was to evaluate the profile of patients undergoing dental treatment in relation to cannabis use. MATERIALS AND METHODS: A comprehensive questionnaire was used to address the type of cannabis preparations, route of intake, frequency of usage, and potential reasoning for use (recreational vs medical use) of patients from the MGH Dental Group. RESULTS: Seventy-six adult patients completed the survey. Sixty-one percent of the participants were female, with the majority (59%) of the participants being ≥51 years or older. Twelve of the 76 participants (16%) were 18-30 years old. The remaining 19 patients (25%) who participated in the study were 31-50 years old. The sample included participants who were predominately non-Hispanic (63 patients, 83%) and White (59 patients, 78%). The majority of patients either had their first use of cannabis prior to 18 years of age (36%) or did not respond to this question (34%) at all. The predominant age at consistent cannabis use was 18-30 years (13%). The most common method of cannabis intake in the preceding year for participants was smoking, followed by ingesting, using cannabidiol (CBD), and vaping (least common). Recreational cannabis use was reported in 47% of the participants vs 28% of participants who reported cannabis intake for medical use. CONCLUSION: This preliminary study characterized the profile of patients undergoing dental treatment in relation to marijuana use. Diminishing restraints to cannabis use may affect the dental profession. CLINICAL SIGNIFICANCE: It is important for dentists to understand cannabis-related oral health conditions to provide customized patient treatments.

Management of Complications Related to Removal of the Buccal Fat Pad.

ABSTRACT: Removal of the buccal fat pad (BFP) is an important topic of discussion in the literature. Several studies have reported improvements in facial esthetics as a result of this technique. The BFP is close to vital structures, such as the facial nerve, parotid duct, and vessels. Injuries related to these structures may occur during the surgical procedure. This manuscript aimed to report and discuss 2 clinical cases of the complications after removal of the BFP. Besides the case presentation, a comprehensive review of the literature was also provided. The reported cases were 2 patients aged 31 and 38 years who were attended by the oral and maxillofacial surgery teams after a complication in the BFP surgery. The first case involved swelling due to Stensen's duct injury, and the second involved uncontrolled bleeding from the internal maxillary artery. Removal of the BFP must have precise indications. Complications may occur during or after surgery; hence, anatomical knowledge is fundamental to appropriate patient management.

Accuracy evaluation of computer-guided implant surgery associated with prototyped surgical guides.

STATEMENT OF PROBLEM: Correct implant placement by means of a pretreatment planning software program is still subject to deviations between the planned and achieved implant positions. Inaccuracy at this level may have drastic consequences, including neurovascular trauma. Further data are therefore needed to evaluate the accuracy of such computer-guided implant planning software programs. PURPOSE: The purpose of this clinical study was to evaluate the accuracy of computer-guided implant surgery associated with prototyped surgical guides. MATERIAL AND METHODS: Cone beam computed tomography (CBCT) scans were made of the participants with a tomographic guide to merge anatomic and prosthetic data. This allowed virtual planning with a prosthetically guided approach respecting the anatomy of the participant. A prototyped surgical guide was then fabricated from the virtual plan, determining the intrasurgical position of the implants. Flapless guided implant surgery was carried out according to the manufacturer's instructions. A second CBCT was made 30 days after the surgery, to enable overlapping of the data from before and after the implant placement. The angular, coronal, central, and apical deviations of the placed implants were measured and compared with those virtually planned. The data were submitted to descriptive statistic and intraclass correlation coefficient (ICC), analysis of variance, and the Student t test (α=.05). RESULTS: A total of 61 implants were analyzed. The mean angular deviation was 2.04 degrees. The mean coronal, central, and apical linear deviations were 0.68 mm, 0.72 mm, and 0.82 mm, respectively. No statistically significant difference was found between the virtual and the real position of the implants inserted. A tendency toward a greater absolute error was observed in the mandible than in the maxilla in terms of angular (P=.047), central (P=.043), and coronal error (P=.031). CONCLUSIONS: Flapless computer-guided implant surgery with virtual planning had some angular and linear deviations; nevertheless, this technique should be acceptably safe and accurate.

Strategy for Optimizing Airway Volume With Genioglossal Advancement Using Cutting Guide in the Treatment of Obstructive Sleep Apnea.

The genioglossus advancement muscle is a technique used to treat obstructive sleep apnea and depends on the precise location of the muscle insertion into the geniotubercle. The aim of this article was to present a case report about a 38-year-old male patient with obstructive sleep apnea even after undergoing uvulopalatopharyngoplasty and mentoplasty. A maxillo-mandibular advancement and genioglossus was proposed, for this a virtual planning of the surgical guide was done using a specialized software. The great advantage is to reduce the osteotomy by focusing precisely on the insertion of the muscle. The cutting guide facilitated the surgical procedure in all aspects and brought safety.

Surgical Treatment of Anterior Sinus Wall Fracture Due to Sports Accident.

Frontal bone fractures represent a low percentage of craniofacial fractures. However, a systematic approach and a correct diagnosis are essential for successful treatment and maintenance of physiology of the frontal sinus and late complications. The purpose of this study was to report a clinical patient with anterior wall fracture of the frontal due to sports accident sinus that was surgically treated.

The influence of electrical high-speed rotation on mandibular third molar surgeries: a prospective, randomized, split-mouth clinical and radiographic study.

The aim of this split-mouth randomized clinical trial was to evaluate the clinical outcomes (operative time, edema, trismus, and pain), the immediate histological effects, the alveolar repair (2 and 4 months), and the quality of life after the extraction of impacted third molars using high-speed pneumatic and electrical rotation. Sixteen patients underwent extraction of the two mandibular third molars with a minimum interval of 15 days. On one side of the participant's mouth, high-speed pneumatic rotation was used (Control Group-CG) while for the other side, high-speed electrical rotation was used (Study Group-SG). Statistical analysis included ANOVA repeated measures and Pearson correlations. SG group showed: shorter operative time (p = 0.019), less pain (p = 0.034), swelling (p < 0.001) and trismus (p = 0.025) on the 1st postoperative day; less pain (p = 0.034) and trismus (p = 0.010) on the 3rd postoperative day; less trismus (p = 0.032) on the 7th postoperative day; and better quality of life (p = 0.007). No differences were observed for peripheral bone damage or bone density of alveolar repair at 2 and 4 months between groups. Electric high-speed rotation provided better postoperative clinical parameters of pain, edema and trismus when compared with pneumatic high-speed rotation for mandibular third molar surgery.Trial registration: Brazilian Registry of Clinical Trials registration number RBR-4xyqhqm ( https://ensaiosclinicos.gov.br/rg/RBR-4xyqhqm ).

Orthobiologics in delayed union and non-union of adult long bones fractures: A systematic review.

Background: Fracture healing poses a significant challenge in orthopedics. Successful regeneration of bone is provided by mechanical stability and a favorable biological microenvironment. This systematic review aims to explore the clinical application of orthobiologics in treating aseptic delayed union and non-union of long bones in adults. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Three databases were explored, with no date restrictions, using keywords related to orthobiologics and delayed union and non-union. Eligible studies included human clinical studies in English, with available full texts, examining orthobiologics such as platelet-rich plasma (PRP), mesenchymal stem cells (MSCs), and bone morphogenetic protein (BMPs) for treating aseptic delayed unions and non-unions in adults. Animal studies, in vitro research, and studies on non-unions due to congenital defects, tumors or infections were excluded. Results: The initial search identified 9417 studies, with 20 ultimately included in the review. These studies involved 493 patients affected by non-union and 256 patients affected by delayed union, with an average age respectively of 40.62 years and 41.7 years. The mean follow-up period was 15.55 months for non-unions and 8.07 months for delayed unions. PRP was the most used orthobiologic, and outcomes were evaluated through time to union, functional scores, and clinical examinations. The results indicated that orthobiologics, especially PRP, tended to yield better outcomes compared to surgical procedures without biological factors. Conclusion: This systematic review suggests that orthobiologics, such as PRP, BMPs, and MSCs, can be effective and safe in the management of delayed union and non-union fractures. These biological treatments have the potential to improve union rates, reduce healing times, and enhance functional outcomes in patients with non-union fractures. Further research is essential to refine treatment protocols and determine the most suitable orthobiologic for specific patient populations and fracture types.

Rodents as an animal model for studying tooth extraction-related medication-related osteonecrosis of the jaw: assessment of outcomes.

OBJECTIVE: To assess the outcomes of several rodent animal models for studying tooth extraction-related medication-related osteonecrosis of the jaw (MRONJ). DESIGN: After a search of the databases, 2004 articles were located, and 118 corroborated the inclusion factors (in vivo studies in rodents evaluating tooth extraction as a risk factor for the development of MRONJ). RESULTS: Numerous studies attempting to establish an optimal protocol to induce MRONJ were found. Zoledronic acid (ZA) was the most used drug, followed by alendronate (ALN). Even when ZA did not lead to the development of MRONJ, its effect compromised the homeostasis of the bone and soft tissue. The association of other risk factors (dexamethasone, diabetes, and tooth-related inflammatory dental disease) besides tooth extraction also played a role in the development of MRONJ. In addition, studies demonstrated a relationship between cumulative dose and MRONJ. CONCLUSIONS: Both ZA and ALN can lead to MRONJ in rodents when equivalent human doses (in osteoporosis or cancer treatment) are used. Local oral risk factors and tooth-related inflammatory dental disease increase the incidence of MRONJ in a tooth extraction-related rodent model.

Arthroscopic management of synovial chondromatosis with skull base perforation: A case report and literature review.

OBJECTIVE: Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a synovial membrane disease characterized by the formation of cartilaginous nodules (CN), that may erode the skull base. Historically, cases with skull base involvement have been treated with open surgery. We report a case of TMJ SC with skull base perforation treated and repaired via minimally invasive TMJ arthroscopy and describe the advanced endoscopic operative maneuvers performed. CASE REPORT: A 34-year-old male presented with a 4-year history of malocclusion and right TMJ arthralgia. Clinical examination demonstrated malocclusion and direct pressure loading pain. Advanced imaging revealed glenoid fossa erosion and numerous homogenous hypointense lesions within an effusion. The initial surgical plan included diagnostic TMJ arthroscopy followed by conversion to open arthroplasty. Endoscopic operative maneuvers allowed for the accomplishment of the surgical goals, completely arthroscopically. Histopathology confirmed SC, and the patient remains on observation, with relief of symptoms. CONCLUSION: Advanced arthroscopy is a viable treatment option for select cases of TMJ SC with skull base involvement that allowed for access to the joint space, retrieval of biopsy specimens and CN, and repair of the skull defect.

Comparative study of the effect of different temperatures on bovine bone used for bone repair of critical calvaria defects in rats.

To evaluate the osteoconductive potential of inorganic biomaterials of bovine origin submitted to different temperatures in the bone repair of critical defects in rat calvaria. Forty-eight rats were divided into four groups according to the material used to fill the defect: control group (GC), the defect was filled only with blood clot (n = 12); GBO, defect filled with Bio-Oss®, deproteinzed at 300°C (n = 12); GOX, defect filled with Inorganic GenOx®, deproteinzed from 850 to 1200°C (n = 12) and G700, defect filled with Inorganic GenOx 700, deproteinzed at 700°C (n = 12). In each animal's calvaria, a trephine bur with 5 mm internal diameter was used to produce a 6 mm-diameter central defect. Gen Derm® resorbable bovine membrane was superimposed over all defects. Subsequently, animals were euthanized at 30 and 60 days after surgery. The pieces were sent for histological and histometric analysis to evaluate the following variables: bone neoformation, presence of biomaterial, mononuclear and polymorphonuclear leukocytes, presence of other tissues (granulation and medullary) and maturation of collagen fibers. The most representative group for bone neoformation was GC. At 30 days, there was a higher mean of mature bone tissue (75.8). At 60 days, there was no statistical difference between the GC (64.9), GBO (32.9), GOX (45.3), and G700 (26.6) groups. GBO presented the highest amount of biomaterial after 30 days (115.9) and 60 days (118.5). All bovine biomaterials were biocompatible and osteoconductive. GOX promoted the best bone repair of the studied materials.

Bone Marrow Stem Cells with Tissue-Engineered Scaffolds for Large Bone Segmental Defects: A Systematic Review.

Critical-sized bone defects (CSBDs) represent a significant clinical challenge, stimulating researchers to seek new methods for successful bone reconstruction. The aim of this systematic review is to assess whether bone marrow stem cells (BMSCs) combined with tissue-engineered scaffolds have demonstrated improved bone regeneration in the treatment of CSBD in large preclinical animal models. A search of electronic databases (PubMed, Embase, Web of Science, and Cochrane Library) focused on in vivo large animal studies identified 10 articles according to the following inclusion criteria: (1) in vivo large animal models with segmental bone defects; (2) treatment with tissue-engineered scaffolds combined with BMSCs; (3) the presence of a control group; and (4) a minimum of a histological analysis outcome. Animal research: reporting of in Vivo Experiments guidelines were used for quality assessment, and Systematic Review Center for Laboratory animal Experimentation's risk of bias tool was used to define internal validity. The results demonstrated that tissue-engineered scaffolds, either from autografts or allografts, when combined with BMSCs provide improved bone mineralization and bone formation, including a critical role in the remodeling phase of bone healing. BMSC-seeded scaffolds showed improved biomechanical properties and microarchitecture properties of the regenerated bone when compared with untreated and scaffold-alone groups. This review highlights the efficacy of tissue engineering strategies for the repair of extensive bone defects in preclinical large-animal models. In particular, the use of mesenchymal stem cells, combined with bioscaffolds, seems to be a successful method in comparison to cell-free scaffolds.

Dose-dependent effects of zoledronic acid on the osteogenic differentiation of human bone marrow stem cells (hBMSCs).

Recent studies have shown that bisphosphonates can also impact osteoblasts besides osteoclasts. This study aimed to evaluate the effects of different concentrations of Zoledronic acid (ZA) during the osteogenic differentiation of human Bone Marrow Stem Cells (hBMSCs) in vitro. Thus, osteogenic differentiation of hBMSCs was conducted with different concentrations of Zoledronic Acid (ZA) (0, 0.1, 1.0, and 5.0 µM) for the first 3 days. Cell metabolism was quantified at 1-, 3-, 7-, and 14 days. At 7- and 14-days, the following analyses were performed: 1) mineralization nodule assay, 2) LIVE/DEAD™, 3) cell adhesion and spreading, 4) alkaline phosphatase (ALP) activity, and 5) qPCR analysis for RUNX-2), ALPL, and COL1 A1. Data were analyzed by ANOVA 2-way, followed by Tukey's post hoc test (p < 0.05). Cell metabolism (3-, 7-, and 14-days) (p < 0.001), mineralization (7-, 14-days) (p < 0.001), and ALP activity (14-days) (p < 0.001) were reduced in ZA 5.0 µM when compared to control (no ZA). Also, ZA 5.0 µM downregulated the expression of RUNX2 at 7- and 14-days (p < 0.001). It is possible to conclude that ZA (5.0 µM) can impair hBMSC differentiation into osteoblasts and interferes with its mineralization phase.

Photo-crosslinked GelMA loaded with dental pulp stem cells and VEGF to repair critical-sized soft tissue defects in rats.

BACKGROUND: Tissue engineering of skin and mucosa is essential for the esthetic and functional reconstruction of individuals disfigured by trauma, resection surgery, or severe burns while overcoming the limited amount of autograft and donor site morbidity. PURPOSE: We aimed to determine whether a combination of Gelatin-methacryloyl (GelMA) hydrogel scaffold alone or loaded with either dental pulp stem cells (DPSCs) and/or vascular endothelial growth factor (VEGF) could improve skin wound healing in rats. MATERIALS AND METHODS: Four 10 mm full-thickness skin defects were created on the dorsum of 15 Sprague-Dawley rats. The wounds were treated with GelMA alone, GelMA+DPSCs, or GelMA+DPSCs+VEGF. Unprotected wounds were used as controls. Animals were euthanized at 1-, 2-, and 4 weeks post-surgery, and the healing wounds were harvested for clinical, histological, and RT-PCR analysis. RESULTS: No signs of clinical inflammation were observed among all groups. Few and sparse mononuclear inflammatory cells were observed in GelMA+DPSCs and GelMA+DPSCs+VEGF groups at 2 weeks, with complete epithelialization of the wounds. At 4 weeks, the epidermis in GelMA+DPSCs and GelMA+DPSCs+VEGF groups was indistinguishable from the empty defect and GelMA groups. The decrease in cellularity and increase in density of collagen fibers were observed over time in both GelMA+DPSCs and GelMA+DPSCs+VEGF groups but were more evident in the GelMA+DPSCs+VEGF group. The GelMA+DPSCs+VEGF group showed a higher expression of the KER 10 gene at all time points compared with the other groups. Expression of Col1 A1 and TGFß-1 were not statistically different over time neither among the groups. CONCLUSION: GelMA scaffolds loaded with DPSCs, and VEGF accelerated the re-epithelialization of skin wounds.

Evaluation of oral implant survival rate in postmenopausal women with osteopenia/osteoporosis. A retrospective pilot study.

BACKGROUND: Implant placement is a common part of dental rehabilitation in older individuals. The role of diminished bone mineral density on the healing of dental implants remains to be elucidated. OBJECTIVE: The aim of this study was to assess the implant survival rate in postmenopausal women with osteopenia/osteoporosis. METHODS: A retrospective cohort study was conducted of postmenopausal women treated with dental implants and stratified into two groups: those receiving antiresorptive therapy (W ≥ 50 years S) or those not receiving treatment (W ≥ 50 years U). The predictor variable was osteopenia/osteoporosis treatment. The outcome variable was implant failure rate at stage two uncovering. Other study variables included: age, implant location, and bone graft placement. T-test, chi-square test, and univariate and multivariate logistic regression were computed. A p-value<0.05 was considered statistically significant. RESULTS: The sample was composed of 93 W ≥ 50 years U (197 implants) and 114 W ≥ 50 years S (189 implants). W ≥ 50 years U showed a statistically higher implant failure rate with chi-square testing compared to W ≥ 50 years S (p=0.022). However, univariate, and multivariate logistic regression between age, location, bone grafting, and implant failure did not demonstrate significant associations. CONCLUSION: Both groups integrated dental implants successfully, with a low failure rate. Implant location, bone grafting, and osteopenia/osteoporosis treatment did not significantly affect osseointegration at uncovering.

Adjunctive use of antimicrobial photodynamic therapy in the surgical treatment of periapical lesions: A case series.

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) is used in endodontics to improve orthograde root canal disinfection as an adjunct to standard treatments. Conversely, evidence concerning the application of aPDT in retrograde endodontic surgery is limited. Thus, the aim of the present study was to provide additional data regarding the use of aPDT in the surgical endodontic treatment of periapical lesions. METHODS: A total of 25 consecutive patients presenting teeth with periapical radiolucency eventually associated with clinical signs and symptoms of apical periodontitis were included. Following access flap completion, osteotomy, mechanical debridement, root apical third resection, and preparation of the root-end cavity, aPDT was applied to decontaminate the surgical site using phenothiazine chloride dye at a concentration of 10 mg/mL and irradiation with a hand-held 100-mW diode laser with a wavelength of 660 ± 10 nm. At the latest follow-up visit, healing was evaluated as successful, uncertain, or failure according to well-established clinical and radiological criteria. RESULTS: Overall, 31 periapical lesions were treated with aPDT. Healing proceeded uneventfully. The mean follow-up time was 36.19 months, with times ranging from 12 to 85 months. A total of 25 (80.65%) cases were classified as successful, 5 (16.13%) as uncertain, and only one (3.22%) as failure. Irrespective of the treatment outcome, all treated teeth were still functional, with no symptoms reported by the patients. CONCLUSION: aPDT as an adjunctive treatment modality in the surgical endodontic treatment of periapical lesions showed promising medium-term results associated with preservation of all diseased teeth.

Successful Osseointegrated Implants in Hypertensive Patients: Retrospective Clinical Study.

PURPOSE: The aim of this study was to investigate the association of hypertension and antihypertensive drugs with the failure of osseointegrated dental implants. MATERIALS AND METHODS: This study conformed to STROBE Guidelines regarding retrospective studies. Data from 602 medical records of patients who received rehabilitation treatment with osseointegrated implants between 2000 and 2017, completed at least 6 months before the study, were analyzed. Data on age, sex, presence or absence of hypertension, use or not of antihypertensive drugs, number of placed and lost implants, and type of prosthetic rehabilitation were collected. Statistical chi-square tests and the Fisher exact test were used to analyze the variables with implant loss, using a significance level of P < .05. RESULTS: One thousand eight hundred eighty-seven implants were placed with a success rate of 97.51% (47 implants lost in 41 patients). Of the 602 patients, 71.43% (432) were normotensive and 28.36% (171) were hypertensive. The success rate of implants in the normotensive group was 93.28%, and in the hypertensive group, it was 92.99%, with no statistical difference between the groups (P = .958). Of these patients, the success rate among the hypertensive group was similar for medication users (92.5%) and for nonusers (94.1%), with no statistically significant difference (P = .939). CONCLUSION: The presence of hypertension, as well as the use of antihypertensives, could not be associated with the failure of osseointegrated implants.