Which factors affect the lingual fracture pattern in sagittal split ramus osteotomy?

The purpose of this study was to elucidate the effects of mandibular anatomy and osteotomy technique on lingual fracture patterns in SSRO. The predictor variables were: length of horizontal medial osteotomy; type of border osteotomy; buccolingual width; and vertical length of the basal cortex. The outcome variable was the type of lingual split pattern. This was categorized into four types according to a lingual split scale (LSS): LSS 1, true Hunsuck; LSS 2, fracture line to posterior border of the ramus; LSS 3, through to mandibular canal; LSS 4, unfavorable fracture pattern. Data were analyzed using analysis of variance and the Pearson χ2 test. Values of p < 0.05 were considered statistically significant. The study sample comprised 312 lingual split patterns in 156 patients. The most common type of lingual split pattern was LSS 1 (n = 204). There was a significant relationship between inferior border osteotomy type and LSS type (p = 0.001). Whilst LSS 1 was the most common among all border osteotomy types. LSS 4 was most frequently observed in cases where the lower border osteotomy remained in the buccal surface. According to the results of this study, the likelihood of an unfavorable split pattern increases when the lower border osteotomy remains in the buccal surface.

Does preventive single dose of intravenous dexketoprofen reduce pain and swelling after orthognathic surgery? A prospective, randomized, double blind clinical trial

Background: The purpose of this study was to evaluate the effect of a single-dose intravenous dexketoprofen administration for preventive analgesia on postoperative pain and reducing swelling in double jaw surgery. Material and methods: The authors designed a prospective, randomized, and double-blind cohort study. Patients who have Class III malocclusion were randomly divided in two groups. 50 mg intravenous dexketoprofen trometamol were administrated 30 minutes before incision in treatment group, while intravenous sterile saline was administrated 30 minutes before incision in placebo group. The primary predictor variable was treatment group. Primary outcomes were pain, swelling and 24-hour opioid intake. Patient- controlled analgesia with tramadol was given for management of postoperative pain. Other variables were demographic and operation related parameters. Visual analogue scale was used to evaluate postoperative pain. 3dMD Face System (3dMD, USA) was used to measure postoperative swelling. Data were analysed using two independent samples t test and Mann Whitney U test. Results: The study sample was composed of 30 patients with a mean age of 20,63 years and 21 were female. Preemptive dexketoprofen administration decreased postoperative tramadol consumption by 25.9% compared to placebo group, and there was a statistically significant decrease in VAS scores (p<0,05). There was no statistically significant difference between the groups in terms of swelling (p>0,05). Conclusions: Preventive administration of intravenous dexketoprofen provides adequate analgesic effect in the postoperative 24-hour period and reduces opioid consumption in orthognathic surgery. (AU)

Custom-Made Root Analog Immediate Dental Implants: A Prospective Clinical Study with 1-Year Follow-up.

PURPOSE: To compare three different types of custom-made root-analog immediate (RAI) dental implants. MATERIALS AND METHODS: Patients with fractured and/or nonrestorable teeth with uncompromised periodontal ligaments were included in the study. The exclusion criteria were as follows: any uncontrolled systemic disease, bruxism, poor oral hygiene, active periodontal disease, and/or chronic marginal periodontitis. CBCT scans of the teeth were taken, and the datasets were used to reconstruct 3D models that were transferred to 3D modeling software to design the RAIs. Group 1 (GR1) consisted of zirconia RAIs manufactured using a computer numerical control (CNC) machine, group 2 (GR2) consisted of titanium RAIs formed by using a CNC machine, and group 3 (GR3) consisted of titanium RAIs manufactured by using direct laser metal sintering (DLMS) technology, all of which were placed immediately after tooth extraction. Primary stability was measured by using Periotest M. Metal-ceramic single crowns were cemented 3 months later. All implants were evaluated clinically and radiologically 1 year after implant placement. RESULTS: A total of 51 patients (18 men, 33 women) aged between 18 and 66 years (average 34.2 years) were included in the study. In 4 patients, RAIs could not be placed due to the lack of primary stability, and they were excluded. In the remaining 47 patients, the custom-made RAIs (GR1: n = 21, GR2: n = 17, GR3: n = 18, total: n = 56) were placed into fresh extraction sockets immediately after tooth extraction for each patient. Primary stability was achieved. Periotest values (PTV) were between -1.4 and -6.2 (mean -3.3). The mean initial PTV (PTV0) was -2.3 ± 1.8 for the failed implants and -4.5 ± 0.8 for the surviving implants. PTV0 was an independent risk factor (HR 3.61, 95% CI: 1.56-8.35, P = .004) for survival rate, which was 33.3%, 70.6%, and 44.4% for GR1, GR2, and GR3, respectively. The overall survival rate was 48.2%. There was no significant difference between the groups regarding the probability of survival (P = .051). The survival rate was significantly lower for anterior RAIs (P < .001). Clinically healthy gingival margins were observed without any signs of periodontitis or implant mobility, and the mean PTV was -4.0 ± 1.9 in surviving implants, whereas the mean marginal bone loss was 1.3 ± 0.6 mm (median, 0.8; 95% CI: 0.1-3.4) at the 1-year follow-up. CONCLUSION: This study was the first attempt to compare different RAI manufacturing techniques and biomaterials in the literature. Although the probability of survival was not statistically significant between the groups, the survival rate in GR2 was higher than in the other two groups. Nevertheless, the overall survival rate was significantly lower (48.2%) than in the previous reports. Primary stability was an independent risk factor for failure. Further studies with the minimized variables between groups should be designed for precise results.

Three-dimensional palatal morphology and upper arch changes following nonsurgical and surgical maxillary expansion in adults.

OBJECTIVE: The objective of this study was to evaluate the effects of nonsurgical rapid maxillary expansion (RME) and surgically assisted RME (SARME) on palatal morphology and upper arch dimensions using three-dimensional (3D) models in skeletally mature patients. STUDY DESIGN: Thirty-eight skeletally mature patients with a maxillary transverse deficiency were divided into RME and SARME groups. Nineteen patients in the RME group (mean age, 19.16 ± 2.25 years) were treated using a full-coverage bonded acrylic splint expander; 19 patients in the SARME group (mean age, 20.38 ± 3.36) were treated using the banded palatal expansion appliance with hyrax screws. The 3D models were obtained before and after expansion. The maxillary dental arch widths, maxillary first molar angulation, palatal area, and palatal volume were calculated on the 3D models. RESULTS: All variables showed statistically significant changes after the retention period (P < .001). The maxillary arch width between first premolars (P < .05), the palatal area (P < .01), and the palatal volume (P < .05) significantly increased in the SARME group compared to the RME group. The maxillary first molar tipping in the RME group was significantly higher than that in the SARME group (P < .01). CONCLUSIONS: Although SARME has more positive effects in skeletally mature patients, nonsurgical RME can be considered as an alternative by evaluating surgical risks, periodontal status, and the need for skeletal expansion.

Bone stress and damage distributions during dental implant insertion: a novel dynamic FEM analysis.

The objective of this research was to evaluate the stress and damage occurring on the bone model of D2 quality during implant insertion procedure using a novel dynamic finite element analysis (FEA) modeling. Three-dimensional finite element method was used to simulate the implant placement into the mandible. The cross-sectional model of the implant was created in SolidWorks 2007 software. The implant model was created to resemble a commercially available fine thread bone level dental implant (Bilimplant®, Turkey). 3 D bone models created with and without cortical bone drilling were specified according to D2 bone (Misch's Bone Classification) with a 1.5 mm cortical bone thickness. The stress patterns in both cancellous and cortical crestal bone were examined during implant insertion by using a novel dynamic FEA in ABACUS/Explicit (ABAQUS/Explicit version 6.14). According to the results of the dynamic FEA, it was reduced stress and damage significantly on the crestal bone region using the cortical drill before the implantation. Also, implant placement time was shorter when the cortical drill was used. The present research is a pilot study using a novel dynamic FEM to model and simulate the dental implant insertion process. This study showed that the use of cortical drills decreased the stress in the bone, especially crestal region, and shortened the whole implant insertion time.

Vascular Complications in Le Fort I Osteotomy: Incidence, Reasons, and Management of the Intraoperative Hemorrhage.

PURPOSE: The aim of this study was to investigate the incidence, types, and reasons for the intraoperative hemorrhage during Le Fort I osteotomy. METHODS: The study sample was composed of the population of the patients who underwent orthognathic surgery from April 2011 to February 2017. The vascular complications of the patients who underwent Le Fort I osteotomy during the surgery were identified. Type of the bleeding, suspected vessel, amount of the intraoperative blood loss, cause, and management of the bleeding were specified and investigated. Descriptive statistics were computed for each study variable. RESULTS: A total of 200 patients underwent Le Fort I osteotomy. The sample's mean age was 22.4 ± 5.8 and 55.5% of patients were female. The intraoperative vascular complication was seen in only 10 (5%) samples. The suspected source of the hemorrhage was the descending palatine artery (DPA) in 8 (4%) cases, while the pterygoid venous plexus in the other 2 (1%) cases. The cause of the bleeding was suspected down-fracture in 8 cases, while pterygomaxillary junction (PMJ) separation in the other 2 cases. DPA was ligated with ligation clips and cauterized in arterial injury cases. The hemorrhage was taken under control using a hemostatic matrix with thrombin (Surgiflo, Ethicon, USA) in the venous bleeding cases. CONCLUSIONS: The down-fracture of the maxilla was found to be more related to the occurrence of vascular complications. Severe bleeding was managed by the use of the hemostatic matrix with thrombin and this hemostatic agent can be used to control this type bleedings in orthognathic surgery.

Effects of combination TGF-B1 transfection and platelet rich plasma (PRP) on three-dimension chondrogenic differentiation of rabbit dental pulp-derived mesenchymal stem cells.

Aim: The aim of this study was to evaluate the effects of standard culture medium and chondrogenic differentiation medium with PRP on chondrogenic differentiation of rabbit dental pulp-derived mesenchymal stem cells (rabbit DPSCs) that are transfected with transforming growth factor-beta 1 (TGF-B1) gene, based on the hypothesis of TGF- B1 and PRP can be effective on the chondrogenesis of stem cells. Materials and Methods: Rabbit DPSCs were characterized by using flow cytometry, immunofluorescent staining, quantitative Real Time Polymerase Chain Reaction (qRT-PCR) and differentiation tests. For the characterization, CD29, CD44 and CD45 mesenchymal cell markers were used. Rabbit DPSCs were transfected with TGF-B1 gene using electroporation technique in group 1; with PRP 10% in group 2; with chondrogenic medium in group 3; with both chondrogenic medium and PRP in group 4. DPSCs were cultured in medium with 10% inactive PRP in group 5, chondrogenic medium in group 6, chondrogenic medium with PRP 10% in group 7. SOX9, MMP13 and Aggrecan gene expression levels were evaluated in 3, 6, 12. and 24. days by qRT-PCR. Results: The expression levels of SOX9, MMP13 and Aggrecan were higher in group 2, 3 and group 7 in 3th day however in 24th day group 7 and group 2 were found higher. The expression levels changed by time-dependent. The extracellular matrix of the cells in experimental groups were positively stained with safranin O and toluidine blue. Conclusion: The combination in culture medium of TGF-B1 gene transfection and 10% PRP accelerates the chondrogenic differentiation of DPSCs.

Evaluation of the Pterygomaxillary Separation Pattern in Le Fort I Osteotomy Using Different Cutting Instruments.

PURPOSE: Pterygomaxillary separation (PMS) is considered the main reason for serious complications associated with Le Fort I osteotomy. The aim of this study was to evaluate whether a piezo surgery, ultrasonic bone scalpel, or conventional bur used in Le Fort I osteotomy has an influence on PMS patterns. MATERIALS AND METHODS: Using a retrospective cohort study design, we enrolled a sample composed of patients who underwent orthognathic surgery. The primary predictor variables were the cutting instruments (ultrasonic bone scalpel, piezo surgery, and Lindeman bur) used to perform Le Fort I osteotomy. Other variables were demographic and anatomic parameters. The outcome variable was the type of PMS pattern, classified as follows: type 1, PMS at the pterygomaxillary junction (ideal PMS); type 2, PMS at the greater palatine foramen; type 3, PMS from the posterior wall of the maxillary sinus; and type 4, PMS with lateral or medial pterygoid fracture. Anatomic parameters, that is, the thickness and width of the pterygomaxillary junction and distance of the greater palatine foramen, were measured on preoperative cone-beam computed tomography images. The pattern of PMS was evaluated on postoperative cone-beam computed tomography. Data were analyzed using analysis of variance and the Pearson χ2 test. P < .05 was considered statistically significant. RESULTS: This study sample was composed of 96 PMSs in 48 patients. The most common type of PMS was type 1 (58), followed by type 4 (21), type 2 (10), and type 3 (7). A statistically significant relation was found between the cutting instrument and the ideal separation (type 1 PMS) pattern (P = .032), and the highest rate of the ideal separation pattern was seen in the ultrasonic bone scalpel group, at 24 of 32, compared with 22 of 38 in the piezo surgery group and 12 of 26 in the conventional bur group. CONCLUSIONS: According to the study, the ultrasonic bone scalpel is safer than other cutting instruments in terms of the ideal separation of the pterygomaxillary junction.

The efficiency of ozone therapy and low-level laser therapy in rat facial nerve injury.

PURPOSE: Comparison of low-level laser therapy (LLLT) and ozone therapy (OT) methods for the treatment of facial nerve injury (FNI) in rats, evaluated by histomorphometric measurement analysis. MATERIALS AND METHODS: Thirty rats were randomly divided into control (C), LLLT, and OT groups. The left facial nerves (FNs) of all rats (n = 30) were used in this study. These were held in a surgical clamp for 30 s to create neuropathic damage. The non-injured right FNs of the rats in the control group formed the fourth, sham (S) group in this study (n = 10). Therefore the total number of evaluated samples was 40. The injured FNs of rats in the control group were left to heal spontaneously, whereas LLLT was applied for 21 consecutive days (output 100 mW/cm2 and wavelength 850 nm) and OT (2 ml; 80 µm/ml) once every 2 days for 21 days. RESULTS: After histomorphological evaluation, the OT group revealed statistically significant outcomes following FNI compared with the OT and control groups in terms of branching of nerve fibers (p = 0.003), nerve fiber diameters (p = 0.0398), nerve fiber areas (p = 0.042), and axon numbers (p = 0.0327). Although the LLLT group revealed a better healing process than the control group, the outcome was not statistically significant in terms of branching of nerve fibers (p = 0.6804), nerve fiber diameters (p = 0.7424), nerve fiber areas (p = 0.7048), and axon numbers (p = 0.7588). CONCLUSIONS: OT resulted in statistically significant differences in outcome when compared with the LLLT and control groups, and provided a safe and effective treatment for FNI in rats. OT could therefore be considered as an alternative treatment of FNI. Clinical studies should now be performed to establish whether comparable results can be achieved in humans.

Risk Factors Influencing Recovery of Neurosensory Disturbances Following Sagittal Split Ramus Osteotomy.

PURPOSE: The aim of this study is to determine the risk factors influencing the recovery time of neurosensory disturbances (NSD) following sagittal split ramus osteotomy. METHODS: One hundred twenty-seven patients (254 operated sites) underwent sagittal split ramus osteotomy due to dentofacial deformities between the period of 2011 and 2017. These patients were followed up for at least 1 year, and the data obtained from changes in sensation of inferior alveolar nerve were recorded subjectively. The subjects were categorized according to age, gender, type of deformity, nerve manipulation, side of the jaw, and the amount of the mandibular movement. The relationship between the above-mentioned parameters, and the recovery time of NSD were investigated. Pearson χ analysis was used, and the value of significance was accepted as P < 0.05. RESULTS: The recovery time of NSD is significantly correlated with the age of the patients, the amount of the mandibular movement (>7 mm), and the nerve manipulation (P < 0.05). There was no statistically significant correlation found between the recovery time of NSD and gender, type of deformity, side of the jaw (P > 0.05). CONCLUSIONS: The recovery time of NSD may prolong in cases of large amounts of mandibular movements more than 7 mm or the nerve manipulation. The older age may increase the risk of permanent NSD.

Is Ultrasonic Bone Scalpel Useful in Le Fort I Osteotomy?

PURPOSE: Safety and precision are 2 main goals in research to improve bone cutting in maxillofacial surgery. The aim of this prospective clinical study was to analyze the outcomes using an ultrasonic bone scalpel versus a piezoelectric surgical device and the conventional technique in a Le Fort I osteotomy. MATERIALS AND METHODS: We designed a prospective, randomized, single-blind cohort study. The predictor variables were the devices used to perform the Le Fort I osteotomy, divided into 3 groups: 1) ultrasonic bone scalpel (BoneScalpel; Misonix, Farmingdale, NY), 2) piezoelectric surgical device, and 3) conventional technique (Lindeman burr and reciprocal saw). The primary outcome of the study was cutting time, whereas secondary outcomes were length of the procedure, total blood loss, intraoperative complications, and postoperative edema. Other variables of interest were age and gender. Data were analyzed using 1-way analysis of variance and the Kruskal-Wallis test. RESULTS: The study sample was composed of 34 patients with a mean age of 21.5 years, and 63.3% of patients were women. The mean cutting time (P < .001) and length of the procedure (P = .012) were significantly shorter with the bone scalpel than with the other types of surgery. The ultrasonic bone scalpel showed a significant reduction in intraoperative blood loss of up to 45% compared with the piezoelectric surgical device and the conventional technique (P = .038). CONCLUSIONS: The results of this study suggest that the ultrasonic bone scalpel is an effective ultrasonic bone-cutting instrument in a Le Fort I osteotomy as evidenced by the significant decrease in the cutting time, intraoperative blood loss, and postoperative edema compared with the other techniques.

Histologic and Biomechanical Evaluation of Osseointegrated Miniscrew Implants Treated with Ozone Therapy and Photobiomodulation at Different Loading Times.

PURPOSE: The aim of this study was to evaluate how continuous heavy orthopedic forces affect the stability of sandblasted, large-grit, acid-etched (SLA)-surfaced miniscrew implants and surrounding bone tissue healing at three different loading periods with treatment of photobiomodulation and ozone therapy. MATERIALS AND METHODS: Miniscrew implants were applied on the tibias of 9-month-old rabbits (n = 18). The animals were randomly divided into three groups: control, photobiomodulation, and ozone therapy. In all groups, miniscrew implants were loaded with 500 gf at 0, 4, and 8 weeks, respectively (G1, G2, and G3). Several biomechanical and histologic analyses were performed in different centers to measure the implant stability quotient level, bone volume, and bone-to-implant contact. RESULTS: According to the results of the Infinite Focus Microscopy, the ozone therapy group revealed significantly higher scores than the control group and photobiomodulation group at the 4-week loading time, whereas the photobiomodulation and ozone therapy groups revealed significantly higher scores than the control group at the 8-week loading time in terms of bone volume measurements in mm3 (P < .05). According to the histologic analysis, the ozone therapy and photobiomodulation groups revealed significantly higher scores than the control group at the 4-week loading time, whereas the photobiomodulation group showed the highest scores among the 8-week loading groups (P < .05). CONCLUSION: This is the first study in the literature that reveals a better osseointegration process in miniscrew implants when treated with photobiomodulation and ozone therapy compared with control groups. Although the photobiomodulation and ozone therapy groups did not reveal significantly higher scores in immediately loaded miniscrew implants (G1), these treatments were significantly more effective when loaded after 4 or 8 weeks of osseointegration (G2 and G3). SLA-surfaced miniscrew implants are successful in the orthopedic forces (500 gf) and can be removed without complications.

Evaluation of Vestibular Bone Thickness in Class I Malocclusion Treatment With Corticotomy-Assisted Rapid Orthodontics.

BACKGROUND: Corticotomy-assisted rapid orthodontics is a widely used method for speeding up conventional orthodontics. This study (i) evaluates the effects of corticotomy alone, corticotomy combined with bone graft, and corticotomy with platelet-rich fibrin (PRF) on vestibular alveolar bone thickness in patients with class I malocclusion; (ii) compares the treatment time with a conventional orthodontic therapy group, and (iii) investigates the periodontal health of patients who have undergone corticotomy-assisted rapid orthodontics. METHODS: The patients were divided into 3 groups: Group 1 (n = 10) underwent corticotomy alone; Group 2 (n = 10) underwent corticotomy combined with bone graft, and Group 3 (n = 10) underwent corticotomy combined with PRF. In the following stage, vestibular alveolar bone thicknesses were evaluated using 3-dimensional cone-beam computed tomography images. RESULTS: The findings showed that Group 2 achieved a more significant augmentation of the vestibular alveolar bone than Groups 1 and 3 (P = 0.001, P = 0.003), while corticotomy-assisted rapid orthodontics decreased treatment times. Sufficient alveolar bone thickness and preservation of the periodontal health were achieved when the corticotomy procedure was either combined with a bone graft or with PRF in the Class-I malocclusion patients. CONCLUSION: Bone grafts provided better bone thickness at the buccal surface of the anterior teeth of the mandible and maxilla, whereas the thickness of the keratinized gingiva was better with PRF.

Does Single-Dose Preemptive Intravenous Ibuprofen Reduce Postoperative Pain After Third Molar Surgery? A Prospective, Randomized, Double-Blind Clinical Study.

PURPOSE: The aim of the present study was to identify the preemptive analgesic effect of intravenous (IV) ibuprofen before and after mandibular third molar surgery. MATERIALS AND METHODS: We randomly divided 75 patients into 3 groups. Group 1 received IV ibuprofen 60 minutes before surgery and IV placebo (100 mL of saline) after surgery. Group 2 received IV placebo (100 mL of saline) before surgery and IV ibuprofen 60 minutes after surgery. Finally, group 3 received IV placebo (100 mL of saline) 60 minutes before and after surgery. Postoperative pain was recorded using a visual analog scale at 1, 2, 4, 6, 8, 12, and 24 hours within the postoperative period. The total dose of rescue acetaminophen intake was recorded during the first 24 hours of the postoperative period. RESULTS: The efficacy of postoperative analgesia was greater within the preoperative IV ibuprofen group compared with the other groups (P < .001). The placebo group had required more rescue analgesia within the first hour compared with the other groups. The average dose of acetaminophen administered in group 1 was 640 mg compared with 1240 mg in group 2 and 1840 mg in group 3 within the first 24 hours after surgery (P < .001). CONCLUSIONS: The present study has shown that the preemptive use of IV ibuprofen resulted in less pain and a decrease in the requirement for rescue analgesia during the first 24 hours after third molar surgery.

The changes of self-esteem, sensitivity to criticism, and social appearance anxiety in orthognathic surgery patients: A controlled study.

OBJECTIVES: To evaluate the changes of psychologic parameters, such as self-esteem, sensitivity to criticism, and social appearance anxiety, in skeletal Class III patients undergoing orthognathic surgery and to compare the psychologic status of skeletal Class III patients with control subjects. METHODS: The first group consisted of 60 patients with a mean age of 22.07 ± 1.30 years who did not need orthognathic surgery. The second group comprised 45 patients with skeletal Class III malocclusion (mean age 21.40 ± 2.02 years) who were evaluated in terms of psychologic changes from before to after surgery. A third group consisted of 50 Class III patients (mean age 20.09 ± 2.59 years) who were evaluated before surgery and a different 50 Class III patients (mean age 22.15 ± 2.03 years) who were investigated after surgery. The Rosenberg Self-Esteem Scale and the Social Appearance Anxiety Scale were used to evaluate psychologic parameters both before and after surgery. Analysis was carried out with the use of independent- and dependent-sample t tests, 1-way analysis of variance, and post hoc Tukey test. RESULTS: Self-esteem of the patients with skeletal Class III malocclusion increased, and sensitivity to criticism and social appearance anxiety decreased significantly after the surgery (P <0.001). In the patients with Class III malocclusion, self-esteem was significantly lower and social appearance anxiety significantly higher before orthognathic surgery than in the control group, and at the postoperative evaluation Class III patients had significantly higher self-esteem than the control group (P <0.001). CONCLUSIONS: Through the improvement in facial appearance after surgery, patients' self-esteem increases and their sensitivity to criticism and social appearance anxiety decrease.

Removal of a supernumerary tooth displaced into the infratemporal fossa during extraction.

Accidental displacement of an impacted tooth into the infratemporal fossa (ITF) is a rare but serious complication because of the vulnerability of the surrounding anatomical structures. Here we present the case of a 40-year-old man who reported pain on the right side of his face. Panoramic radiography and cone-beam computed tomography revealed an impacted third molar and a supernumerary tooth positioned immediately below it. Under local anesthesia, the third molar was easily extracted; however, the supernumerary tooth was inadvertently displaced into the ITF. The position of the tooth was confirmed by radiographic examination, and it was immediately removed intraorally by expanding the flap and carefully dissecting the soft tissues. Clinical aspects of this rare complication were evaluated, with special emphasis on the reliability of imaging modalities and surgical techniques.

Effects of boric acid on bone formation after maxillary sinus floor augmentation in rabbits.

PURPOSE: Augmentation of the maxillary sinus floor with bone grafting is commonly used for successful treatment of edentulous posterior maxilla with dental implants, and it is essential to maintain good bone volume and quality for long-term success of dental implants. The aim of this experimental study was to investigate the local and systemic effects of boric acid on new bone formation after maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS: Twenty-four male, New Zealand rabbits were randomly divided into three groups with eight rabbits each, and bilateral MSFA was performed in each animal. An autogenous bone/xenograft mixture was used to augment the maxillary sinuses in each group. Group 1 was determined as control with no additional materials, whereas 3 mg/kg boric acid (BA) was added to the mixture in group 2, and 3 mg/kg boric acid solution added to drinking water daily in group 3. RESULTS: The animals were sacrificed and also histologic, histomorphometric, and immunnohistochemical analyses were performed at weeks 4 and 8. At week 4, bone regeneration was better in the local BA group than in the control and systemic BA groups (p < 0.05). However, no significant difference was found among the groups in terms of bone regeneration at the end of week 8 (p > 0.05). CONCLUSION: Significant higher new bone formation was revealed by BA at early healing especially with local application. BA may be a therapeutic option for improving the bone regeneration.

Gastrointestinal tract metastasis of mandibular diffuse large B-cell lymphoma.

Not only diffuse large B-cell lymphoma is a malignancy, but also is initially and orally diagnosed in early stages. However, it could be misdiagnosed with other oral pathologies. However yet, early diagnosis is still crucial for the prognosis, morbidity, and mortality in such cases. Additionally, whole-body scanning with positron emission tomography/computed tomography should be performed for diagnosis and treatment process.

Spontaneous and Excellent Healing of Bilateral Brown Tumors in Mandible after Endocrinal Therapy and Subtotal Parathyroidectomy: Case Report with 4-Year Follow-Up.

Primary hyperparathyroidism is an endocrine disorder occurring due to increased secretion of parathormone resulting in a complex of clinical, anatomical, and biochemical alterations. On the other hand, excision of a parathyroid adenoma can normalize the metabolic status. A 24-year-old man was referred to the hospital with bilateral swelling and spontaneous gingival bleeding from posterior of the mandible also with radiolucent well-demarcated lesions bilaterally in the mandibular third molar regions. After consultations, the patient was hospitalized in the endocrinology department where further tests were performed due to highly increased PTH level as 714 pg/ml. Bilateral brown tumors started to regress spontaneously, and no additional surgery was required after subtotal parathyroidectomy was performed. The presented case is the first patient whose bilateral brown tumors in the jaws spontaneously and totally healed after subtotal parathyroidectomy and endocrinal therapy who was strictly followed up for 4 years even though the lesions were associated with impacted third molars.

Reusing dental implants?: an experimental study for detecting the success rates of re-osseointegration.

BACKGROUND: The aim of this study was to histomorphometrically compare the implant-host integration between retrieved implants and new implants. METHODS: Jaws in 10 male beagle dogs were divided into four groups, and 36 dental implants were inserted into the jaws. In groups 1 and 2, experimental peri-implantitis was induced within 2 months after implant insertion. In group 1, surface decontamination of implants was achieved using air-flow and citric acid. In group 2, implants were sterilized with autoclave after air-flow and citric acid surface decontamination. Subsequently, these implants were inserted in contralateral jaws of the same dogs and a 3-month period was allowed for osseointegration. In group 3, the implants were removed from human jaws due to peri-implantitis and were inserted into dog jaws following surface cleaning protocol and sterilization with autoclave and a 3-month period was allowed for osseointegration. Group 4 was set as the control group. After the osseointegration period, all the animals were sacrificed. The degree of osseointegration in all groups was evaluated by evaluating the ISQ values and by using histomorphometric measurements. RESULTS: Histological findings showed that bone-implant contact (BIC) percentage (mean ± SD) was 83.39% ± 6.37 in group 1, 79.93% ± 11.83 in group 2, 75.45% ± 9.09 in group 3, and 80.53 ± 5.22 in group 4. Moreover, the resonance frequency analysis (RFA) and ISQ values were similar in all four groups both before and after the implantation. CONCLUSIONS: The results of this experimental study indicated that there is no significant difference between new dental implants and re-used dental implants with regards to osseointegration around the implant.