The stability of implants and microbiological effects following photobiomodulation therapy with one-stage placement: A randomized, controlled, single-blinded, and split-mouth clinical study.

BACKGROUND: Studies have reported a positive effect on bone healing and the elimination of microorganisms placed on the titanium implants, while others have not confirmed the positive photobiomodulation therapy (PBMT) effects on bone regeneration and bone structure around the implants. PURPOSE: The aim of the present study was to address the following questions: Does PBMT improve implant stability and affect microbiota around dental implants in the early stage of osseointegration? MATERIALS AND METHODS: This study was designed as randomized-controlled prospective, split mouth, single-blinded clinical trial. Implants were randomly divided into two groups and implants placed in the test group were treated with Gallium-aluminum-arsenide (GaAlAs) diode laser with PBMT immediately after surgery and for 15 days (n = 47). In the control group, implants were not irradiated(n = 46). The primary stability of the implants was measured by the Resonance frequency analysis (RFA) after insertion and the secondary stability values were recorded at 30th, 60th, and 90th days after surgery as implant stability quotient (ISQ). The hand-held RFA was held perpendicular to the jaw line as indicated by the manufacturer for buccal-lingual (BL), mesial-distal (MD), and lingual-buccal (LB) measurement and different measurements were analyzed as separately. RESULTS: Significantly higher magnetic RFA values were achieved on the 90th day in all measurement sides for both groups. ISQ levels in groups at baseline and the day-30, 60, and 90. ISQ readings were not statistically significant between test and control groups for each time point. A statistically significant increase in ISQ reading for BL, MD, and LB dimensions in both groups was noted from baseline to the day-90 (P < .05). CONCLUSION: It was concluded that PBMT did not have a clinically significant effect on implant stabilization, especially in terms of ISQ values at early alveolar bone healing term. Clinical trial number is NCT04495335.

Zygomatic miniplates for skeletal anchorage in orthopedic correction of Class III malocclusion: A controlled clinical trial.

OBJECTIVE: To evaluate the effects of facemask therapy, which was anchored from the zygomatic buttresses of the maxilla by using two miniplates, in skeletal Class III patients with maxillary deficiency. METHODS: Eighteen skeletal Class III patients (10 girls and 8 boys; mean age, 11.4 ± 1.28 years) with maxillary deficiency were treated using miniplate-anchored facemasks, and their outcomes were compared with those of a Class III control group (9 girls and 9 boys; mean age, 10.6 ± 1.12 years). Two I-shaped miniplates were placed on the right and left zygomatic buttresses of the maxilla, and a facemask was applied with a 400 g force per side. Intragroup comparisons were made using the Wilcoxon test, and intergroup comparisons were made using the Mann-Whitney U-test (p < 0.05). RESULTS: In the treatment group, the maxilla moved 3.3 mm forward, the mandible showed posterior rotation by 1.5°, and the lower incisors were retroclined after treatment. These results were significantly different from those in the control group (p < 0.05). No significant anterior rotation of the palatal plane was observed after treatment. Moreover, changes in the sagittal positions of the maxillary incisors and molars were similar between the treatment and control groups. CONCLUSIONS: Skeletally anchored facemask therapy is an effective method for correcting Class III malocclusions, which also minimizes the undesired dental side effects of conventional methods in the maxilla.

Is age a determinant for nausea and vomiting in disabled patients after dental treatment under sedation?

BACKGROUND AND AIM: Postoperative nausea and vomiting (PONV) is one of most frequently encountered problems after dental treatment of mentally and/or motor disabled patients under sedation or general anesthesia. In this study, we aimed to investigate whether PONV incidence in disabled patients differs between adults (≥18 years) and children/teenage (<18 years). Also investigating complication rates related with anesthesia protocols were additional objectives of the study. MATERIALS AND METHODS: We retrospectively evaluated anesthesia reports of 664 cases undergone different dental treatment procedures under deep sedation with various anesthetic agents. Two study groups (Group 1 consisted from patients with special needs <18 years, while Group 2 consisted from patients ≥18 years) were created. PONV incidence and other complications recorded. RESULTS: There was no statistical difference between groups in terms of used anesthetic agent except midazolam (P < 0.017), while higher female/male ratio and longer duration of anesthesia was recorded in Group 2 (P = 0.043 and P = 0.046, respectively). We found significantly higher PONV rates in disabled patients under 18 years (P = 0.006). Hypoxia (peripheral oxygen saturation (SpO2) <90%) and bradycardia (heart rate <50/minute) were observed in only two patients. CONCLUSION: PONV is more common in disabled patients younger than 18 years and dental treatment procedures under deep sedation can be provided with acceptable complication rates in patients with special needs.

The Comparison of Porous Titanium Granule and Xenograft in the Surgical Treatment of Peri-Implantitis: A Prospective Clinical Study.

BACKGROUND: Regarding the current approach, there is no evidence to show which treatment technique is the most accurate and useful in peri-implant defects. PURPOSE: The aim of this study is comparing the effect of porous titanium granule (PTG) with rotary titanium brush and the use of xenograft and collagen membrane in the treatment of intra-bony peri-implant defects. MATERIALS AND METHODS: Twenty-two patients, suffering peri-implantitis defects were included this study. Patients were divided into two groups: The PTG group used rotary titanium brush, PTG, and platelet rich fibrin (PRF) membrane. The XGF group used xenograft bone substitute, collagen membrane, and PRF membrane. Clinical measurements and cone beam computed tomography per region were recorded as baseline and sixth month after surgery. RESULTS: The mean CAL values were improved from 5.29 ± 1.06 to 3.59 ± 0.88 mm in PTG group, while in XGF group; these values were improved from 4.77 ± 1.05 to 3.30 ± 0.58 mm. Radiographic bone filling values displayed a statistically significant difference between of groups. In PTG groups, these radiological values increased more than the XGF group. CONCLUSIONS: PTG may be more appropriate for peri-implantitis surgery than xenograft due to inert structure and comfortable use of PTG to provide mechanical support for enlarging the surface area of the implant.

Implant-supported hybrid prosthesis: Conventional treatment method for borderline cases.

An implant-supported hybrid prosthesis is an acrylic resin complete fixed dental prosthesis and supported by implants might be a solution in extreme cases that the need of the restoration for esthetics, function, lip support, and speech. This clinical report aims to present the esthetic and functional prosthetic rehabilitation of three borderline cases with implant-supported hybrid prostheses. Patient 1 (62-year-old man) and Patient 2 (61-year-old man) presented a chief complaint of a compromised esthetic. After clinical evaluations, in Patient 1, 8 implants in the maxilla and 7 implants in mandibula were observed. Patient 2 had 7 implants in the maxilla and 7 implants in mandibula, which were previously placed. The intra-arch dimension of both patients was excessive and an insufficient peri-oral soft tissue support was observed. Patient 3 was a 61-year-old man had 2 implants with a history of previously implanted graft infection and implant loss on his maxillary posterior jaw. An excessive intra-arch dimension was observed in clinical examination. In addition, massive bone defect and insufficient soft tissue support were examined. In all patients, implant-supported hybrid prostheses were successfully performed. The clinical and radiologic findings were satisfactory. After 3 years of follow-up, no functional, phonetic, or esthetic problems with the restorations were noted. These case reports suggest that implant-supported hybrid prostheses can be a reliable alternative treatment procedure when a porcelain-fused metal fixed restoration does not satisfy a patient's requirements for esthetics, phonetics, oral hygiene, and oral comfort.

Experimental evaluation of the effects of Ankaferd Blood Stopper and collagenated heterologous bone graft on bone healing in sinus floor augmentation.

PURPOSE: The aim of this study was to evaluate the effect of collagenated heterologous bone graft (CHBG) and Ankaferd Blood Stopper (ABS), a plant extract, on bone healing after sinus floor augmentation. MATERIALS AND METHODS: Thirty-six New Zealand rabbits were used. Bilateral sinus augmentation was performed, and 72 bone defects were created. The maxillary sinuses were grafted with four different biomaterials: blood clot (control group), CHBG (Apatos Mix, OsteoBiol, Tecnoss) (graft group), ABS (ABS group), and ABS + CHBG (ABS+graft group). The rabbits were sacrificed at 1, 4, and 8 weeks after surgery. Histochemical and immunohistochemical examinations were performed on all samples. Staining with hematoxylin-eosin and Masson trichrome was performed, and bone marker activity was evaluated. RESULTS: Lymphocyte infiltration was high at the first week in all groups and decreased from 1 to 8 weeks. All materials were biocompatible. Osteoclast numbers increased in the control group from 1 to 8 weeks and decreased in the other groups. There was no new bone formation in week 1 in all groups. New bone formation increased in all groups from 1 to 8 weeks, and at the fourth week, new bone formation was greater in the ABS and ABS+graft groups than in the other groups. There were osteoclasts around the bone graft materials, but degeneration of the graft was seen only in the ABS+graft group at week 8. CONCLUSION: ABS accelerates bone healing in sinus augmentation procedures and can be used alone or with CHBG. CHBG has osteoconductive properties, and ABS can accelerate bone graft degeneration.

Complication After Cryosurgery Treatment for Gingival Melanin Pigmentation: A Case Report.

INTRODUCTION: Gingival melanin pigmentation (GMP) is considered a physiologic or racial situation. Complaints of "black gums" are common, and demands for depigmentation are usually made for esthetic reasons. In this case report, a cryosurgical depigmentation procedure is described and the effectiveness and complications of cryosurgery are examined. CASE PRESENTATION: A 40-year-old, systemically healthy female presented with esthetic problems associated with GMP. Cryosurgery was performed from the midline by cross-segments from canine to canine for the treatment of maxillary and mandibular gingival tissues. One month after the cryosurgery procedure, a bone sequestrum became apparent between the mandibular right central incisor and canine, and it was removed from the area. A 2-mm gingival recession was observed 1 month after the surgery to remove the sequestrum. CONCLUSIONS: Methods such as cryosurgery seem to be effective in the treatment of GMP. Various complications can be observed in the application of cryosurgical procedures, such as infection, hemorrhage, recession, and pain. Anatomic structures of the pigmented sites, the width of the gingiva, the length of the keratinized gingiva, the dose, and application distance of cryosurgenic gas must be carefully considered.

Evaluation of bone graft harvesting techniques from anterior ilium.

Autogenous bone harvest from the anterior ilium is a common procedure in the surgical field. In the current study, a retrospective analysis was performed regarding the bone graft harvesting techniques from the anterior ilium. The retrospective analysis with a 1-year period included 16 patients who had undergone iliac bone grafting for oral and maxillofacial reconstruction. Medial and lateral approaches were assessed. No major complications were observed. One patient undergoing medial approach and 2 patients undergoing lateral approach experienced gait disturbances at the postoperative period. Harvesting bone from the anterior ilium did not result in greater donor site morbidity or complications in the early term. The medial approach revealed an earlier recovery time than the lateral one. Anterior ilium is a good choice for the reconstruction of jaws, but donor site morbidity remains a problem and should be considered in the treatment plan.

Florid cemento-osseous dysplasia: Report of a case documented with clinical, radiographic, biochemical and histological findings.

Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions.

The predictivity of mandibular third molar position as a risk indicator for pericoronitis.

The aim of this study was to describe the characteristics of the mandibular third molar at highest risk for acute pericoronitis using clinical and radiographic analysis. A total of 102 volunteers, including 40 (39%) male and 62 (60%) female patients presenting with acute pericoronitis, participated in the study. The mean age of the participants was 23.4 years (range 17-30 years). The variables tested included the percentage of soft tissue coverage, availability of impinging maxillary dentition, and the angulation and eruption level of the mandibular third molar. While vertical impaction was the most frequent angulation (51%), horizontal impaction was quite rare (3%). Mesioangular impaction (25%) was slightly higher than distoangular impaction (21%). Difference between type of angulation was statistically significant for all groups (p < 0.05). The frequency of partial soft tissue coverage, particularly 75% coverage, was far more observed than the full soft tissue coverage (47%). The difference for the amount of soft tissue coverage was statistically significant (p < 0.05). In 57% of the cases, pericoronitis was associated with the third molars that erupted at the same level of the adjacent tooth occlusal plane. The difference among the three levels of eruption was significant (p < 0.000). Impinging maxillary dentition did not have a significant impact on development of pericoronitis (41%). Evidence of impinging maxillary dentition did not have a statistically significant impact on presence of pericoronitis (p = 0.075). Mandibular third molars at or near to the same level of the occlusal plane of the arch and exhibiting vertical inclination were considered at highest risk for developing pericoronitis. Such third molars can be given high priority for prophylactic care due to the possibility of severe consequences of acute pericoronitis.

Review of flap design influence on the health of the periodontium after mandibular third molar surgery.

The purpose of this study is to review the effect of flap design in terms of periodontal status of the preceding second molar after lower third molar surgery. Impacted lower third molar surgery may result in periodontal complications on the distal surface of the adjacent second molar. Flap design that is used during impacted third molar surgery is important to prevent those complications. Several different flap techniques, mainly envelope, triangular (vertical) flaps, and their modifications have been developed to minimize those complications. Each technique has some advantages as well as disadvantages. It is also reported that the selection of a flap design does not seem to have a lasting effect on the health of periodontal tissue. The effect of the type of flap used for lower third molar surgery on the periodontal status of the second molar, as well as the factors that may influence this outcome, has been uncertain. The decision to use on one or the other of the flaps should be based on surgeon's preference.

The treatment of lymphangioma in the buccal mucosa by radiofrequency ablation: a case report.

Lymphangioma is a benign, hamartomatous tumor of the lymphatic system. It is usually found in the head and neck region and is widely regarded as a developmental lesion rather than a true neoplasia. Most lymphangiomas are present at birth (60%), and by the age of 2 years 80% to 90% are present. In the head and neck area, the most common location is the submandibular region, followed by the parotid gland. When lymphangioma occurs in the mouth, the anterior two thirds of the tongue is the most commonly affected region. Various methods have been tried for treatment of lymphangioma including surgery, radiation, laser therapy, and sclerotherapy. Recently, a new and more conservative surgical approach to this lesion using radiofrequency ablation has been described. In this report, a case of lymphangioma in the right buccal mucosa of the mental foramen area that has been treated by radiofrequency ablation is presented.

Childhood craniofacial Burkitt's lymphoma presenting as maxillary swelling: report of a case and review of literature.

Burkitt's lymphoma (BL) is an undifferentiated malignant lymphoma comprising of uniformly primitive lymphoreticular cells. The tumor was seen originally in patients in Africa. African type BL usually occurs in the jaws of young children. In American cases, abdominal involvement predominates. Strong evidence implicats Epstein-Barr virus in the development of BL. BL is found most commonly in childhood, with a peak incidence in African cases at 5 to 8 years old and in American cases at 10 to 12 years old. The disease shows a preference for males in a 2:1 to 4:1 ratio. BL is the most rapidly growing neoplasm requiring immediate diagnosis and treatment; however, it is extremely sensitive to chemotherapy. In this report, a case of BL that was initially misdiagnosed as an acute dental abscess is presented and the role of the dentist in the diagnosis and treatment of these patients is emphasized.