[C-reactive protein as an inflammatory marker in monitoring therapy effectiveness of acute odontogenic infections].

INTRODUCTION: Clinical presentation of acute odontogenic infections may vary, while adequate evaluation of its severity is of great importance for determination of appropriate and effective therapy. OBJECTIVE: The aim of the present study was to monitor changes of C-reactive protein (CRP) levels, to correlate its values with symptoms of different acute odontogenic infections (AOI), and to monitor the effectiveness of the applied therapy. METHODS: Fifty-four patients with AOI were included in the study. Eighteen patients with good drainage and normal body temperature were treated only by surgical incision without using antibiotics. Twenty-two patients with poor drainage after incision and normal body temperature were treated by surgical incision and antibiotics. Fourteen patients with elevated body temperature were treated by incision and antibiotics, irrespective of the quality of the drainage. CRP levels were measured on admission, on the 3rd and 7th day after therapy initiation. RESULTS: On admission CRP levels were higher in AOI with elevated body temperature compared to poorly and well-drained AOI. There were no differences in CRP levels between well and poorly drained AOI on admission. On the 3rd day, a decline in the CRP levels was evident in all three groups of patients, and there was no difference among the groups. On the 7th day, the CRP levels normalized in all groups. CONCLUSION: CRP levels correlate well with the severity and resolution of AOI and could be used as a reliable parameter in monitoring the effectiveness of AOI therapy.

Resonance frequency analysis as a reliable criterion for early loading of sandblasted/acid-etched active surface implants placed by the osteotome sinus floor elevation technique.

PURPOSE: This study was intended to investigate, through resonance frequency analysis (RFA), the stability of implants placed in an early loading protocol via the osteotome sinus floor elevation technique in the posterior maxilla. All implants featured a sandblasted/acid-etched active surface. MATERIALS AND METHODS: An early loading protocol was considered for patients in whom implants with a sandblasted, large-grit/acid-etched active surface (SLActive) were placed in the posterior maxilla by the osteotome sinus floor elevation technique. Implant stability, which was measured by RFA at surgery and at weekly intervals for the following 6 weeks, was used as the most significant inclusion criterion. At the end of the stability observation period, only implants with a stability quotient of 65 or higher were loaded. Implants were followed for 2 years. RESULTS: Twenty-seven patients received 42 implants, 40 of which were subjected to an early loading protocol 6 weeks after placement. Two years after loading, all 40 implants were surviving, without clinically or radiographically detectible complications. CONCLUSION: An early loading protocol can be used for SLActive implants placed in the posterior maxilla via the osteotome sinus floor elevation technique if their stability is confirmed by RFA.

Cemento-ossifying fibroma of jaws-correlation of clinical and pathological findings.

Cemento-ossifying fibroma (COF) belongs to the group of bone-related lesions of the oral cavity. The aim of this study was refine its histologic features and to correlate histopathological picture and clinical behavior of the tumor. The quantity of bone spherules, their cellularity, the existence of hemorrhage, inflammation, and endochondral ossification in the stroma of the tumor were analyzed and correlated with patients main symptoms of ten patients with COF. All patients had swelling that lasted between 3 and 20 months (mean 10.4 months). Other clinical symptoms were facial asymmetry, eye bulb protrusion, and teeth displacement. The evolution of the tumor was longer in the mandible (12.3 months) than in maxilla (9.5 months). The main histomorphological diagnostic criterion for COF was psammoma-like structures. In lesions with longer case history, the number of "psammomatoid" bodies was greater. In lesions with shorter course of the disease, their number was lower and stromal hemorrhage and inflammation were presented. One patient had secondary superposition of aneurysmal bone cyst in the prime COF of mandible. Histological appearance of COF may be influenced by the tumor evolution. A siginificant correlation between the clinical course of the disease and histological parameters has been certified.

Mast cells in periapical lesions: potential role in their pathogenesis.

OBJECTIVE: The aim of this study was to qualitatively and semi-quantitatively analyze mast cells in periapical lesions. MATERIALS AND METHODS: Biopsy specimens of 96 periapical lesions were stained with hematoxylin-eosin, histochemical Giemsa and immunohistochemical CD 117 (C kit) antibody. Mast cell count below 100 mast cells on 1000 fields of high power magnification was noted as 'negative', 101-400 as 'mild', 401-800 cells as 'moderate', and over 800 cells as 'severe'. RESULTS: Mast cells are found in 68 (70.8%) lesions. The presence of mast cells was greater in cysts than in granulomas (P < 0.0028). There was no difference in semi-quantitative expression of CD 117 in granulomas and cysts (P > 0.05). Mast cells were placed in both: inflammatory infiltrate and in fibroblastic areas of periapical lesions, and their presence was most frequently mild to moderate. CONCLUSIONS: The findings of present study could suggest a role of mast cells in regulation of cellular immune mechanisms in periapical lesions, balancing between alterative and reparatory processes in inflamed periapical tissue.

Functional endoscopic sinus surgery as an adjunctive treatment for closure of oroantral fistulae: a retrospective analysis.

OBJECTIVE: The objective of this study was to report results of functional endoscopic sinus surgery (FESS) for treatment of chronic maxillary sinusitis of dental origin in a series of patients with oroantral fistulae (OAF). STUDY DESIGN: Fourteen patients were treated by FESS and OAF closure by local flap. Data on severity of symptoms, diagnostic endoscopy, and coronal CT scan findings, as well as intraoperative course and complications, were recorded. The follow-up period lasted up to 2 years, comprising clinical examinations and control CT scans. RESULTS: All OAF healed uneventfully. All patients reported improvement in severity of sinusitis symptoms, which was confirmed through results of clinical examinations and control CT scans. No significant complications were recorded. No revision surgery was needed in any case. CONCLUSION: These results indicate that FESS, combined with OAF closure by buccal flap, might be an effective and safe option for treatment of selected cases of chronic odontogenic sinusitis with OAF.

The closure of oroantral communications with resorbable PLGA-coated beta-TCP root analogs, hemostatic gauze, or buccal flaps: a prospective study.

OBJECTIVE: The aim of this study was to compare the treatment of oroantral communications (OACs) with bioresorbable root analogs made of poly(lactide-co-glycolide) (PLGA)-coated beta-tricalcium phosphate (beta-TCP), hemostatic gauze or a buccal flap technique. STUDY DESIGN: In this prospective clinical study, 30 patients with oroantral communications were randomly assigned to a treatment. Clinical success, vestibular depth at the defect site, pain, and swelling were monitored. RESULTS: The OAC closure was successful in all cases. The vestibular depth stayed constant in the groups treated with the PLGA-beta-TCP composite or hemostatic gauze. In contrast, a vestibular depth reduction of 1.2 +/- 0.2 mm was observed in the buccal flap group, indicating atrophy of the alveolar ridge in these patients. Furthermore, pain and swelling were more pronounced in this group. CONCLUSION: Closures of OACs with PLGA-beta-TCP composite or hemostatic gauze are reliable minimally invasive methods that minimize atrophy of the alveolar ridge, swelling, and pain compared with a buccal flap technique.