The Effect of Parathyroid Hormone Analogues When Added to Mineralized Bone Xenografts.

Implants can be a treatment option when there is sufficient quantity and quality of bone to provide support for long-term success. In the reconstruction of defects, autogenous bone remains the gold standard for its osteogenic and compatibility properties. However, the disadvantage of secondary surgery and the associated donor site morbidity prompts researchers to develop the ideal bone substitute for optimum bone reconstruction. Parathyroid hormone (PTH1-34) has provided a new option for improvement in bone regeneration. This study used a pig model to evaluate the effectiveness of parathyroid hormone when added to a xenograft, Bio-Oss, in reconstructing mandible defects. Six domestic pigs were used to create 3 posterior mandibular defects measuring 2 × 1-cm bilaterally with a total of 36 defects to simulate tooth extraction sites in humans. The defects were grafted in random order and divided into 3 groups as follows: control (no graft), Bio-Oss without PTH, and Bio-Oss with PTH. Defects were assessed with cone beam computerized tomography (CBCT), micro computerized tomography (microCT), nanoindentation, and histology. Results showed that adding PTH1-34 significantly enhanced the graft construct. CBCT showed a significant increase in the degree of bone mineralization. Nanoindentation showed increased hardness of regenerated bone and accelerated bone mineralization with PTH. MicroCT analysis revealed a trend toward higher bone regeneration and mineralization. The histological analysis showed a positive trend of the increase in cortical bone thickness and mineral apposition rate. In conclusion, the local addition of PTH1-34 to a xenograft has shown promising results to enhance bone regeneration in the reconstruction of mandibular defects.

Fabrication of an implant-supported fixed complete denture using multiple digital technologies for a patient with a perioral burn: A clinical report.

This clinical report describes the prosthetic and surgical management of a patient with a restricted oral orifice due to a perioral burn. Complete oral rehabilitation was achieved with maxillary and mandibular implant-supported fixed prostheses using a combination of digital and conventional impressions, design, and processing techniques.

Does ultrasonic resorbable pin fixation offer predictable results for augmentation eminoplasty in recurrent dislocations?

PURPOSE: To assess the outcome of interpositional calvarial block grafting fixed with an ultrasonic resorbable system (SonicWeld, KLS Martin, Mühlheim, Germany) for augmentation eminoplasty in chronic recurrent condylar dislocations. PATIENTS AND METHODS: We designed and implemented a retrospective cohort study. Eight female patients (mean age 48 years) were treated. The primary predictor variable was time (preoperative vs postoperative). The primary outcome variable was cessation of dislocation. The secondary outcome variables were the height of the articular eminences (HAE), maximum interincisal opening, pain score (visual analog scale [VAS]), postoperative magnetic resonance imaging (MRI) findings, and facial nerve paralysis. RESULTS: All 8 patients had been experiencing recurrent dislocations a mean of 10 times each month preoperatively. None of the patients had experienced a dislocation at 2 years postoperatively. The preoperative mean HAE was 5.75 and the VAS score for pain was 72.5. The mean vertical HAE was 15.75 mm, and the mean VAS score for pain was 11.2 at 12 months postoperatively. Complete resorption of the SonicWeld pins was observed on the first year follow-up computed tomography scans. Of the 8 patients, 3 presented with disc displacement without reduction and 2 with disc displacement with reduction on the postoperative MRI scan, and none of the patients had a facial nerve deficit at 24 months of follow-up. CONCLUSIONS: Fixation of cortical calvarial grafts using the ultrasonic resorbable system for augmentation eminoplasty provided sufficient stabilization and favorable outcomes. Degradation of the osteosynthesis material and the absence of intermaxillary fixation were the most advantageous parts of the technique.

Evaluation of temporomandibular joint disc-repositioning surgery with Mitek mini anchors.

PURPOSE: The aim of this study is to evaluate outcome of Mitek mini anchors (DePuy Mitek, Raynham, MA) in TMJ discopexy and assess patient satisfaction based on MRI findings. PATIENTS AND METHODS: 7 patients suffered from significant pain and dysfunction diagnosed on MRI findings as anterior disc displacement without reduction selected for this study. Anchor stability, assessment of positional changes and roofing were evaluated by postop MRI and OPTGs. Satisfaction was assessed with VAS. Preop and postop maximum interincisal opening measurements were compared. RESULTS: There was significant difference between preop and posto P values of MIO and VAS. All 7 patients noted complete absence of pain at the postop 1-year follow-up. Only 1 patient had postop clicking but showed remarkable improvement of jaw functions (MIO). The articular disk was observed at its normal position in 6 patients except one patient whom MRI confirmed postop partial roofing. OPTGs reveal neither radiologic changes around the mini anchors in the condylar head nor any positional shifts. CONCLUSION: Disc repositioning with Mitek mini anchors represent improvement in post-op VAS scores and clinical findings (MIO) based on comparison preop and postop MRI scans and panoramic films. However, our study group consists of limited number of patients, further studies with more number of cases are required to evaluate the outcomes.