Combined approach to treatment of advanced stages of medication-related osteonecrosis of the jaw patients.

INTRODUCTION: Increased incidence of localized osteonecrosis in the jaw bones caused by bisphosphanate use and reduced quality of life of the patients led researchers to diagnose the disease in the early period and to investigate the effective treatment modality. OBJECTIVE: Treatment of medication-related osteonecrosis of the jaw patients is based on individual protocols from clinical experience, as there are no definitive treatment guidelines. In view of the lack of consensus on the effectiveness of medication-related osteonecrosis of the jaw treatments in the literature, the aim of this study was to evaluate the surgical technique described in the treatment of advanced stages of medication-related osteonecrosis of the jaw patients. METHODS: Twenty-one patients affected by Stage 2-3 medication-related osteonecrosis of the jaw were treated with ultrasonic piezoelectric bone surgery for necrotic bone removing, leukocyte and platelet-rich fibrin concentrate obtained from the patient's peripheral blood and Nd:YAG laser for biostimulation. Success was assessed as the maintenance of full mucosal coverage without signs of residual infection at 1-month (T1), 3-months (T2), 6-months (T3) and 1-year (T4) after surgery. Logistic regressions were used to evaluate the association between the different independent variables and treatment outcomes. RESULTS: Two Stage 3 patients had delayed healing at 1 month after the operation. Complete mucosal healing was achieved in all patients at the third month. Multivariate analysis demonstrated that different variables were not significantly correlated with delayed healing (p > 0.05). CONCLUSION: The surgical protocol presented in this study shows promising results for surgical management of advanced stages of medication-related osteonecrosis of the jaw patients.

Silver nanoparticle incorporation effect on mechanical and thermal properties of denture base acrylic resins.

OBJECTIVE: The aim of the present study was to evaluate the mechanical and thermal characteristics of two denture base acrylic resins containing silver nanoparticles (AgNPs). MATERIAL AND METHODS: Two different acrylic denture base resins (heat-polymerized and microwave polymerized) containing 0.3, 0.8 and 1.6 wt% AgNPs were evaluated for flexural strength, elastic modulus and impact strength. The glass transition temperature (Tg) and relative heat capacity (Cp) of the samples were determined from the Differential Scanning Calorimetry (DSC) results. For statistical analysis, two-way ANOVA and Tukey-HSD tests were performed. RESULTS: Addition of 0.8% and 1.6% AgNPs in microwave-polymerized resin significantly decreased the transverse strength and elastic modulus. In terms of impact strength, the addition of AgNPs has no effect on both resin groups. Glass transition temperature (Tg) was decreased with the addition of AgNPs for both denture base resins. CONCLUSIONS: The incorporation of AgNPs, generally used for antimicrobial efficiency, affected the transverse strength of the denture base acrylic resins depending on the concentration of nanoparticles. Tg was decreased with the addition of AgNPs for both denture base resins.