Anatomical Factors of the Anterior and Posterior Maxilla Affecting Immediate Implant Placement Based on Cone Beam Computed Tomography Analysis: A Narrative Review.

BACKGROUND: The aim of this narrative review was to provide insights into the influence of the morphological characteristics of the anatomical structures of the upper jaw based on cone beam computed tomography (CBCT) analysis on the immediate implant placement in this region. MATERIAL AND METHODS: To conduct this research, we used many electronic databases, and the resulting papers were chosen and analyzed. From the clinical point of view, the region of the anterior maxilla is specific and can be difficult for immediate implant placement. FINDINGS: Anatomical structures in the anterior maxilla, such as the nasopalatine canal and accessory canals, may limit and influence the implant therapy outcome. In addition to the aforementioned region, immediate implant placement in the posterior maxilla may be challenging for clinicians, especially in prosthetic-driven immediate implant placement procedures. Data presented within the recently published materials summarize the investigations performed in order to achieve more reliable indicators that may make more accurate decisions for clinicians. CONCLUSION: The possibility for immediate implant placement may be affected by the NPC shape in the anterior maxilla, while the presence of ACs may increase the incidence of immediate implant placement complications. The variations in IRS characteristics may be considered important criteria for choosing the implant properties required for successful immediate implant placement.

Novel Insights into Amlodipine-Induced Gingival Enlargement: A Clinical and Molecular Perspective.

This study aimed to identify risk factors for amlodipine-induced gingival enlargement, assess quality of life, and analyze gingival tissue. This cross-sectional study involved hypertensive patients on amlodipine, divided into groups with and without gingival enlargement. Assessments included sociodemographic data, clinical evaluations, and clinical parameters. Quality of life was assessed using OHIP-14 and WB-HRQoL scales. Gingival tissue samples were analyzed for oxidative status and key molecules using RT-PCR and colorimetric assays. The study included 32 patients with no significant sociodemographic differences between groups (p > 0.05). Patients with gingival enlargement had higher systolic blood pressure (139.63 ± 10.743 vs. 128.38 ± 7.249, p = 0.028) and higher OHIP-14 scores. The RT-PCR analysis showed significant differences in IL-6, TNF-α, IL-33, ST2, TGF-ß1, FGF-2, CTGF, VEGF-D, and KGF expression. IL-6, TNF-α, ST2, and FGF-2 expression levels were lower in patients taking amlodipine, with and without gingival enlargement. TGF-ß1 and CTGF expression levels were highest in patients with amlodipine-induced gingival enlargement. SOD activity was also highest in these patients, whereas MDA levels were higher in patients with gingival enlargement without amlodipine. Our study highlights the impact of amlodipine-induced gingival enlargement on oral health and quality of life, emphasizing fibrosis and oxidative stress, and suggests the need for integrated healthcare approaches and further research.

Effectiveness of Plasma-Rich Fibrin and De-Epithelialized Free Gingival Graft in the Treatment of Gingival Recessions.

Introduction/Aim: Soft tissue dehiscences such as gingival recessions are a very common problem that we face in modern periodontics. This clinical study aimed to analyze the effectiveness of surgical procedures using a de-epithelialized gingival graft (DGG) combined with a coronally advanced flap and to evaluate the application of plasma-rich fibrin (PRF). Methods: The study included 40 teeth (20 patients) with Miller class I and II gingival recessions. Twenty recessions (20 patients) were treated utilizing the de-epithelialized gingival graft in combination with the coronally advanced flap, and on the opposite side of the jaw, the same number of recessions were treated utilizing plasma-rich fibrin combined with the coronally advanced flap. To evaluate tissue condition and the clinical parameters before and after the surgical procedure, the following parameters were used: the degree of epithelial attachment (DEA), the width of keratinized gingiva (WKG), and the vertical depth of recession (VDR). Results: based on the achieved results and the analysis of clinical parameters, a statistically significant reduction in the vertical depth of recession was proven in both groups, with very similar mean percentages of root coverage, with the difference being that the stability of the soft tissues of the treated region was more visible in the DGG. Conclusion: using modern surgical procedures allows the regeneration of not only the soft tissues but also deeper periodontal tissues.

Oral Health and Oral Health-Related Quality of Life in Patients with Primary Sjögren's Syndrome.

Background and Objectives: Oral disorders, frequently observed in patients with primary Sjögren's syndrome, can profoundly affect patients' daily lives and well-being, as oral health represents a fundamental part of general health. Saliva plays an essential part in maintaining and protecting oral health, so the decrease in its quantity and quality leads to chronic oral discomfort alongside a broad spectrum of problems. The objective of the present study was to evaluate the oral health of patients with primary Sjögren's syndrome and establish its effect on the different domains of their oral health-related quality of life (OHRQoL). Materials and Methods: The research was designed as an observational case-control study with prospective data collection. Eighty patients, divided into two groups based on their oral status, participated in the study. All subjects underwent a complete oral examination. The OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14). Results: The most prevalent oral manifestation was exfoliative cheilitis, while 30% of subjects complained of chewing and swallowing difficulties. The OHIP-14 summary score was significantly higher in the patients with oral lesions (26.0 (5.0) vs. 17.0 (4.0), respectively; p < 0.001). Oral manifestations, systemic involvement, medication, and periodontal indexes were significantly associated with OHIP-14 scores. Conclusions: Patients with oral alterations had a substantially decreased OHRQoL. These findings emphasize the importance of oral diseases for patients' well-being. Therefore, it is essential for dentists to be included in the multidisciplinary teams managing primary Sjögren's syndrome, as improving patients' oral status would lead to better oral health and enhanced OHRQoL.

Applications of Biodegradable Magnesium-Based Materials in Reconstructive Oral and Maxillofacial Surgery: A Review.

Reconstruction of defects in the maxillofacial region following traumatic injuries, craniofacial deformities, defects from tumor removal, or infections in the maxillofacial area represents a major challenge for surgeons. Various materials have been studied for the reconstruction of defects in the maxillofacial area. Biodegradable metals have been widely researched due to their excellent biological properties. Magnesium (Mg) and Mg-based materials have been extensively studied for tissue regeneration procedures due to biodegradability, mechanical characteristics, osteogenic capacity, biocompatibility, and antibacterial properties. The aim of this review was to analyze and discuss the applications of Mg and Mg-based materials in reconstructive oral and maxillofacial surgery in the fields of guided bone regeneration, dental implantology, fixation of facial bone fractures and soft tissue regeneration.

The Importance of Correlation between CBCT Analysis of Bone Density and Primary Stability When Choosing the Design of Dental Implants-Ex Vivo Study.

This study aims to determine the correlation between the mean value of bone density measured on the CBCT device and the primary stability of dental implants determined by resonant frequency analysis. An experimental study was conducted on a material of animal origin: bovine femur and pig ribs. Two types of implants were used in this study: self-tapping and non-self-tapping of the same dimensions. Results of the experimental study showed a statistically significant correlation between bone density expressed in HU units and the primary stability of self-tapping and non-self- tapping dental implants expressed in ISQ units in bovine femur bones and self-tapping implants and pig rib bones. There was no statistically significant correlation between non-self-tapping dental implants in pig rib bones. Self-tapping and non-self-tapping implants did not show statistical significance in the primary stability in bones of different qualities. The analysis of bone density from CBCT images in the software of the apparatus expressed in HU units can be used to predict the degree of primary stability of self-tapping and non-self-tapping dental implants in bones of densities D1 and D2, and self-tapping dental implants in bones of the lower quality D4.

Assessment of Maxillary Molars Interradicular Septum Morphological Characteristics as Criteria for Ideal Immediate Implant Placement-The Advantages of Cone Beam Computed Tomography Analysis.

The aim of this study was to evaluate the interradicular septum bone morphometric characteristics using cone beam computed tomography (CBCT) images, as well as to establish quantitative shortcuts to allow clinicians to make a faster and more reliable plan for immediate implant placement in the maxillary molars area. This retrospective quantitative study was conducted on CBCT images obtained from 100 patients. The morphometric analysis of the maxillary molars region was based on the parameters obtained on the sagittal and axial slices. The analysis performed on sagittal slices showed that the first maxillary molars had a wider interradicular septum when compared to the second molars, but the septum height in the first molars was significantly below the height in the second maxillary molars. The axial CBCT slices analysis showed that both interradicular septum perimeter and surface area were significantly more pronounced in the first than in the second maxillary molars. The interradicular furcation angle significantly correlated with the surface area (positively) and septum height (negatively) for both molars. The results of this study may recommend CBCT image analysis as a useful tool in predefining the circumstances that can allow for substantially better planning of immediate implant placement procedures in the region of maxillary molars.

Comparison of Hydroxyapatite/Poly(lactide-co-glycolide) and Hydroxyapatite/Polyethyleneimine Composite Scaffolds in Bone Regeneration of Swine Mandibular Critical Size Defects: In Vivo Study.

Reconstruction of jaw bone defects present a significant problem because of specific aesthetic and functional requirements. Although widely used, the transplantation of standard autograft and allograft materials is still associated with significant constraints. Composite scaffolds, combining advantages of biodegradable polymers with bioceramics, have potential to overcome limitations of standard grafts. Polyethyleneimine could be an interesting novel biocompatible polymer for scaffold construction due to its biocompatibility and chemical structure. To date, there have been no in vivo studies assessing biological properties of hydroxyapatite bioceramics scaffold modified with polyethyleneimine. The aim of this study was to evaluate in vivo effects of composite scaffolds of hydroxyapatite ceramics and poly(lactide-co-glycolide) and novel polyethyleneimine on bone repair in swine's mandibular defects, and to compare them to conventional bone allograft (BioOss). Scaffolds were prepared using the method of polymer foam template in three steps. Pigs, 3 months old, were used and defects were made in the canine, premolar, and molar area of their mandibles. Four months following the surgical procedure, the bone was analyzed using radiological, histological, and gene expression techniques. Hydroxyapatite ceramics/polyethyleneimine composite scaffold demonstrated improved biological behavior compared to conventional allograft in treatment of swine's mandibular defects, in terms of bone density and bone tissue histological characteristics.

Efficacy of nanocrystalline bone substitute biphasic calcium phosphate/poly-DL-lactide-co-glycolide for periodontal intrabony defects filling.

BACKGROUND/AIM: Different bone substitutes have been used for filling and reparation of intrabony defects. The aim of this study was to compare nanocrystalline material, biphasic calcium phosphate poly-DL-lactide-co-glycolide (BCP/PLGA) with deproteinised bovine bone (DPBB) and beta-tricalcium phosphate (P-TCP) in the treatment of periodontal intrabony defects. METHODS: The study included 24 patients with bilateral, intrabony defects in the region of the upper first and second premolar, and the upper first molar. On one side of the mouth, DPBB (BioOss) was used to fill defects in upper premolars while P-TCP (RTR) was used for the upper first molar. BCP/PLGA was applied into periodontal defects of the upper premolars and upper first molar of the opposite side. RESULTS: The comparison of the BCP/PLGA and the P-TCP group, 6 months following filling of defects, showed a statistically significant reduction of periodontal pocket depth (PPD) and the position of the cement-enamel junction (CEJ) in the group with BCP/PLGA, when compared to the beta-TCP group. The reduction of PPD and CEJ was similar in the groups treated with BCP/PLGA and DPBB. CONCLUSION: Significant reductions of PPD and CEJ were registered in the group with BCP/PLGA when compared to the beta-TCP group.

Decompression as an effective primary approach to large radicular cyst in the maxillary sinus--A case report.

INTRODUCTION: Therapeutic approach to jaw cysts may depend on their dimensions and localization. Enucleation of cystic lesion is not always preferable in the first act, especially if large cysts are in close proximity to important anatomical structures. The aim of this paper was to present the outcome of the treatment protocol comprising preoperative decompression and subsequent enucleation of a large maxillary cyst. CASE REPORT: A 21-year-old male patient with large asymptomatic radicular cyst in the right maxillary sinus was presented to our clinic. Cone-beam computed tomography (CBCT) showed a large cyst, which perforated the right anterior maxillary wall by 1.5 cm, and was in the intimate contact with the orbital floor. Surgical treatment of the cystic lesion comprised: preoperative decompression with biopsy in the first act and enucleation, performed under general anesthesia, 6 months after the observation period. CONCLUSION: Decompression with subsequent enucleation proved to be effective treatment of large radicular cyst in maxillary sinus with low-morbidity.