Autogenous dentin graft versus alloplastic graft combined with socket shield for pre-implant socket preservation: a split-mouth randomized clinical trial.

After tooth extraction, alveolar bone resorption and labial bone plate thinning occur due to the lack of periodontal ligaments. The socket shield method was developed to preserve the alveolar ridge. A split-mouth study was performed in which eight patients were treated using alloplast with socket shield on one side (alloplast group, control) and autogenous dentin graft with socket shield on the contralateral side (dentin group, test). After 3 months, a trephine bone core was collected from all sites and evaluated by histological, histomorphometric, and radiographic analysis. Thin bony trabeculae were formed surrounding the residual alloplast, while thicker trabeculae of bone formed and fused to the autogenous dentin. The percentage of newly formed bone was significantly higher in the dentin group when compared to the alloplast group (P = 0.020). Radiographically, there was no significant difference in the mean percentage increase in bone density from preoperative to post-grafting between the two groups. Moreover, when comparing the change in labial bone level from preoperative to 3 months post-grafting between the two groups, there was no significant difference. The autogenous dentin graft combined with socket shield could be a promising technique for socket preservation.

Large branchial arch cyst excision using superficial and deep cervical plexus blocks in a patient with severe comorbidities.

Branchial arches are embryologic structures that develop between the fourth and seventh gestational week. Anomalies may form if these structures fail to develop. The majority of cases are diagnosed during childhood, with surgical excision recommended to prevent risk of infection, growth or malignancy. We report an unusual case of a 72-year-old man with severe cardiac comorbidities who presented with a large second branchial arch cyst extending into the oropharynx. General anaesthesia to facilitate surgical excision was deemed too risky. Therefore, we performed successful ultrasound-guided superficial and deep cervical plexus blocks as a sole mode of anaesthesia. This case highlights how regional anaesthesia can be utilised to facilitate surgery in high-risk patients, as well as presenting an alternative for general anaesthesia.