Does Biphasic Calcium Phosphate-Coated Surface Increase the Secondary Stability in Dental Implants? A Split-Mouth Study.

Purpose: This study aimed to evaluate biphasic calcium phosphate coating (BCPC) on the secondary stability of dental implants compared to sand-blasted and acid-etched (SLA) implants. Materials and Methods: This is a split-mouth study. Thirty subjects (20 males and ten females) underwent a dental implant procedure to replace mandibular first or second molars bilaterally. The subjects were randomly assigned to BCPC or SLA groups. The resonance frequency analysis measurements were performed two, four, six, and eight weeks after the implant placement. Results: Sixty implants were placed in the two groups (30 implants per group). The mean ISQ was 52.26 ± 3.73 in group 1 and 50.21 ± 2.59 in group 2 on day 14 after the implant insertion, 63.20 ± 2.76 in group 1 and 58.80 ± 2.14 in group 2 on day 28, 72.30 ± 3.15 in group 1 and 64.53 ± 3.19 in group 2 on day 42, and 78.70 ± 1.56 in group 1 and 71.63 ± 3.22 in group 2 on day 56. The data analysis demonstrated significant differences between the two groups in terms of the mean ISQ at various evaluation times. Conclusion: Regarding ISQ measurements, the secondary stability in BCPC implants may be higher compared to SLA implants in two months after implant insertion.

Evaluation of Bone Density in Sinus Elevation by Using Allograft and Xenograft: A CBCT Study.

PURPOSE: The stability and density of the grafted bone in the maxillary sinus are essential for dental implant survival. This study aimed to compare bone density following mineralized allogeneic bone and deproteinized bovine bone and evaluate the volumetric changes as the secondary outcome. MATERIALS AND METHODS: In this prospective cohort study, subjects were randomly allocated into two groups of mineralized bone and deproteinized bone to augment the maxillary sinus. Subjects underwent CBCT immediately after augmentation and 9 months later. The relative bone density was the primary outcome, and the volumetric change after 9 months was the secondary outcome of the study. The authors used an independent t test for assessing the bone density and volumetric change between the two groups. RESULTS: Fifty patients were studied (n = 25 in each group). At 9 months after sinus elevation, the mean bone density was 237.20 ± 55.72 Hounsfield units (HU) in group 1 (mineralized bone) and 634.8 ± 166.11 HU in group 2 (deproteinized bone). There was a substantial difference statistically for the mean of HU between groups 1 and 2 (P < .001). The mean volume change was 0.25 ± 0.13 cm3 in group 1 (mineralized bone) and 0.06 ± 0.05 cm3 in group 2 (deproteinized bone). Assessment of the data showed a substantial difference in the mean volume change at 9 months after sinus elevation between groups 1 and 2 (P < .001). CONCLUSION: Considering the results of this study, the deproteinized bone was associated with higher relative bone density than the mineralized bone 9 months after sinus elevation. The volume change of the deproteinized bone was less than the mineralized bone in the study time.

What Is a Safe Distance for Preservation of the Inferior Alveolar Nerve in Lower Gingival Squamous Cell Carcinoma? A Radiographic and Histopathological Study.

PURPOSE: Involvement of the inferior alveolar nerve (IAN) is important in the prognosis and treatment of gingival squamous cell carcinoma (SCC). METHODS: In this cross sectional study, patients with gingival SCC (T4a), undergoing hemimandibulectomy or subtotal hemimandibulectomy, were examined. The distance between the lesion and inferior alveolar canal (IAC) was measured, using axial computed tomography scans before resection. Following that, histopathological evaluation of IAN was conducted. The receiver operating characteristic curve was plotted to determine the association of IAN involvement in histopathological evaluation with various distances between the lesion and IAC. RESULTS: A total of 29 patients were examined in this study. The mean distance between the lesion and IAC was 9.40 ±â€Š2.21 mm. Nerve involvement was documented in 9 (45%) out of 20 males, while 11 (55%) men showed no involvement. Thirteen (44.82%) patients showed IAN involvement. The receiver operating characteristic curve demonstrated a cut-off point of 9.75 mm for the lesion-IAN distance. The possibility of IAN involvement was 23.33 times higher in patients who reported paresthesia, compared with patients without nerve involvement (odds ratio, 23.33; 95% CL; P = 0.001) CONCLUSION:: It seems that in a CT scan view, a 9.75-mm safe margin is associated with high accuracy for preserving IAN in patients with gingival SCC. Also, neurosensory disturbance can be considered a strong predictor of IAN involvement.

Does Fixation Method Affect Stability of Sagittal Split Osteotomy and Condylar Position?

PURPOSE: Fixation methods are important for condylar position and stability in sagittal split osteotomy (SSO) procedures. The aim of the present study was to compare the changes in the condylar position and stability after SSO for mandibular setback in plate fixation with monocortical screws and bicortical screws. PATIENTS AND METHODS: In the present retrospective cohort study, patients who had undergone mandibular setback were studied in 2 groups. In group 1, fixation was performed using a miniplate with 4 monocortical screws. In group 2, fixation was performed using 3 bicortical screws. Cone beam computed tomography scans were taken before and immediately after the SSOs and 1 year later. The condylar position was evaluated linearly (mediolateral movement in the coronal view) and angularly (condylar axis with Frankfort plane in the coronal view). The stability of the mandible was determined at the B point horizontally and vertically. RESULTS: A total of 50 patients were studied in 2 equal groups; however, 2 patients were lost to follow-up in group 2. A significant difference in the mediolateral changes of the condyle before and after osteotomy was detected between the 2 groups (P = .003). No difference was found between the 2 groups in the angular changes of the condyle before and after SSO in the coronal view (P = .45). Analysis of the data did not reveal any differences for vertical relapse at the B point (P = .47) or horizontal relapse between the 2 groups (P = .21). CONCLUSIONS: According to our results, bicortical screw fixation might be associated with more condylar displacement. However, we could not find significant differences in surgical stability between miniplate fixation with monocortical screws and bicortical screw fixation after 1 year of follow-up.

Giant Osteoma of Mandible Causing Dyspnea: A Rare Case Presentation and Review of the Literature.

Osteomas are benign slow growing tumors of bone. Tumors are usually asymptomatic until they attain remarkable size and cause asymmetry or dysfunction. In view of few reported cases of giant osteoma of mandible, this article presents a case of giant osteoma of left mandible in a 53-year old male causing dyspnea due to compression of air way space.

Predictors of postoperative atrial fibrillation after coronary artery bypass graft surgery.

OBJECTIVES: The present study was aimed to identify the preoperative, intraoperative, and postoperative predictors of AF in a pure cohort of the patients with coronary artery disease who underwent CABG surgery. METHODS: Between November 2005 and May 2006, 302 consecutive patients were included in this prospective study. All the relevant clinical, electrocardiographic, echocardiographic, and laboratory data were gathered in the included patients and they were also monitored for development of post-CABG AF. RESULTS: Postoperative AF occurred in 46 (15%) of patients. By univariate analysis, older age, P-wave abnormality in ECG, presence of mitral regurgitation, larger left atrium (LA), left main coronary artery involvement, failure to graft right coronary artery (RCA), and adrenergic use in ICU were significantly associated with occurrence of post-CABG AF (all P< 0.05). However, in the logistic regression model, age (OR: 1.067, 95%CI: 1.02-1.116, P=0.005), LA dimension (OR: 1.102, 95%CI: 1.017-1.1936, P=0.017), P-wave morphology (OR: 12.07, 95%CI: 3.35-48.22, P=0.0001), failure to graft RCA (OR: 3.57, 95%CI: 1.20-10.64, P=0.022), and postoperative adrenergic use (OR: 0.35, 95%CI: 0.13-0.93, P=0.036) remained independently predictive of postoperative AF. CONCLUSION: The present study suggested that age, P-wave morphology, LA dimension, failure to graft right coronary artery, and postoperative adrenergic use were independent predictors of post-CABG AF. Therefore, clinical data, ECG and echocardiography may be useful in preoperative risk stratification of the surgical patients for the occurrence of post-CABG AF.