Tissue engineering innovations to enhance osseointegration in immediate dental implant loading: A narrative review.

The demand for efficient and accelerated osseointegration in dental implantology has led to the exploration of innovative tissue engineering strategies. Immediate implant loading reduces treatment duration and necessitates robust osseointegration to ensure long-term implant success. This review article discusses the current studies of tissue engineering innovations for enhancing osseointegration in immediate dental implant loading in the recent decade. Keywords "tissue engineering," "osseointegration," "immediate implant loading," and related terms were systematically searched. The review highlights the potential of bioactive materials and growth factor delivery systems in promoting osteogenic activity and accelerating bone regeneration. The in vivo experiment demonstrates significantly improved osseointegration in the experimental group compared to traditional immediate loading techniques, as evidenced by histological analyses and biomechanical assessments. It is possible to revolutionize the treatment outcomes and patient satisfaction in dental implants by integrating bioactive materials and growth factors.

The effects of antimicrobial photocatalytic nanoparticles on the flexural strength of orthodontic acrylic resins: A systematic review and meta-analysis.

BACKGROUND/PURPOSE: Orthodontic acrylic resins containing antimicrobial photocatalytic nanoparticles aims to reduce oral lesions including denture stomatitis and white spot lesions but they should not imperil its mechanical properties. This systematic review was done to evaluate the effect of various photocatalytic nanoparticles on the flexural strength (FS) of acrylic resins. MATERIALS AND METHODS: We systematically searched the PubMed/Medline, Cochrane Library, and Scopus databases from January 2018 to October 2023. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the quality of the studies was evaluated using the QUIN tool, which is specifically designed to assess the risk of bias in vitro studies. RESULTS: Following screening of 1016 initial records, 23 studies were deemed eligible for inclusion. The addition of photocatalytic nanoparticles, such as emodin (Emo), curcumin (Cur), Cur nisin (CurNis), zeolite/zinc oxide (Zeo/ZnO), and Ulva lactuca (U. lactuca), to acrylic resins resulted in a reduction in FS, with the extent of reduction dependent on the nanoparticle concentration. Specifically, the addition of Emo (≥0.5 %), Cur (≥0.5 %), CurNis (≥5 %), Zeo/ZnO (≥2), and U. lactuca (≥1 %) to acrylic resins significantly decreased FS. Conversely, the inclusion of ZnO and titanium dioxide (TiO2) in acrylic resins improved FS, but higher concentrations (≥5 % for TiO2) had a limited positive effect. CONCLUSION: Our study supports the use of low concentrations of photocatalytic nanoparticles, such as ZnO (≤2 %), TiO2 (≤3 %), Emo (≤0.5 %), Cur (≤0.5 %), CurNis (≤5 %), and U. lactuca (≤1 %), in orthodontic acrylic resins without compromising FS.

The current applications of nano and biomaterials in drug delivery of dental implant.

BACKGROUND AND AIM: Dental implantology has revolutionized oral rehabilitation, offering a sophisticated solution for restoring missing teeth. Despite advancements, issues like infection, inflammation, and osseointegration persist. Nano and biomaterials, with their unique properties, present promising opportunities for enhancing dental implant therapies by improving drug delivery systems. This review discussed the current applications of nano and biomaterials in drug delivery for dental implants. METHOD: A literature review examined recent studies and advancements in nano and biomaterials for drug delivery in dental implantology. Various materials, including nanoparticles, biocompatible polymers, and bioactive coatings, were reviewed for their efficacy in controlled drug release, antimicrobial properties, and promotion of osseointegration. RESULTS: Nano and biomaterials exhibit considerable potential in improving drug delivery for dental implants. Nanostructured drug carriers demonstrate enhanced therapeutic efficacy, sustained release profiles, and improved biocompatibility. Furthermore, bioactive coatings contribute to better osseointegration and reduced risks of infections. CONCLUSION: Integrating current nano and biomaterials in drug delivery for dental implants holds promise for advancing clinical outcomes. Enhanced drug delivery systems can mitigate complications associated with dental implant procedures, offering improved infection control, reduced inflammation, and optimized osseointegration.

Antimicrobial photodynamic therapy for managing the peri-implant mucositis and peri-implantitis: A systematic review of randomized clinical trials.

BACKGROUND: The presence of peri­implant inflammation including peri­implant mucositis and peri­implantitis, is a crucial factor that impacts the long-term stability and success of dental implants. This review aimed to evaluate the safety and effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjuvant therapy option for managing peri­implant mucositis and peri­implantitis. METHODS: We systematically searched the PubMed/MEDLINE, Cochrane Library, Scopus, and Google Scholar databases (no time limitation). The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the quality of the studies was assessed using the Cochrane Collaboration tool. RESULTS: Of 322 eligible articles, 14 studies were included in this review. The heterogeneity and poor quality of the articles reviewed prevented a meta-analysis. The reviewed articles used a light source (60 s, 1 session) with a wavelength of 635 to 810 nm for optimal tissue penetration. These studies showed improved clinical parameters such as probing depth, bleeding on probing (BOP), and plaque index after aPDT treatment. However, in smokers, BOP increased after aPDT. Compared to conventional therapy, aPDT had a longer-term antimicrobial effect and reduced periopathogens like Porphyromonas gingivalis, as well as inflammatory factors such as Interleukin (IL)-1ß, IL-6, and Tumor necrosis factor alpha (TNF-α). No undesired side effects were reported in the studies. CONCLUSION: Although the reviewed articles had limitations, aPDT showed effectiveness in improving peri­implant mucositis and peri­implantitis. It is recommended as an adjunctive strategy for managing peri­implant diseases, but further high-quality research is needed for efficacy and long-term outcomes.

Effect of Different Bleaching Methods on Monomer Release from Aged Microhybrid and Nanohybrid Resin Composites.

Introduction: Recently, the application of laser-assisted bleaching has increased in dental practice. This method might affect the physical and chemical properties of resin composite and its monomer release. This study aimed to evaluate the effect of in-office, at-home, and laser-assisted bleaching on the monomer release (bisphenol A diglycidyl dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), and urethane dimethacrylate (UDMA)) from aged nanohybrid (Grandio, Voco) and microhybrid (Clearfil AP-X Esthetics, Kuraray) resin composites. Methods: Thirty-two samples of each composite were prepared. The samples underwent aging procedure with UV light at 65°C for 100 hr. The samples were divided into 4 groups: OB: conventional in-office bleaching with Opalescence Boost PF 40% gel; HB: home bleaching with Opalescence PF 15% gel; LB: bleaching with JW Power bleaching gel followed by diode laser application; and C: control group without bleaching. Then, the samples were immersed in a solution containing 75% ethanol + 25% distilled water. The medium was renewed after 8, 16, 24 hr, and 7 days and was analyzed using high-performance liquid chromatography method to evaluate the monomer release. The data were analyzed using Two-way ANOVA and Post hoc Tukey test. Results: The bleaching method had no effect on TEGDMA and BisGMA release in both composites while it affected UDMA release in nanohybrid composite; UDMA release was significantly higher in LB compared to control and also higher in OB and LB compared to HB. No difference was observed in the microhybrid composite in this regard. Conclusion: Laser-assisted bleaching did not affect monomer release from microhybrid composite while it increased UDMA release from nanohybrid composite. The bleaching method had no effect on TEGDMA and BisGMA release.

Effect of delayed photobiomodulation therapy on neurosensory recovery in patients with mandibular nerve neurotmesis following traumatic mandibular fracture: A randomized triple-blinded clinical trial.

INTRODUCTION: There is a possibility of neurotmesis of the inferior alveolar nerve (IAN) in mandibular fractures, which leads to neurosensory impairment. In this study, we aimed to investigate the efficacy of photobiomodulation therapy (PBMT) in patients with neurotmesis following trauma and mandibular fracture. MATERIALS AND METHODS: This triple-blind randomized trial was carried out on patients who suffered neurotmesis of the IAN following mandibular angle and body fracture at least for 6 months. In the intervention group, laser irradiation was applied with a low-level GaAlAs diode laser (continuous wave of 810 nm wavelength, power of 200 mW, and energy density of 12-14 J/cm2). In the control group, the laser probe was turned off and placed on the affected area. LLLT was done for 12 sessions (2 times/week for 6 weeks). Light touch sensations, two-point discrimination, thermal discrimination (cold and warm stimulus), electric pulp test (EPT), and oral health impact profile (OHIP)-14 questionnaire were performed before the intervention, immediately after each PBMT session, and after 3, 6, 9 and 12 months. RESULTS: In both groups, 3 and 23 patients were female and male, respectively. The results showed significantly improved light (cotton swab), light (wooden cotton swab), and sharp (dental needle) touch sensations, and two-point discrimination test in the PBMT group after the 10th, 11th, 10th, and 10th session, respectively. Two-way repeated measure ANOVA revealed that the trend of light touch sensation with cotton swab and two-point discrimination test was statistically significant (p-value = 0.002 and 0.001, respectively). The results of OHIP-14 test showed a significantly higher mean in the PBMT group 3 months after PBMT. There was no statistically significant difference in EPT and thermal discrimination tests regarding the patients' group. CONCLUSION: PBMT could be an effective treatment for late post-traumatic nerve neurotmesis following a traumatic mandibular fracture.

Reconstruction of the Occipital and Parietal Congenital Defect with 3D Custom-Made Titanium Prosthesis: A Case Report with Four and a Half Years of Follow-Up and a Brief Review of Literature.

Management of patients with congenital skull defects requires a multidisciplinary approach. Considering the defect's location and size, brain protection, and the cosmetic outcome makes such reconstructions challenging. Due to limited resemblance to skull contour and donor site morbidity of autogenous bone grafts, alloplastic materials are widely used for skull reconstructions. Titanium alloys have proper strength values, low infection rates, favorable osseointegration property, and excellent marginal adaptability when manufactured by computer-aided design (CAD) and computer-aided manufacturing (CAM). A 13-year-old female patient presented with congenital defects at the superior third of occipital bone and posterior thirds of the bilateral parietal bones. On CT scan, the exact size and shape of the defect were determined. Using CAD/CAM, a 3D virtual model of the prosthesis was designed and then printed with titanium alloy (TiAl6V4) via additive manufacturing method. The prosthesis was placed on the defect in a total surgery time of only 90 minutes. On 4.5 years of follow-up, the contour of the skull was ideal and the skin over the defect and neurologic status was intact. Due to their biocompatibility and rigidity, custom-made titanium prostheses are promising options for reconstructing complex skull defects.

Staged reconstruction of hemimaxillectomy defect: Application of buccal fat pad flap, iliac bone graft and implant-supported dental prostheses.

In order to achieve a fixed implant-supported prosthesis in a posthemimaxilectomy patient, ideal soft and hard tissue rehabilitation is necessary. Here, we present a staged approach for soft tissue reconstruction with local flaps followed by anterior iliac crest bone graft which resulted in a predictable and satisfactory outcome.

Fascin Expression in Ameloblastoma, Odontogenic Keratocyst and Dentigerous Cyst.

OBJECTIVE: The purpose of this study was to assess and compare fascin expression in 4 lesions which differ in aggressiveness: odontogenic keratocyst, dentigerous cyst and two types of ameloblastoma (solid and unicystic), and to find out whether fascin expression is associated with aggressiveness of these lesions or not. MATERIAL AND METHOD: Nine solid ameloblastomas , 12 unicystic ameloblastomas, 13 odontogenic keratocyst and 12 dentigerous cyst were assessed in this study. The slides were examined at x400 magnification. Finally the lesions were divided into two groups based on microscopic examination, "low expression" and "high expression". RESULTS: There were no significant differences between the lesions, except that fascin expression was slightly higher in unicystic ameloblastomas in comparison to other groups in intensity and count of the immunostaining cells. CONCLUSION: The results of this study suggest that local aggressiveness does not result in fascin expression. We suggest more studies with more samples, assessing expression of different proteins be done in the future.

Assessing the Anatomical Variability of Deep Circumflex Iliac Vessels in Harvesting of Iliac Crest-Free Flap for Mandibular Reconstruction.

In this study, the authors' aims were to measure the length and location of branching of the pedicle from iliac artery, to describe the anatomical variability of iliac crest free flap with deep circumflex iliac (DCI) artery pedicle. Fourteen patients with ameloblastoma, osteosarcoma, and squamous cell carcinoma underwent mandibular resection and iliac crest-free flap reconstruction in one-step surgery. During surgery and before harvesting the deep circumflex iliac artery vascular pedicle, the location, origin, and the branching pattern of the pedicles were studied. Then, the pedicle length was measured and the data was analyzed using χ and independent samples t test. In all patients, the DCI vascular pedicles were separated with a common trunk from the external iliac artery and vein and the DCI arteries were posterior and lateral to the veins. Also after branching from the external iliac artery, all vascular DCI pedicles traveled upward and medially along the Iliacus muscle and the iliac fascia. The mean pedicle length was 21.78 mm for men and 19 mm for women. No statistically significant relationship was observed between the patient's age and the vascular pedicle length or number of branches. There are great variations in the anatomy of this vascular pedicle. According to the finding of this study, the length of the vascular pedicle is 2.78 mm higher in men which might help to increase the feasibility and success rate of this operation. No significant correlation was found between other variables.

Neoadjuvant Chemotherapy for Locally Advanced Squamous Carcinoma of Oral Cavity: a Pilot Study.

To evaluate the effect of adding neoadjuvant chemotherapy to surgery and radiation therapy for locally advanced resectable oral cavity squamous cell carcinoma, 24 patients with T3 or T4a oral cavity squamous cell carcinoma were randomly assigned to surgery alone or Docetaxel, Cisplatin, and 5-FU (TPF) induction chemotherapy followed by surgery. All patients were planned to receive chemoradiotherapy after surgery. The primary end-points were organ preservation and progression-free-survival. SPSS version 17 was used for data analysis. Median follow-up was 16 months. The median age of the patients was 62 years old (23-75 years). Man/woman ratio was 1.13. The primary site of the tumor was the tongue in most patients (48%). No significant difference was observed between pathologic characteristics of the two groups. Chemotherapy group showed 16% complete pathologic response to TPF. No significant difference in organ preservation surgery or overall survival was detected. However, the patients in the chemotherapy group had longer progression-free-survival (P=0.014). Surgery followed by chemoradiotherapy with or without TPF induction results in similar survival time. However, progression-free-survival improves with the TPF induction chemotherapy. Studies with more patents and new strategies are recommended to evaluate organ preservation improvement and long-term outcomes.