Periodontal plastic surgery for the management of an ankylosed permanent maxillary lateral incisor: A clinical report with 5-year follow-up.

Anterior maxillary tooth ankylosis disturbs the development of the alveolar bone process, leading to discrepancies between the cervical gingival margin and incisal edge position of the affected tooth, and therefore, the esthetics is compromised. Proposed treatments in adults and growing patients have been used successfully, but they have disadvantages and are contraindicated in some circumstances. This article proposes an alternative treatment for an ankylosed permanent maxillary anterior tooth with a slow replacement resorption rate in an adult patient, for whom a combination of a periodontal plastic surgery procedure and a fixed dental prosthesis was used to correct the esthetics. This treatment has less risk of complications, preserves the ankylosed tooth as long as possible, creates an optimal gingival contour, and maintains the alveolar bone for further treatment should the tooth be lost.

Anterior loop of the inferior alveolar nerve: Averages and prevalence based on CT scans.

STATEMENT OF PROBLEM: The treatment of edentulous patients by using a complete implant-supported fixed prosthetic with distal extension has been widely studied; success is mainly dependent upon the placement of the distal implants. The location of the inferior alveolar nerve determines implant placement, but the length, prevalence, and symmetry between the left and right side of the anterior loop of the alveolar nerve are unknown. PURPOSE: The purpose of this clinical study was to measure the anterior loop of the inferior alveolar nerve, which determines the placement of distal implants, in a group of 55 Mexican participants. The study expected to ascertain the average length, prevalence, and symmetry between left and right side and any sex differences. To differentiate the inferior alveolar nerve path, a new technique was applied using Hounsfield unit (HU) thresholds. The null hypothesis was that no significant differences would be found between the left and right sides or between men and women for the anterior loop of the inferior alveolar nerve. MATERIAL AND METHODS: Fifty-five computed tomography (CT) scans were made (Somatom Sensation 16; Siemens Healthcare) and were visualized with InVesalius software. Anterior loop measurements were made on 3-dimensional surfaces. To determine statistical differences between the left and right side and between the sexes, the t test was used. The interclass correlation coefficient test was also applied to verify the reliability of the measurements. RESULTS: Ninety percent of participants showed the anterior loop of the inferior alveolar nerve. The length of the anterior loop ranged between 0 and 6.68 mm, with a mean of 2.19 mm. No significant differences were found between the left and right sides or between men and women. CONCLUSIONS: The mean length for the anterior loop in the sample was 2.19 mm. As the anterior loop length shows a high degree of variability, these findings suggest that a CT scan for each patient is recommended in order to visualize a safety zone before placing implants close to the mental foramen.

Metal-reinforced single implant mandibular overdenture retained by an attachment: a clinical report.

Results of studies have shown that a single implant mandibular overdenture significantly increases the satisfaction and quality of life of patients with edentulism. The single implant-retained overdenture has the additional advantage of being less expensive and invasive than a 2-implant supported overdenture but has a high incidence of fracture of the acrylic resin base at the point of the implant. The treatment, design, and fabrication of a metal-reinforced single-implant mandibular overdenture with the Locator attachment as a retention device is described.

A novel osteotropic biomaterial OG-PLG: in vitro efficacy.

Previously, a novel osteotropic biomaterial, OG-PLG [simvastatin grafted to poly(lactide-co-glycolide), PLG], was synthesized and shown to have degradation-controlled release kinetics. The objective here was to determine the effect of grafting statins to PLG on bone regeneration in vitro. Rat bone marrow cells were stimulated in vitro with simvastatin dissolved in media, saponified simvastatin dissolved in media, simvastatin released through diffusion from emulsion freeze-dried scaffolds, and OG-PLG. Unstimulated cultures and cultures stimulated with dexamethasone were used as negative and positive controls, respectively. In vitro bone formation was assessed using the alkaline phosphatase (ALP) and von Kossa assays at different times up to 16 days. ALP analysis revealed that saponified simvastatin at 10(-7)M and OG-PLG significantly increased ALP expression at various time points. von Kossa assay showed that simvastatin, saponified simvastatin, and OG-PLG significantly enhanced mineralization, with the effect from OG-PLG being the most significant. In short, OG-PLG significantly enhanced in vitro bone cell mineralization beyond the effect of simvastatin or saponified simvastatin dissolved in media and simvastatin released via diffusion from scaffolds.

Bone formation in the maxillary sinus by using platelet-rich plasma: an experimental study in sheep.

Recently, platelet-rich plasma (PRP) has been proven to be an effective regeneration adjunct when combined with autogenous bone in the reconstruction of mandibular defects. However, little is known about the effect of PRP when combined with a bone allograft in the maxillary sinus. The purpose of this study was to quantitatively evaluate the ability of PRP to enhance bone regeneration in the maxillary sinus of sheep when combined with demineralized freeze-dried bone allograft (DFDBA) and cortical cancellous freeze-dried bone allograft (CCFDBA). Ten sheep were selected for bilateral sinus augmentation DFDBA + CCFDBA + PRP (test) and DFDBA + CCFDBA (control). Five were sacrificed at 3 months and the other 5 at 6 months. Hematology tests were performed for platelet count, and histology slides were obtained for histomorphometric analysis taking 2 measures of interest: total area (square millimeters) and percentage of bone fill. Student t tests showed no significant difference between test and control groups for total area (P > .25) and percentage of bone fill (P > .80) at either 3 or 6 months. The control group showed no statistical difference for total area (P < .095) and percentage of bone fill (P <.60) between 3- and 6-month healing times. The test group, however, showed a significant increase in total area (P <.025) but not in percentage of bone fill (P <.40) for the 2 healing periods. When the treatments were compared for interactions within the animal model, no clear tendency was evident for the test group to perform in relation to the control group regarding total area (r = .766, P < .01). A moderate tendency existed between the percentages of bone filled (r = .824, P < .005). Platelet-rich plasma showed higher platelet count than did the whole blood (2 to 5 times). However, no correlation was found between the log ratio and the bone measures. Within the limitations of this study, PRP failed to enhance or accelerate bone regeneration in the maxillary sinus of sheep when combined with bone allograft.

Platelet-rich plasma and bone graft materials: a review and a standardized research protocol.

Since the introduction of platelet-rich plasma (PRP), several authors (clinicians and researchers) have investigated its efficacy using different bone grafting materials. There have been various research protocols and different types of clinical cases. This position paper suggests a standardized research protocol for the use of, and evaluation of PRP and bone grafts.