2019 Jan-Mar; Vol 10, No 1
Prevalence of Peri-Implantitis in Implants with Turned and Rough Surfaces: a Systematic Review
J Oral Maxillofac Res 2019;10(1):e1
Objectives: Moderately-rough implant surface may improve implant therapy in terms of bone integration, but the increased surface roughness might affect the initiation and development of peri-implantitis. The aim of the present review was to compare the prevalence of peri-implantitis in implants with rough and turned (machined) implant surfaces.
Material and Methods: An electronic literature search was conducted of the MEDLINE and EMBASE databases for articles published between 1 January 1990 and 1 March 2018. Clinical human studies in the English language that had reported on prevalence of peri-implantitis in tuned and rough surface implants searched. The initial search resulted in 690 articles.
Results: Eight articles with 2992 implants were included in the systematic review. The incidence of peri-implantitis for two implant surfaces varied between studies. A meta-analysis was not feasible due to the heterogeneity among studies. Implant with rough surfaces were more favourable for plaque accumulation during short-term follow-up. On a long-term, turned implants surfaces were associated with more plaque and higher peri-implant bone loss. Peri-implant clinical parameters and survival rate for two implant surfaces was similar.
Conclusions: Within the limitations of the present study, rough implant surface does not seem to increase the incidence of peri-implantitis in comparison to turned implants surface.
Keywords: dental implant; osseointegrated dental implantation; peri-implantitis; systematic review; titanium.
Alveolar Ridge Preservation after Tooth Extraction Using Different Bone Graft Materials and Autologous Platelet Concentrates: a Systematic Review
J Oral Maxillofac Res 2019;10(1):e2
Objectives: To review and assess the efficiency of different post extraction socket preservation techniques.
Material and Methods: An electronic literature search was performed on the MEDLINE and Embase databases. The review included human studies published between from January 1st, 2007 to January 1st, 2018, in English. Outcome measures included dimensional changes and/or histological evaluation of alveolar bone.
Results: Twenty-six full text articles were reviewed, 16 of which met the inclusion criteria and were selected for the study. Autogenous tooth graft prevented vertical resorption the most: -0.28 (SD 0.13) mm, observation period (OP): 4 months, while the least effective approach was beta tri-calcium phosphate (β-TCP): -1.72 (SD 0.56) mm, OP: 4 months. Estimating horizontal resorption, the most effective technique was biphasic calcium sulphate (BCS) with β-TCP and hydroxyapatite (HA) - BCS + TCP + HA: 0.03 (SD 2.32) mm, OP: 4 months, while β-TCP was the least efficient: -1.45 (SD 0.4) mm, OP: 4 months. Evaluating residual graft particles (RG) and newly formed bone (NFB) ratio the best results were achieved with demineralized freeze-dried bone allograft: RG: 8.88%, NFB: 38.42%, OP: 5 months, whereas magnesium-enriched hydroxyapatite was least effective: RG: 40.82%, NFB: 31.85%, OP: 4 months.
Conclusions: This review revealed that even though there are numerous types of biomaterials for socket preservation none of them can completely stop alveolar bone loss after tooth extraction. Furthermore, lack of information about qualitative evaluation of bone was noticed indicating that further studies regarding this topic are needed.
Keywords: allografts; alveolar bone loss; biocompatible materials; platelet-rich fibrin; tooth extraction.
Effectiveness of Xenograft and Porcine-Derived Resorbable Membrane in Augmentation of Posterior Extraction Sockets with a Severe Wall Defect. A Radiographic/Tomographic Evaluation
J Oral Maxillofac Res 2019;10(1):e3
Objectives: The aim of the present prospective study was to evaluate, by means of intraoral periapical radiographs and cone-beam computed tomography, hard tissue changes after ridge augmentation procedures in posterior extraction sockets with severe wall defects.
Material and Methods: Twenty patients, with a non-restorable premolar/molar tooth and severe wall defect, were enrolled in the present study, and underwent single-tooth extraction. Extraction sites were grafted with porcine-derived bone covered by porcine-derived collagen membrane. Intraoral periapical radiographs and cone-beam computed tomography scans, obtained at enrolment, and 6 months after ridge augmentation procedures were analysed and compared.
Results: In the intraoral periapical radiographs, mean vertical bone gains detected at the distal, central and mesial aspects of the extraction sockets were 3.5 (SD 1.1) mm, 8.2 (SD 2.1) mm, and 3.9 (SD 1.7) mm, respectively. In the cone-beam computed tomography scans, the mean vertical bone gains detected at the more vestibular and more palatal aspects were 4.4 (SD 1.9) mm, and 3.3 (SD 2.8) mm, respectively. The mean horizontal bone gain was 3.5 (SD 1.6) mm. In all examined defects, mean vertical and horizontal bone levels showed a statistically significant increase (P < 0.05) at 6 months after extraction.
Conclusions: Within the limits of this study, the results suggest that porcine-derived bone graft covered by a collagen membrane can support significant vertical and horizontal bone gain at posterior post-extraction sockets with severe wall defects.
Keywords: alveolar ridge augmentation; bone regeneration; bone substitutes; cone-beam computed tomography.
Synovial Cysts in the Temporomandibular Joint: a Case Report and Critical Review of the Literature
J Oral Maxillofac Res 2019;10(1):e4
Background: Synovial cysts of the temporomandibular joint are rare and treatment is based on consensus from cases reporting unilateral successful outcomes. A patient with a synovial cyst is presented, treated with successful surgical excision of the cyst, but without remission of joint symptoms. Furthermore, the case is supplemented by a critical, literature review.
Methods: This case report deals with a patient with a synovial cyst that presented with temporomandibular joint (TMJ) pain and reduced mouth opening. Magnetic resonance imaging verified a TMJ cyst.
Results: Surgical excision removed the synovial cyst, and the patient was followed-up for 4 years, with no recurrence of the cyst. Despite successful excision of the cyst, the symptoms did not subside, and the patient is still in treatment. The critical, literature review found 23 case reports describing 24 synovial cysts. In addition, 4 cases were included as their synovial cysts were erroneously described as ganglion cysts. In 4 cases, histological diagnosis could not be confirmed, and they were excluded. All cases described treatment by surgical excision without recurrence. The reported median follow-up was 10 months and postoperative TMJ symptoms were rarely examined or described.
Conclusions: The temporomandibular joint symptoms may persist despite successful removal of the synovial cyst. Furthermore, the 4 identified synovial cysts, mislabelled as ganglion cysts, represents almost a quarter of the cases of the reported synovial cysts. Correct labelling and reporting of synovial cysts are still imperative to describe the diverse aspects of treatment outcomes following surgical excision.
Keywords: ganglion cysts; magnetic resonance imaging; synovial cyst; temporomandibular joint disorder.
Restoring Edentulous Mandible with an Implant-Retained Overdenture in a Day by Means of Flapless Surgery and Stereolithographic Surgical Guide: a Case Report
J Oral Maxillofac Res 2019;10(1):e5
Background: Digital revolution is here and becoming more and more influential in our daily lives by transforming several things such as our habits, interactions with other people and the practice of dentistry. In implant dentistry, the newer methods by using cone-beam computed tomography and computer-aided design and computer-aided manufacturing recently offer more predictable and aesthetics outcomes in a shorter period of treatment time when compared to the traditional prosthetic procedures.
Methods: A 66 year-old male patient with an edentulous mandible and several failing maxillary teeth presented to our clinic. After cone-beam computed-tomography scans and virtual implant placement by using three-dimensional software, a stereolithographic surgical guide was fabricated. The patient received two mandibular implants without any flap elevation by means of a computer-aided design and computer-aided manufacturing surgical guide and a maxillary complete denture in a day.
Results: The surgical and restorative procedures were performed without any issues. The patient was followed-up for three years and no major complications with the implants and prostheses were observed.
Conclusions: The technique illustrated in this report may be successfully used to restore edentulous arches in a day if it is executed by trained restorative dentists and if patient selection is appropriate.
Keywords: cone-beam CT; CAD/CAM; implant; overdenture; stereolithography; surgery.