2022 Apr-Jun; Vol 13, No 2
Comparison of Classifications and Indexes for Extraction Socket and Implant Supported Restoration in the Aesthetic Zone: a Systematic Review
J Oral Maxillofac Res 2022;13(2):e1
Objectives: The primary objective of the present systematic review is to test the hypothesis - the revision of the complexity of the extraction sockets morphology classifications will reveal the most important parameters for implant aesthetic and functional success in case of immediate dental implant placement in aesthetic zone. The secondary objective is to revise the most important parameters of aesthetic indexes created for implant-supported restoration in aesthetic zone.
Material and Methods: MEDLINE (PubMed) and Cochrane Library search in combination with hand-search of relevant journals was conducted including human studies published in English between 1 January 2005 and 1 February 2022. After evaluation of the titles and abstracts in accordance with the PRISMA guidelines, risk-of-bias assessment was evaluated and data was extracted from the full papers.
Results: Electronic and hand searching resulted in 477 entries. Five systematic reviews, research syntheses and 7 prospective studies met the inclusion criteria and were included in the final data synthesis. Selected articles reported the different classifications complexity of the extraction sockets morphology and aesthetic indexes for implant supported restoration in aesthetic zone.
Conclusions: The most important parameters for implant aesthetics and functional success, incorporated in classifications of extraction sockets are facial soft tissue level and quality, gingival biotype, keratinized gingival, mesial and distal papillae appearance, buccal bone level and thickness, labial and buccal bone plates damage and bone lesions. The most important aesthetic indexes parameters are soft tissue contour position, including colour and texture, interdental papilla, mesial and distal interproximal bone height, gingival biotype.
Keywords: bone loss; classification; dental esthetics; dental implant; review literature; tooth socket.
Evaluation of Postoperative Pain and Discomfort in Patients Undergoing Surgical Exposure of Impacted Maxillary Canines
J Oral Maxillofac Res 2022;13(2):e2
Objectives: The purpose of the retrospective study was to evaluate pain and discomfort related to surgical exposure according to initial localization of impacted maxillary canines.
Material and Methods: Pre-treatment cone-beam computed tomography (CBCT) data and discomfort evaluation questionnaire of 25 patients (17 female, 8 male), treated with combined surgical-orthodontic approach was analysed. The questions included: level of discomfort during surgery (0 to 10), level of pain (0 to 10) in the evening, one, two days and a week after surgery. CBCT analysis consisted of evaluation of impacted maxillary canines mesiodistal inclination, horizontal, vertical dislocation from alveolar process edge, labiopalatal localization and length of eruption path. To carry out research objectives a Spearman and interclass correlation coefficients, Mann-Whitney U test, Cohen's kappa coefficient were used. Level of significance was 0.05.
Results: Average level of discomfort during the procedure was 2.8 (SD 2.3). Pain level the evening after the surgery was the highest - 3.3 (SD 2.1) and decreased over the week. Pain level differed significantly between different days (P < 0.001). Neither labial or palatal location nor the unilateral or bilateral impaction had effect on the level of pain (P > 0.05). The results showed that pain during different stages of measuring as well as level of discomfort during surgical exposure did not differ statistically significantly depending on severity of impaction (P > 0.05).
Conclusions: There was no significant relation between the discomfort and the location of the impacted canine. Patient's gender or age did not have an impact on discomfort and pain.
Keywords: canine teeth; surgical procedure; pain perception; orthodontics.
Evaluation of the Effects of Topical Ellagic Acid and Graft Application on Bone Regeneration: an Experimental Study
J Oral Maxillofac Res 2022;13(2):e3
Objectives: The aim of this experimental animal study is to investigate the effect of bone graft and topical ellagic acid application on bone regeneration in rats with critical-sized calvarial bone defects.
Material and Methods: A total of 24 male Wistar rats were divided into three groups, and 7 mm critical-sized calvarial bone defects were created surgically in them. In the first group, the created defect was left empty, and this acted as a control group. In the second group, only a bone graft was placed in the created defect. In the third group, in addition to placing a bone graft in the created defect, 0.325 mg/kg ellagic acid (EA) was applied topically to the defect.
Results: As a result of semiquantitative scoring, osteoblast counts were 2 (SD 0.82) in the control group, 2.71 (SD 0.76) in the graft group, and 1.14 (SD 0.69) in the EA + graft group. The number of osteocytes was 2.29 (SD 0.76) in the control group, 2.71 (SD 1.11) in the graft group, and 1.43 (SD 0.54) in the EA + graft group. When inflammations were evaluated, values of 1.71 (SD 0.75), 1.14 (SD 0.69), and 3 (SD 0.82) were obtained in the control, graft, and EA + graft groups, respectively.
Conclusions: Topical ellagic and graft applications show different effects at different doses under topical and systemic conditions. The dose amount of ellagic acid applied, especially in topical applications, has critical importance in bone healing.
Keywords: bone; ellagic acid; fracture healing; graft.
Retrospective Assessment of the Anatomy and Dimensions of Nasopalatine Canal with Cone-Beam Computed Tomography
J Oral Maxillofac Res 2022;13(2):e4
Objectives: The objective of this retrospective study was to evaluate the anatomy and morphology of the nasopalatine canal in axial, sagittal, and coronal sections with cone-beam computed tomography and to appraise the effect of gender, age, and dental status on the nasopalatine canal.
Material and Methods: Overall 1000 patients with cone-beam computed tomography (CBCT) images were analysed retrospectively. The morphology of the nasopalatine canal (NPC) was classified according to sections. Its sizes were measured, and variations were evaluated. The variables obtained were statistically analysed.
Results: It was observed that the most common NPC shape was the cylindrical type (47.1%) in sagittal sections, and the C-shaped canal (51.1%) in coronal sections. In the axial section, two Stenson foramen (45.2%) were observed most frequently, and the most common form was found as oval (60.7%). In sagittal sections, statistically significant differences were obtained between all morphometric measurements and shapes of the NPC except the angle of the canal. It was found that all morphometric measurements in sagittal and coronal sections were higher in men. Also, it was found that the NPC angle and NPC length decreased with tooth loss.
Conclusions: The nasopalatine canal shows many variations, and its dimensions differ according to gender, age, and dental status. For this reason, before the surgical procedures are applied to the maxilla, it should be evaluated radiologically to prevent complications.
Keywords: anatomy; cone-beam computed tomography; maxilla; radiology.
Correlation Analysis between Airway Volume and Risk of Sleep Apnea/Periodontitis
J Oral Maxillofac Res 2022;13(1):e5
Objectives: Sleep apnea and periodontitis have high incidences in general population. They share common risk factors such as obesity, smoking, and aging. As cone-beam computed tomography becomes popular in dentistry, airway analysis is very accessible to dentists. However, not many studies have investigated the correlations between airway volume and risk of sleep apnea and periodontitis. The purpose of this retrospective study was to investigate the association between airway volume and the occurrence of sleep apnea and periodontitis.
Material and Methods: Overall, 258 patients were enrolled (male: 118, female: 140, age from 13 to 88). axiUm® was used to collect demographical/physical information and the status of sleep apnea and periodontitis. Invivo™ software was utilized to measure airway dimensions. One-way ANOVA followed by Tukey's HSD post-hoc test and Pearson analysis were run to determine statistical difference in airway volumes among patients with various demographic and health status, and association of airway dimensions with their sleep apnea and periodontal conditions.
Results: Sleep apnea patients had significantly higher body weight, body mass index, and significantly smaller airway compared to non-apnea patients (P < 0.05). Old age, male, and diabetes were found to be positively correlated with sleep apnea. No association between airway dimension and periodontal status was identified.
Conclusions: Patients with high body mass index are at higher risk of developing constricted airway and sleep apnea. There appears to be no association between restricted airway and occurrence of periodontitis. Cone-beam computed tomography plays a critical role in identifying narrow airway and necessitating proper referral.
Keywords: airway resistance; cone-beam computed tomography; periodontitis; sleep apnea.