2022 Jul-Sep; Vol 13, No 3
Dimensional Influence of Epithelialized Tissue Graft Harvested From Palate on Postoperative Pain: a Systematic Review
J Oral Maxillofac Res 2022;13(3):e1
Objectives: The aim of the present systematic review was to evaluate the dimensional influence of the epithelialized tissue graft harvested from the palate in the postoperative pain.
Material and Methods: Research was conducted in electronic databases Cochrane Library, Embase, LILACS, PubMed, Scopus, and Web of Science upwards May 15, 2022. Studies that reported the influence of graft dimensions of palatal epithelized harvesting on postoperative pain were eligible. The evaluation was made using the methodological quality assessment by Joanna Briggs Institute Critical Appraisal Checklist for randomized clinical trials and non-randomized studies and the level of evidence according to GRADE.
Results: Four studies were included. The clinical and methodological heterogeneity among studies led to an analysed narrative. The postoperative pain was assessed during the period of 1 to 28 postoperative days. It was determined by using visual analog score in three studies, while the evaluation was performed indirectly based on analgesics intake in one study. According to three studies, bigger graft sizes were associated with higher postoperative pain. The methodological quality assessment categorized two study as high (one randomized control trial and one non-randomized), and two as moderate (one randomized control trial and one non-randomized). The data was considered moderate.
Conclusions: Based on the moderate certainty level, bigger graft sizes of palatal epithelized harvesting appear to promote more postoperative pain. Understanding the postoperative pain as a response to a graft extension may assist some clinical decisions regarding the surgical periodontal and peri-implant planning.
Keywords: autografts; periodontal guided tissue regeneration; systematic review; wound healing.
The Radiological Evaluation of Mandibular Canal Related Variables in Mandibular Third Molar Region: a Retrospective Multicenter Study
J Oral Maxillofac Res 2022;13(3):e2
Objectives: The aim of this retrospective study was to investigate anatomical structure of mandibular canal and the factors those increase the possibility of inferior alveolar nerve damage in mandibular third molar region of Turkish population.
Material and Methods: Overall 320 participants with 436 mandibular third molars were included from four different study centers. Following variables were measured: type and depth of third molar impaction, position of mandibular canal in relation to third molars, morphology of mandibular canal, cortication status of mandibular canal, possible contact between the third molars and mandibular canal, thickness and density of superior, buccal, and lingual mandibular canal wall, bucco-lingual and apico-coronal mandibular canal diameters on cone-beam computed tomography scans.
Results: Lingual mandibular canal wall density and thickness were decreased significantly as the impaction depth of mandibular third molar was increased (P = 0.045, P = 0.001 respectively). Highest buccal mandibular canal wall density and thickness were observed in lingual position of mandibular canal in relation to mandibular third molar (P = 0.021, P = 0.034 respectively). Mandibular canal with oval/round morphology had higher apico-coronal diameter in comparison to tear drop and dumbbell morphologies (P = 0.018). Additionally, mandibular canals with observed cortication border and no contact with mandibular third molar had denser and thicker lingual mandibular canal wall (P = 0.003, P = 0.001 respectively).
Conclusions: Buccal and lingual mandibular canal wall density, thickness and mandibular canal diameter may be related with high-risk indicators of inferior alveolar nerve injury.
Keywords: mandible; radiology; surgery; tomography.
Possible Association between the Quantity of Peri-implant Crevicular Fluid, Clinical Indices, and the Dimensions of Endosseous Implants
J Oral Maxillofac Res 2022;13(3):e3
Objectives: The objectives of this clinical observational study are to measure peri-implant crevicular fluid volume based on dental implant diameter and length, and to evaluate the possible relationship between peri-implant crevicular fluid/gingival crevicular fluid volumes and clinical periodontal indices.
Material and Methods: The information about length and diameter of dental implants was noted. Clinical indices (probing depth, plaque index, gingival bleeding time index, and gingival index) were recorded. Peri-implant crevicular fluid (PICF)/gingival crevicular fluid (GCF) volumes were measured from 4 sites (mesial, buccal, distal, and lingual/palatal) of each dental implant including its one or more equivalent natural tooth/teeth.
Results: One-hundred-sixty-one loaded dental implants and 221 natural teeth of 101 patients were evaluated. The length of dental implant had no effect on PICF volume (P > 0.05). However, PICF volumes of narrow (< 3.5 mm) and wide (> 4.5 mm) diameter implants were higher than standard diameter implants (≥ 3.5 mm, and ≤ 4.5 mm) (P < 0.05). PICF and GCF volumes of areas with peri-implant/periodontal diseases were significantly higher than healthy areas (P < 0.05). PICF and GCF volumes showed positive correlations with clinical indices (P < 0.05).
Conclusions: In accordance with the results of the present study, the implant diameter, not the implant length, affects peri-implant crevicular fluid volume.
Keywords: dental implants; diagnosis; gingival crevicular fluid; inflammation.
Reliability of Acoustic Pharyngometry and Rhinometry Examination in Children and Adolescents
J Oral Maxillofac Res 2022;13(3):e4
Objectives: The aim of this cross-sectional study was to examine the method error and reliability of acoustic pharyngometry and rhinometry in children and adolescents and to describe the feasibility of these methods in a young population.
Material and Methods: The study sample included 35 healthy subjects in the age of 9 to 14 years. The subjects were randomly recruited for the present project in the period from June 2021 to February 2022. Repeated measurements of the upper airway dimensions in standing mirror position were performed by the use of Acoustic Pharyngometer and Rhinometer. Volume (cm3), calculated resistance (cm H2O/L/min), mean area (cm2), minimum cross-sectional area (MCA, cm2) and distance to MCA (cm) were examined. Method errors and reliability coefficients were evaluated using Dahlberg’s formula and the Houston reliability coefficient. The feasibility of the methods were analysed using paired t-test and estimated by difference in drop-out
Results: No systematic error exhibited in the repeated measurements except volume in the left nostril (P = 0.017). The method errors of the acoustic pharyngometry and rhinometry were betweeen 0.0002 to 0.069 and 0.001 to 0.082 respectively. The Houston reliability coefficient for both methods were between 0.952 to 0.999. The acoustic pharyngometry was significantly more feasible compared to rhinometry (P < 0.001).
Conclusions: The study shows that acoustic pharyngometry and rhinometry in the standing mirror position are reliable methods, with acoustic pharyngometry being even more feasible than rhinometry, which is why it is recommended to practice the methods with children and ensure reliability of results before registering measurements.
Keywords: acoustics; child; pharynx; nose; reproducibility of results.
Dental Implant Placement in Focal Osteoporotic Bone Marrow Defect: a Case Report and Treatment Recommendations
J Oral Maxillofac Res 2022;13(3):e5
Background: Focal osteoporotic bone marrow defect is asymptomatic radiolucent area usually discovered incidentally during radiographic examination of the jaws. This bone condition can lead to clinical complications during dental implant placement or during osseointegration process.
Methods: A 54-year-old woman was referred to private dental implant centre for a dental implant rehabilitation treatment in May 17, 2016. Oral examination revealed a healthy mucosa with no visible pathology. Adentia of tooth #46 and moderate atrophy of the edentulous alveolar process were found. Panoramic radiography of the jaws showed 2 cm x 2 cm radiolucency with irregular borders located in tooth #46 region. The margins of the bone defect were uneven, single trabeculae were visible, and the cortical layer was not deformed. In the absence of signs of pathology, it was decided to perform a dental implant surgery in the edentulous jaw segment #46.
Results: The osteoporotic focus was filled with natural bovine bone substitute Cerabone®. The granules were gently condensed to the sides - to the buccal and lingual walls until they filled the entire cavity. A 10 mm long, 4.1 mm diameter Straumann® Tissue Level implant was surgically placed with the shoulder of the implant resting on the margins of the osteotomy. It was proposed six steps protocol for surgical dental implant installation in focal osteoporotic bone marrow defect in mandible.
Conclusions: A six-step protocol for surgical placement of dental implants in focal osteoporotic bone marrow defects may be a useful tool for clinicians in implant dentistry.
Keywords: bone marrow; bone substitutes; dental implants; radiography; mandible.