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Objectives@#The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. @*Patients and Methods@#This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, conebeam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. @*Results@#Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). @*Conclusion@#Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.
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Background@#Nicotine can have detrimental effects on dental implant osseointegration. This study aimed to evaluate the influence of systemic L-arginine supplement on the osseointegration of dental implants in nicotine consumer dogs. @*Methods@#Twelve 1-year Labrador Retriever dogs had their right and left third and fourth mandibular premolars removed, and the sockets were left to heal for 6 months. Dogs were randomly divided into three groups (n = 16): group 1—0.2 mg/kg nicotine was injected twice daily; group 2—0.2 mg/kg nicotine was injected twice daily in addition to 200 mg/kg L-arginine capsules taken orally; and group 3—placebo. Forty-eight dental implants were inserted into the healed sockets of the dog’s mandible and were assessed by implant stability quotient (ISQ) using resonance frequency analysis (RFA) during 4 weeks and insertion and removal torque value analysis. @*Results@#No implant failure occurred during the study period. The change in torque value between insertion and removal was similar in the placebo and nicotine+arginine consumer dogs (p = 0.276), which shows a positive effect of arginine supplementation in nicotine consumers. There was a significant difference in torque value change between nicotine+arginine vs. nicotine consumers (p = 0.049) and placebo vs. nicotine (p = 0.003). After 4 weeks, the placebo had the most significant improvement in torque value (47.0 ± 16.9), followed by nicotine+arginine (25.1 ± 37.8), and the worst torque value was for the nicotine group (− 5.7 ± 24.0) pound per inch. The results show that except in the first week, there are significant differences in ISQ between the groups in different periods. ISQ in all of the groups has reduced at first but then increased over time. At the time of implant placement, insertion torque was significantly higher in the nicotine consumer group than the nicotine+arginine consumer group and placebo group (p = 0.020). @*Conclusion@#Arginine supplementation promotes bone healing and implant primary stability by improving dental implant osseointegration biomechanical characteristics.
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Aims: Inflammation occurring after the surgical removal of impacted lower third molars can cause complications such as pain and swelling. The aim of this study was to compare the effectiveness of dexamethasone injection into the medial pterygoid and gluteal muscles in preventing postoperative complications after surgical removal of bony impacted mandibular third molars. Study Design: Parallel randomized clinical trial. Place and Duration of Study: Oral Surgery Department of the Torabinejad Dental Research Center, between April 2013 and January 2014. Methodology: This trial included 77 participants aged between 18 and 35 years [mean age (mean ± standard deviation), 25.04±4.33 years] requiring surgical removal of a single bony impacted mandibular third molar under local anesthesia. Participants were randomly assigned to 3 groups based on systematic random. Postoperative pain, swelling, patients’ general satisfaction, and changes in daily life function were evaluated. These factors were first analyzed by the Kruskal–Wallis and ANOVA tests, followed by the Mann–Whitney test. Results: The two dexamethasone groups had significantly less postoperative pain, swelling, and change in appearance at 48 h after the surgery compared with the DF group. Conclusion: With the caution of a small sample size, the results of this study indicate that near the surgical field preoperative injection of dexamethasone in the medial pterygoid muscle can control postoperative pain, swelling, and changes in appearance as efficiently as the same in the gluteus muscle.
ABSTRACT
Aim: This study is aimed to investigate the success rate and clinical outcome of placed implants in reconstructed alveolar ridges using iliac cortico-cancellus bone graft compared to normal nonaugmented alveolar ridge. Materials and Methods: In this clinical trial study, 30 patients who were selected and assigned in case and control groups. The case group included patients with severe alveolar bone loss, who needed bone grafting. The control group included patients with sufficient alveolar ridge and no need for bone grafting. The prosthesis was placed on implants after 3 to 8 months. Plaque index, bleeding, pocket depth, mobility, pain, pus secretion and bone loss were evaluated after 24 month. Data were analyzed by SPSS 13. P-value less than 0.05 was considered as significant. Results: Out of 30 patients, two were excluded due to their requirements. Totally 97 implants were placed in patients, which included 52 implants in control group and 45 implants in case group. All of the implants were successfully osseointegrated and loaded. There was no significant difference between the success of inserted implants between both groups (P=0.05). The mesial and distal bone losses were significantly more in patients without iliac bone graft (P=0.05). There was no statistically significant difference between measured outcomes including plaque, bleeding, pocket depth, mobility, pain, and pus secretion (P=0.05). Conclusion: Inserted implant in free non-vascularized iliac bone graft has high rate of success comapred to non-augmented alveolar ridges and has shown to be a reliable method for reconstruction of severe atrophic jaws.