Review of the Long-Term Outcomes of Guided Bone Regeneration and Autologous Bone Block Augmentation for Vertical Dental Restoration of Dental Implants.

Vertical bone resorption is a frequent consequence of tooth loss. Hence, implant-supported restorations imply, first of all, bone reconstruction. We aimed to review the current status of guided bone regeneration and autologous bone block augmentation for vertical dental restoration of dental implants. This review identified that between 2009 and 2022 there were few clinical studies that included more than 10 patients and a follow-up period of more than 5 years after bone restoration. The highest vertical bone gain was reported in the autologous bone grafting technique (4-7.6 mm), whereas the minimum augmentation was reported for one of the guided bone regeneration techniques. When comparing intraoral to extraoral bone blocks, the highest values for the mean vertical bone gains were obtained in the cases in which intraoral bone blocks were used as graft material. The highest rate of bone resorption was observed in the extraoral bone block group. Implant survival rate was not significantly influenced by surgical technique. Complications had a higher incidence in autologous bone block augmentation studies. Soft tissue recession showed similar results for guided bone regeneration as for autologous bone block augmentation. Vertical ridge augmentation is a predictable option for the reconstruction of alveolar ridges with severe atrophy, but complications can appear.

Osseointegration of chemically modified sandblasted and acid-etched titanium implant surface in diabetic rats: a histological and scanning electron microscopy study.

INTRODUCTION: The aim of this study is to assess the osseointegration of different dental implants surfaces in diabetic rats. MATERIALS AND METHODS: In this study, were used 56 male Wistar rats, average weight of 300-350 g. Diabetes was induced by a single intraperitoneal injection of Streptozotocin. The glucose levels and weight of rats were periodically evaluated. After the diabetes mellitus is confirmed, the sandblasted, large-grit, acid-etched (SLA) and SLActive endosseous dental implants (TAG dental implants, TAG Medical, Israel), made of titanium alloy, Ti-6Al-4V, 1 mm diameter and 3 mm in length were inserted in the distal metaphysis of the left femur. RESULTS: Diabetic rats have naturally lower number of bone cells and bone-implant contact (BIC%) than healthy rats when using the SLA implant, but when using SLActive implant, diabetic and healthy rats have the same numbers. CONCLUSIONS: The use of the SLActive surface resulted in positive effects in healthy and especially in diabetic animals, which demonstrate that could improve the osseointegration progress in humans with diabetes.

Three-Dimensional Evaluation of Maxillary Sinus Septa for Implant Placement.

BACKGROUND: The aim of our study was to investigate, in 3 dimensions, the maxillary sinus septa as an alternative site for dental implant placement to avoid sinus lift procedures. MATERIAL AND METHODS: We selected 100 dentate and 100 edentate patients with the presence of a maxillary sinus septum by reviewing a larger cone beam computer tomography (CBCT) database from the Department of Oral and Maxillofacial Surgery at Cliniques Universitaires Saint Luc in Bruxelles, Belgium. Three-dimensional reconstructions of 200 maxillary sinus septa were performed using Maxilim software. Ten measurements (length, lateral height, and thickness of the middle and medial region of the septum) were performed by 1 observer, 2 times, with an interval of 1 week between measurements. The angle between the septum and the maxillary plane was also measured. Finally, localization and orientation were assessed for each septum. RESULTS: There was no statistically significant difference between the 2 intraobserver measurements (p>0.05). Student's t-test was used to compare means. Middle height was the only measurement for which there was a difference between edentate and dentate patients (p=0.0095, edentate mean < dentate mean). The location of the septa observed in our study groups demonstrated greater prevalence in the posterior region than in the anterior and middle regions. For the spatial orientation of the septum, we found that most septa (81.2% in dentate patients, 53% in edentate patients) were oblique. CONCLUSIONS: Three-dimensional evaluation of maxillary sinus septa using 3D CBCT imaging showed that the sinus septum could offer an alternative site for implant placement in the maxillary sinus.

Three-Dimensional Evaluation of Implant Positioning in the Maxillary Sinus Septum: A Retrospective Study.

BACKGROUND: The aim of this study was to simulate implant placement in the maxillary sinus septum, as a potential alternative site to avoid sinus grafting. MATERIAL AND METHODS: One hundred partially or completely edentulous patients, with their maxillary sinus septum present in the edentulous region, were selected from the database of the Department of Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Bruxelles, Belgium. Three-dimensional (3D) reconstructions were created using 3D planning software. 3D reconstructions were performed for each maxillary sinus. Using the software implant library, the implants that presented the best fit with the maxillary sinus septum and that followed the established inclusion criteria were selected. RESULTS: All of the implants were inserted in premolar and molar regions. Most implants were inserted in the position of the second molar (21 of 55) or in the position of the first molar (17 of 55). In all sites the most frequently used implant was 4 mm in diameter and 7 mm in height. The mean coronal angle for the implant was 80.19±17.13 degrees and the mean sagittal angle was 94.83±9.94 degrees. The septal height represents 38.13% of the total available bone height (ABH). The mean percentage of the septum used to insert the implants was 47.33±2.47%. The septum increased the available bone height by a mean value of 2.18±1.47 mm. In 45 cases, the septa did not permit implant placement. CONCLUSIONS: In completely edentulous patients, inserting implants in sinus septa does not exclude the need for sinus grafting, but in partially edentulous patients, this minimally invasive technique is an alternative to subantral augmentation.

Reliability and accuracy of three different computerized cephalometric analysis software.

The aim of this investigation was to determine, compare and evaluate three different computerized tracing programs, where the lateral cephalograms were digitized on the screen. 39 randomly selected cephalometric radiographs were used in the present study. Three programs Planmeca Romexis® (Romexis 3.2.0., Helsinki, Finland), Orthalis (France) and AxCeph (A.C 2.3.0.74, Ljubljana, Slovenia) were evaluated. 12 skeletal, 9 dental and 3 soft tissue parameters were measured that consisted of 11 linear and 13 angular measurements. Statistical analysis was carried out using multivariate analysis of variance (MANOVA), Levene test, Tukey Honestly Significant Difference (HSD) test and Kruskal-Wallis test. The measurements obtained with the cephalometric analyses programs used in the study were reliable.

Maxillary sinus anatomic and pathologic CT findings in edentulous patients scheduled for sinus augmentation.

OBJECTIVES: An aberrant sinus anatomy or pathology can influence the sinus lift technique if it is encountered during surgical exposure. The purpose of the present study was to determine the prevalence of sinus disease and variations of normal anatomy among edentulous patients prior to sinus augmentation. MATERIAL AND METHODS: 120 patients attending a private surgical practice (53 women and 67 men, with a mean age of 62.02 years, ranging between 34 and 81 years old) for whom treatment was planned for sinus augmentation were evaluated--medical history, radiographic and clinical examinations. Computerized tomograms (CT) and 3D reconstructions from 240 sinuses were analyzed using Dental CT. RESULTS: Abnormalities were diagnosed in 74.2% of cases. Mucosal thickening was the most prevalent abnormality (68.3%), followed by retention cysts (15.8%) and opacification (9.2%). The diagnosed conditions included mucosal thickening, chronic sinusitis, sinus cysts and polyps. The prevalence of one or more septa per sinus was found to be 30%. Males present pathology more often than females (p=.028). No statistical correlation could be found between age and pathology (p>0.05) No significant differences in age or gender between patients with and without sinus septum were found (p>0.05). CONCLUSIONS: The results reinforce the importance of thorough history taking and clinical and radiographic assessment prior to performing sinus augmentation, to prevent the probability of complications.

Quantitative and qualitative bone assessment of the posterior mandible in patients with diabetes mellitus: a cone beam computed tomography study.

UNLABELLED: Evaluation of mandibular bone features is very important for the diagnosis, treatment planning and management of dental procedures such as osseointegrated implants. AIM: To evaluate the bone quantity and quality of the posterior region of the mandible using the CBCT technique for implant planning in patients with diabetes mellitus. METHODS: Twenty-three patients with diabetes mellitus and 27 control subjects participated in the study. Mandibular bone measurements were performed on the cone beam computed tomography (CBCT) images. One previously calibrated oral radiologist with CBCT experience measured the distance from mandibular canal to alveolar ridge and the distance from bucal to lingual cortical wall. Also, it was assessed the bone quality of each region of interest, by measuring the bone mineral density. The study protocol was approved by the local Ethics Committee. RESULTS: The study revealed the presence of significant correlations between bone quality and values ofglycosylated hemoglobin and a significant association between patient gender and bone type. There is a significant inverse correlation between the values of cortical and trabecular bone density in the posterior region of the mandible and HbA1c. CONCLUSIONS: In conclusion the use of CBCT in preoperative bone measurements will help provide valuable information about the quantity and quality of bone before the placement of dental implants.

The essential role of cone beam computed tomography to diagnose the localization of impacted maxillary canine and to detect the austerity of the adjacent root resorption in the Romanian population.

UNLABELLED: The impaction phenomenon is a pathological condition which is defined as the lack of eruption of a permanent tooth in the oral cavity. After third molar, the first permanent tooth impacted in the alveolar bone is the permanent maxillary canine, with varies from 1% to 3%. The aim of this study was to use the most recently imaging technique--CBCT, to evaluate the position of the impacted maxillary canine and to determinate the severity of root resorption of the adjacent teeth. MATERIAL AND METHODS: The all 230 patients of this study were referred to a CBCT scanning with Scanora machine and only the region of clinical interest was irradiated. RESULTS: The age of the subjects was distributed between the ages of 11 and 42 years. From a total of 364 impacted canine teeth, 92 were side impacted canines, 97 right impacted canines and 87 were left impacted canines. DISCUSSION: We report a lateral incisors root resorption present in 54.37% and 24.29% the resorption of central incisors. CONCLUSIONS: The use of CBCT in patients with impacted canines has potential diagnostic and may influence the planning of treatment. Also the CBCT can be a genuine method used to rectify, to diagnose and to make a suggestive treatment for the resorption of the root of incisors.