Comparison between platelet rich fibrin as space filling material versus xenograft and alloplastic bone grafting materials in immediate implant placement: a randomized clinical trial.

BACKGROUND: This study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla. MATERIALS AND METHODS: Thirty-six implants were inserted in patients seeking for replacement of non-restorable maxillary anterior and premolar teeth (esthetic zone) by immediate implant. Patients were randomly distributed into three equal groups, twelve implants in each group. Group 1 received Platelet Rich Fibrin (PRF) into the jumping distance, Group 2 received Xenograft into the jumping distance and Group 3 received Alloplastic bone grafting material into the jumping distance. Implant stability by measuring the changes in Resonance Frequency Analysis (RFA), peri-implant pocket depth, marginal bone loss and changes in buccal bone thickness were evaluated during follow up periods. All the clinical and radiographic data were subjected to statistical analysis by One Way ANOVA test and the Post Hoc Tukey test. RESULTS: This study involved 19 female patients and 17 male patients who received 36 dental implants. There was no significant difference between the study groups regarding implant stability, peri-implant pocket depth and palatal bone loss, while there was a significant difference between PRF Group (Group 1) and the other Groups regarding buccal bone loss and changes in buccal bone thickness. CONCLUSION: PRF can be used as a gap filling material in conjunction with immediate implant placement, but other bone grafting materials give superior result regarding buccal bone loss and changes in buccal bone thickness. TRIAL REGISTRATION: The study was listed on www. CLINICALTRIALS: gov with registration number (NCT05878392) on 26/05/2023. The Institutional Review Board (IRB) of the Faculty of Dentistry, Mansoura University, Mansoura, Egypt, approved the current study in compliance with the seventh revision of the Helsinki Declaration in 2013 (A0103023OS).

Comparison of Clinical Efficacy of Screw-retained Arch Bar vs Conventional Erich's Arch Bar in Maxillomandibular Fixation: A Randomized Clinical Trial.

AIM: This study aimed to compare the clinical outcomes of a conventional Erich's arch bar vs a modified screw-retained arch bar in maxillomandibular fixation of mandibular fracture. MATERIALS AND METHODS: This parallel-arm randomized control trial included patients from the outpatient clinic with single favorable mandibular fractures that are indicated for closed reduction. They were subjected to maxillomandibular fixation using conventional Erich's arch bars in the control group and modified screw-retained arch bars in the study group. The outcome measures included operating time, glove perforations, postoperative pain, oral hygiene, fixation stability, occlusion, and mucosal coverage. RESULTS: A total of 20 patients (12 males and 8 females) with a 1:1 allocation ratio were included. There was a significant statistical difference regarding operation time and number of glove perforations in favor of group B as p < 0.001, p = 0.007, respectively. There was a significant statistical difference regarding pain after 1 day (p < 0.001), 1 week (p < 0.001) in favor of group B, and at 4 weeks (p = 0.015), and 6 weeks (p = 0.002) in favor of group A. Regarding oral hygiene at 1 week (p = 0.021) and at 6 weeks (p < 0.001), there was a significant statistical difference in favor of group B. Regarding mucosal coverage at 6 weeks, there was a significant statistical difference in favor of group A (p = 0.005). CONCLUSION: The modified screw-retained arch bar can be considered an alternative to conventional arch bar as it provided less application time and better operator safety. It also showed better patient satisfaction regarding pain and oral hygiene. CLINICAL SIGNIFICANCE: Maxillomandibular fixation with the conventional technique was modified to screw-retained arch bar which is less time-consuming and provides better patient and operator satisfaction. How to cite this article: Elhadidi MH, Awad S, Elsheikh HAE, et al. Comparison of Clinical Efficacy of Screw-retained Arch Bar vs Conventional Erich's Arch Bar in Maxillomandibular Fixation: A Randomized Clinical Trial. J Contemp Dent Pract 2023;24(12):928-935.

Biological Impact of Alloplastic Bone Graft vs Bovine Xenograft and Allograft Materials in Bone Healing: An Experimental Study.

AIM: This study aims to compare the performance of beta-tricalcium phosphate with calcium sulfate (ß-TCP/CS) vs a bovine xenograft, freeze-dried mineralized allograft, and spontaneous healing in surgically prepared bone defects in rabbit tibia. MATERIALS AND METHODS: The grafting materials were implanted in three out of four standardized monocortical bony defects, 3-mm diameter and 3-mm deep, in rabbit tibia while one defect was left empty for spontaneous healing as a control group. Twelve rabbits were euthanized at 2 and 6 weeks after surgery. The bone tissue specimens were histologically evaluated using hematoxylin and eosin, Masson's trichrome and osteoprotegrin (OPG) immunohistochemical staining. Results were quantitatively evaluated. RESULTS: An enhancement of bone healing was noticed in the defects grafted with ß-TCP/CS compared with all other groups at 2 and 6 weeks after surgery as it showed significant increase in OPG expression and a significant decrease in the amount of collagen at 6 weeks after surgery. The residual grafted particles were the least with ß-TCP/CS at 6 weeks after surgery. CONCLUSION: The ß-TCP/CS grafting material is a promising bioactive alloplastic bone substitute as it proved to be biocompatible, osteoconductive, and bioresorbable bone substitute. CLINICAL SIGNIFICANCE: The ß-TCP/CS grafting material can be used for guided bone regeneration resulting in pronounced high-quality bone which aids in oral and maxillofacial reconstruction.

Impact of Three Different Surgical Drilling Protocols on Early Loaded Single Implant in Posterior Maxilla: A 3-year Follow-up.

AIM: This study aims to compare three different drilling techniques for implant site preparation to enhance the primary stability of the early loaded single implant in the posterior maxilla. MATERIALS AND METHODS: A total of 36 dental implants were used in this study for the replacement of a missing single tooth or more in the maxillary posterior region with an early loaded dental implant. The patients were randomly divided into three groups. In group I, the drilling was performed using an undersized drilling technique, in group II, the drilling was performed using bone expanders, and in group III, the drilling was performed using the osseodensification (OD) technique. Patients were evaluated clinically and radiographically at regular time intervals immediately, 4 weeks, 6 months, 1 year, 2 years, and 3 years after surgery. All clinical and radiographic parameters were subjected to statistical analysis. RESULTS: All implants in group I were stable and successful, while 11 from 12 implants survived in both groups II and III. There was no significant difference in peri-implant soft tissue health and marginal bone loss (MBL) throughout the whole study period between the three groups, while there was a significant difference in implant stability and insertion torque between groups I, II, and III at the time of implant placement. CONCLUSION: Preparing the implant bed using the undersized drilling technique with drills with similar geometry to the implant being inserted provides high implant primary stability without the need for additional instruments or cost. CLINICAL SIGNIFICANCE: Dental implants can be early loaded in the posterior maxilla by using an undersized drilling technique, as it improves primary stability.