Histologic and Immunohistochemical Assessment of the Effect of Various Biomaterials on New Bone Formation in the Maxillary Sinus Floor Augmentation Procedure.

PURPOSE: To assess the effect of different kinds of biomaterials placed with maxillary sinus floor augmentation (MSFA) on bone regeneration. MATERIALS AND METHODS: Thirty-six New Zealand rabbits were used in the study. A standardized method of surgical approach was used for MSFA under anesthesia in all groups. The procedure was performed for each animal. Six separate groups with 12 cases were created. In group 1, no graft was used in MSFA. Advanced platelet-rich fibrin (A-PRF), absorbable collagen cone (ACC), venous blood, the combination of ACC and platelet-rich plasma (PRP), and the combination of ACC and enamel matrix derivative (EMD) were used in groups 2, 3, 4, 5, and 6, respectively. At the end of 4 and 12 weeks, three rabbits from each group were sacrificed by applying high-dose anesthetic, and samples were examined histologically and immunohistochemically. RESULTS: Groups 2 and 5 showed significantly increased new bone formation compared with groups 1 and 4, 4 weeks after MSFA (P < .05). Twelve weeks after sinus floor augmentation, groups 2, 3, 5, and 6 showed significantly higher new bone formation than group 1 (P < .05). Groups 2 and 5 showed significantly higher hard tissue response than groups 1 and 4 at the end of 4 weeks (P < .05). Groups 5 and 6 demonstrated significantly higher hard tissue response than group 1 at the end of 12 weeks (P < .05). Group 5 also showed significantly higher hard tissue response than group 4 at the end of 12 weeks (P < .05). Immunohistochemical analysis showed a significant difference between the osteocalcin scores of groups 2 and 4 and group 1 at the end of 4 and 12 weeks (P < .05). There was also a statistically significant difference between osteocalcin scores at 4 and 12 weeks for groups 1 and 5 (P < .05). When osteopontin scores were compared, there was no significant difference between groups at 4 and 12 weeks (P > .05). Groups 1, 2, and 5 showed significant changes in osteopontin scores between 4 and 12 weeks (P < .05). CONCLUSION: The combination of ACC and PRP and the combination of ACC and EMD showed increased new bone formation and hard tissue response. A-PRF also showed promising results in new bone formation at the end of both 4 and 12 weeks. The usage of ACC as a carrier for liquid-form biomaterials may be more beneficial than the usage of ACC alone.

Radiographic Evaluation of Low-Level Laser Therapy-Enhanced Maxillary Sinus Augmentation with Simultaneous Dental Implant Placement.

BACKGROUND: To evaluate the effect of low-level laser therapy (LLLT) on bone healing in patients undergoing bilateral sinus lifting and simultaneous dental implant application. METHODS: Twelve patients with total/partial posterior maxillary edentulism who needed bilateral sinus bone augmentation were included in the study. Dental implants were inserted in the same session. LLLT (λ = 630-660 nm, 25 mW/cm2, 6 min) was used for one operation side on the 1st, 3rd, 5th, and 7th days, whereas contralateral side served as control side. Preoperative and postoperative 1st, 3rd, and 6th month orthopantomograms were obtained using the aluminum step-wedge technique. Optic density analyses were performed using a Cardinal Health Digital Densitometer (Fluke Biomedical 07-443) with 1 mm diameter. Digital densitometry results were obtained as the equivalent aluminum thickness for each radiograph. These data were used to evaluate the changes in optical bone density and to compare the treatment side with the control side for each patient. RESULTS: The LLLT side showed better results than the control side according to the densitometry results. Increase in the bone density at all the postoperative intervals was statistically significant (P < 0.05). CONCLUSIONS: LLLT enhances bone regeneration in sinus augmentation with simultaneous dental implant placement.

Evaluation of New Bone Formation in Sinus Floor Augmentation With Injectable Platelet-Rich Fibrin-Soaked Collagen Plug: A Pilot Study.

INTRODUCTION: The objective of this study is to evaluate the new bone formation after sinus floor augmentation with collagen plugs used as carriers for injectable platelet-rich fibrin (i-PRF). MATERIALS AND METHODS: Postoperative immediate and postoperative 6th month panoramic radiographies of patients treated between January 1, 2015, and February 1, 2018, with sinus floor augmentation using i-PRF-soaked collagen plugs were retrieved from the archives, and subantral bone heights of distal and mesial regions of simultaneously inserted implants were measured with a software program. Statistical analysis was performed to understand whether there is a significant change in new bone formation at 6th month follow-up control. RESULTS: A total of 18 implants were inserted in 12 patients. There was significant new bone formation at 6th month follow-up radiography at mesial and distal regions of inserted implants (P < 0.05). CONCLUSION: New bone was regenerated with i-PRF carried by collagen plugs in sinus floor augmentation.

Techniques and modifications for TMJ arthrocentesis: A literature review.

OBJECTIVES: To discuss advantages and disadvantages of TMJ arthrocentesis techniques, identifying modifications as reported in the literature. METHODS: A PubMed web-based search was carried out, using the terms TMJ and arthrocentesis, to determine the scope of coverage in well-documented articles in English. RESULTS: Among 237 articles, 12 distinct techniques were described for TMJ arthrocentesis in 12 articles. Among 12 techniques, 5 were classified as double puncture arthrocentesis (DPA) and 7 as single puncture arthrocentesis (SPA). In total, 17 well documented articles about SPA were found in literature. DISCUSSION: Arthrocentesis of the temporomandibular joint (TMJ) was first described in 1991. To make the traditional procedure even less invasive, many arthrocentesis methods have been described. However, in 2015, TMJ arthrocentesis techniques were divided into two groups to limit the complexities surrounding the concepts related to TMJ arthrocentesis techniques.

Effect of platelet rich fibrin on edema and pain following third molar surgery: a split mouth control study.

BACKGROUND: To evaluate the efficacy of platelet-rich fibrine (PRF) on postoperative edema and pain after impacted mandibular third molar surgery. METHODS: The prospective study was comprised 30 patients who presented for the removal of bilateral impacted mandibular third molar teeth. After extraction, the sockets were filled with PRF or without PRF in the study and control groups, respectively. Postoperative edema was measured with a flexible tape measure by calculating the distance between several facial landmarks on postoperative days two and seven. Postoperative pain was evaluated with a line-type visual analogue scale (VAS) and a verbal scale (VRS). SPSS version 20.0 was used for data analysis. RESULTS: Both groups recorded significant improvement compared to the baseline levels in almost all of the outcome variables. There was no statistically significant difference between the study and control groups (p > 0.05). CONCLUSIONS: Using or not using PRF to reduce postoperative pain and edema in third molar surgery was equally successful. TRIAL REGISTRATION: This study was retrospectively registered at the ISRCTN registry ( ISRCTN16849867 ) on 6 March 2017.

Horizontal maxillary sinus septa: An uncommon entity.

INTRODUCTION: Maxillary sinus septas are barriers of cortical bone that arise from the floor or from the walls of sinus and may even divide the sinus into two or more cavities. Morphologically maxillary sinus septa are generally oriented in buccopalatinal orientation horizontal or sagittal orientation of the sinus septa is a rare condition. PRESENTATION OF CASE: This report presents two sinus lift case, in which observed septa in a horizontal orientation was presented. Both cases were fixed by an implant supported prosthethic restoration. DISCUSSION: Surgeons must know detailed knowledge about maxillary sinus anatomy for successful sinus augmentation. Computed tomography (CT) is useful for examining the maxillary sinus. CONCLUSION: Horizontal-type sinus septa are rarely seen. Surgeons must be aware of septa types and orientations.

Is the 810-nm diode laser the best choice in oral soft tissue therapy?

OBJECTIVE: To evaluate the safety and efficacy of an 810-nm diode laser for treatment of benign oral soft tissue lesions. MATERIALS AND METHODS: Treatment with the 810-nm diode laser was applied to a group of eighteen patients with pathological frenulum and epulis fissuratum; five patients with oral lichen planus, oral leukoplakia, and mucous membrane pemphigoid; and four patients with pyogenic granuloma. RESULTS: Although the conventional surgery wound heals in a fairly short time, in the present study, the simple oral soft tissue lesions healed within two weeks, the white and vesiculobullous lesions healed completely within six weeks, and the pyogenic granuloma lesions healed within four weeks. Any complication was treated by using the 810-nm diode laser. CONCLUSIONS: Patient acceptance and satisfaction, without compromising health and function, have been found to be of a high degree in this present study. Thus, we can say that the use of the 810-nm diode laser may indeed be the best choice in oral soft tissue surgery.