Spontaneous regeneration of bone following mandibular ramus bone harvesting: a CBCT analysis.

The aim of this study was to evaluate healing at the donor site following autogenous block graft harvesting from the mandibular ramus. In this retrospective study, cone beam computed tomography images taken at different time-points were examined, and the volumes of preoperative and postoperative regions of interest were calculated in the software. Images were classified into four groups: 0-3 months, 4-6 months, 7-12 months, and >12 months post-surgery. To characterize the healing process over time, statistical analyses were conducted for both the 70% and 80% healing thresholds. Nearly half (n = 15, 47%) of the 32 patients included in this study achieved 70% bone healing within 4-12 months post-surgery. At the end of the 28-month period covered by this study, 21 patients (66%) had achieved 70% bone healing. The median time to achieve 70% healing was 9 months, while the median time to achieve 80% healing was 28 months. The findings of this study validate the feasibility of reutilizing the mandibular ramus area for additional bone augmentation when other intraoral sites are unavailable.

Effect of Polymerization on the Color of Resin Composites.

OBJECTIVES: The initial shade of a resin-based restorative material should be the same as that after polymerization. In this study, the color changes of translucent and opaque composites from nine different brands were assessed after polymerization using a spectrophotometer and cross-polarization (CP) photography. METHODS AND MATERIALS: Thirteen nano-hybrid (Essentia LE, GC Corp; Ceram.x Duo SphereTEC A2E/A2D, Dentsply Sirona; Harmonize A2E/A2D, Kerr Dental; IPS Empress Direct A2E/A2D, Ivoclar Vivadent; Mosaic EN/A2, Ultradent Products; Clearfil Majesty Es-2 A2E/A2D, Kuraray Noritake; Charisma Topaz A2/OL, Kulzer), two supra nano-hybrid (Estelite Asteria NE/A2B; Tokuyama), two nano-filled (Filtek Ultimate A2E/A2D; 3M) light-curing resin composites, and one micro-hybrid (Essentia MD, GC Corp) light-curing resin composite were tested. Disc-shaped specimens (n=5) were prepared using silicone molds (12 × 5 mm) and polymerized from both sides using an LED curing light (Elipar Deepcure S, 3M) at a light intensity of 1470 mW/cm2. Measurements were performed before and 1 day after polymerization using a contact-type dental spectrophotometer (Easy Shade 5, VITA Zahnfabrik, Bad Säckingen, Germany) and a combination of CP photography and Photoshop CC software (Adobe Inc, San Jose, CA, USA). Spectrophotometry and CP photography ΔE* values were calculated; the perceptibility threshold was a ΔE* value of 1.2. VITA spectrophotometry color change scores were also calculated and evaluated. RESULTS: The overall ΔE* values ranged between 0.34 and 12.56. Two-way analysis of variance (ANOVA) showed that color change was associated most strongly with composite brand (p<0.001), followed by shade (p=0.002). Color change (p=0.002) and degree of darkening/lightening (p<0.001) were significantly greater for dentin compared to enamel shades. Clearfil Majesty Es-2 (Kuraray Noritake) showed significant lightening, whereas all other composites showed darkening after polymerization. All composite brands presented perceptible (ΔE*≥1.2) color changes. Estelite Asteria (Tokuyama), Ceram.x Duo SphereTEC (Dentsply Sirona), and Harmonize (Kerr Dental) were considered the most reliable brands regardless of the shade. The spectrophotometry and CP photography methods were positively correlated (p<0.001). Also, CIEDE2000 and CIELCH (also referred to as CIE L*c*h) color systems were positively correlated based on the ΔE* values (p<0.001). CONCLUSIONS: Despite improvements in the chemical composition of, and fillers for, contemporary resin-based composites (RBCs), all tested composite brands showed perceptible color change after polymerization, except for some shades. Under the conditions in this study, it is preferable to polymerize the composite during the trial phase, before identifying the most appropriate shade. CP photography in combination with Photoshop analysis appears to be a reliable and promising approach for color evaluation.

Does shelf preparation have efficacy on immediate loading of 4 implants supporting screw-retained full-arch dental prosthesis?

Background: Bone reduction and shelf preparation is a common procedure to establish a new alveolar plane before implant surgery, which might effect the primary stability. Aim: Primary stability was questioned in terms of bone reduction and shelf preparation. The suitability of immediate loading was compared between the implants placed on crests, which underwent alveoloplasty, and the implants placed on a naturally healed alveolar bone. Patients and Methods: We designed and implemented a retrospective cohort study. Twenty patients (mean age 49.2 years) were treated with 160 dental implants. The primary predictor variable was extraction and bone reduction. The secondary predictor variables were bone density and the implant surface. The outcome variables were resonance frequency analysis (RFA) and insertion torque (IT) values. Results: There was no statistically significant difference between groups regarding RFA and IT (P > 0,05). Interactions of surface area with the RFA and IT in both groups were not statistically significant; however, bone density presented a statistically significant effect on outcome variables for both groups. Conclusion: IT and RFA are not influenced by bone reduction, shelf preparation, or the implant surface. Primary stability is mostly affected by bone density in the immediate load of 4 implants to support a full-arch prosthesis.

Impact of informed consent on patient decisions regarding third molar removal.

PURPOSE: We investigated whether the order in which patients learned about complication risks affected their anxiety about and willingness to undergo the removal of their third molar. MATERIALS AND METHODS: In total, 171 patients (65 males, 106 females) were included in the study. The distributions of gender and the position of mandibular third molars were recorded. The Amsterdam Preoperative Anxiety and Information Scale and Spielberger's State-Trait Anxiety Inventory were used to evaluate anxiety. Associations of anxiety with timing (pre/post), gender, and the order in which the information was presented in the consent form were analyzed. RESULTS: The most common angulations were horizontal (26.3%) and mesioangular (60.2%), and these were more common in women. All patients obtained significantly higher anxiety scores after reading the consent form. There was no significant difference in anxiety scores, according to the order of information. In total, 88 patients underwent surgery, whereas 83 postponed the extraction after reading the consent form. Women were significantly more anxious than men before the procedure. Patients showed lower anxiety levels after the procedure (P < 0.05). CONCLUSION: Increased anxiety was not associated with the order in which information was presented in the informed consent form. However, the informed consent form itself was a major contributor to increased patient anxiety. Further studies regarding the contents of consent forms and their effects on patient anxiety and decisions regarding third molar removal are needed.

Actinomycosis: report of a case with a persistent extraoral sinus tract.

Cervicofacial actinomycosis is a chronic suppurative and granulomatous infection that may reside for years and recur with sudden onset. It is the second most common type of actinomycosis and could be caused by trauma or infection. We report a draining actinomycotic sinus tract with extraordinary thickness that occurred owing to a long-standing chronic periapical infection of an extracted upper left second premolar 3 years before.