Use of platelet-rich fibrin versus connective tissue graft in treatment of gingival recessions: Literature review.

AIM: To compare and evaluate the effects of two different approaches on treating gingival recessions: coronally advanced flap (CAF) with platelet rich-fibrin (PRF) membrane and coronally advanced flap (CAF) with connective tissue graft (CTG). MATERIAL AND METHODS: A systematic literature review was performed of randomized control trials in English identified in MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (Cochrane Library), Springer Link, Science Direct and Google Scholar databases, published between 2015 and 2020. Studies had to be performed in vivo with follow-up periods of ≥6 months. RESULTS: 153 publications were found, out of which 8 were identified as relevant to the theme. Six of these studies evaluated periodontal parameters such as probing depth (PD), clinical attachment level (CAL), recession depth (RD), keratinized tissue width (KTW) and gingival thickness (GT). In 3 studies discomfort and aesthetic scores were analyzed as subjective parameters. 1 study histologically evaluated different techniques of gingival recession treatment. CONCLUSION: Both techniques are effective in the treatment of Miller's class I and II gingival recessions. Although the CTG technique may provide better results in KTW and GT, PRF avoids a donor site, which means a major decrease in postoperative discomfort.

Autologous platelet concentrates in treatment of medication related osteonecrosis of the jaw.

BACKGROUND: Medication related osteonecrosis of the jaw (MRONJ) is a severe adverse drug reaction occurring as a progressive bone destruction in the maxillofacial region. MRONJ is usually initiated after oral surgery procedures, however periodontal disease and other chronic inflammations are also risk factors. There is no clear treatment protocol for management of MRONJ, for this reason autologous platelet concentrates (APC) have been introduced to enhance the healing process. AIM: To evaluate the effectiveness of APCs in treatment of MRONJ. METHODS: A systematic literature review was performed according to PRISMA guidelines in MEDLINE (PubMed) and Google Scholar databases. Only no older than 5 years, in vivo studies in English with follow-up until condition totally resolves were included. RESULTS: A total of 2683 publications were identified out of which only 7 met the inclusion criteria, 6 cohort and 1 randomized clinical trial. Most of the studies preferred platelet rich fibrin (PRF) and only one used platelet rich plasma (PRP) in MRONJ treatment. MRONJ stage, patients mean age, drug therapy, follow-up and success rate were analysed in all the studies. Five studies also named how MRONJ initiated and 4 studies mentioned duration of drug intake before developing MRONJ. CONCLUSION: The published data is not sufficient to confirm a specific treatment protocol although the published results are promising. More prospective randomized controlled clinical trials are required in order to evaluate the effectiveness of APCs for treatment of MRONJ.

Uses of maxillary sinus lateral wall bony window in an open window sinus lift procedure: literature review.

AIM: To review all of the possible uses for maxillary sinus lateral wall bony window in an open maxillary sinus lift procedure and to evaluate the influence of each method to the rate of sinus membrane perforations. METHODS: A systematic literature review was performed of randomized control studies in English identified in MEDLINE (PubMed) and Cochrane online databases, published between 2007.09.01 and 2017.09.01. Surgeries had to be performed in vivo, for patients over 18 years old. A study had to have at least 10 sinus lifting procedures, had to detail how the bony window was used and had to report the number of Schneiderian membrane perforations. RESULTS: 922 publications were found, out of which 68 were selected for qualitative assessment. 29 of them were selected for quantitative assessment. 4 distinct uses for bony window were found: bony window is elevated into the sinus cavity under the membrane; removed and discarded; repositioned to its original position after the surgery; used as a graft material for sinus lift. CONCLUSIONS: there is a statistically significant difference of sinus membrane perforations between different uses of the lateral bony window of an open sinus lift procedure. However, due to the lack of publications that investigate the effects of different bony window usage methods, clinical recommendations cannot be drawn from current data.

Implant-supported prosthesis treatment planning aspects of Kaunas city dentists and dental specialists.

OBJECTIVE: Rehabilitation of mastication using fixed or removable prosthesis on dental implants is a daily procedure in modern dentistry.The huge variety of diagnostic tools and methods, such as cone beam computed tomography or surgical guides help to avoid complications. A vast quantity of diagnostic tools and prosthesis require a tight communication between surgeons and prosthodontists in order to achieve better treatment plan. METHODS: The questionnaire was approved by LUHS Committee of Ethics. A questionnaire of 17 demographic and specialized questions was composed. A randomized survey of dentists and dental specialists was conducted in Kaunas. A statistical analysis was performed using χ2test and Student's T-test criteria. RESULTS: Most of correspondents believe that treatment plan should be created by the current dentist, regardless his/hers specialization. All correspondents performing dental implantation, use elevation of mucoperiosteal flap. The most common diagnostic tool among dentists and oral surgeons is panoramic x-ray. The most common diagnostic tools between prosthodontists are panoramic x-ray and analysis of dental stone castings. The most common complications among dentists and prosthodontists are improper adjustment of soft tissue and errors of dental technicians, among oral surgeons - improper adjustment of soft tissues and implant position. CONCLUSIONS: 1. The creation of treatment plan does not depend on specialization of dentist. 2. The elevation of mucoperiosteal flap is more common than non-flap procedure. 3. The most used diagnostic method is panoramic x-ray. 4. The most prevalent complications are improper adjustment of soft tissues and errors of dental technicians.