Time interval after radiotherapy and dental implant failure: systematic review of observational studies and meta-analysis.

BACKGROUND: Typically, dental implants are placed in irradiated bone after a delay that exceeds 6 months, but it is not known whether longer delays are beneficial. PURPOSE: The purpose of the study is to review the literature comparing the failure rate of dental implants placed in irradiated bone between 6 and 12 months and after 12 months from the cessation of radiotherapy. MATERIALS AND METHODS: Four electronic databases were searched for articles published until February 2013 without language restriction: Lilacs, Medline, Scopus, and the Cochrane Central Register of Controlled Trials. Two reviewers independently assessed the eligibility criteria and extracted data. Fixed effect meta-analysis was performed. RESULTS: Overall, 3,749 observational studies were identified. After the screening of titles and abstracts, 236 publications were selected, and 10 were included in the final analysis. The pooled relative risk (RR) of failure was RRpooled = 1.34 (95% confidence interval [CI]: 1.01-1.79), higher in individuals who had dental implants installed between 6 and 12 months after receiving radiotherapy. I(2) indicated nearly 21% heterogeneity (p = .25). Egger's test indicated no evidence of publication bias (p = .62); however, the removal of one study significantly affected the overall RR (RRpooled = 1.08, 95% CI: 0.77-1.52). CONCLUSIONS: Placing implants in bone within a period shorter than 12 months after radiotherapy may result in a higher risk of failure; however, additional evidence from clinical trials is needed to verify this risk.

Effect of surface roughness and low-level laser therapy on removal torque of implants placed in rat femurs.

The present study measured removal torque and bone-implant interface resistance of machined implants, acid-etched implants, or machined implants irradiated around the implant area with infrared low-level laser therapy (LLLT; 830 nm) immediately after surgery. There were statistically significant differences between Groups A (control) and B (rough surface) (P = .03). Implants with a rough surface seem to add resistance to the bone-implant interface compared with smooth titanium implants or implants treated with LLLT.

Surgical management of a projectile within the temporomandibular joint.

Facial gunshot wounds pose a challenge for head and neck surgeons as it is usually accompanied by significant soft and bone tissue loss and impairment of the stomatognathic system. This article reports the case of a patient who had sustained facial gunshot wound and had the projectile lodged at the upper disk space of the right-side temporomandibular joint, which caused mandible function impairment and pain. The projectile was surgically removed via endaural access, and the patient was later submitted to physiotherapy. After treatment, the function of the joint was reestablished, the pain disappeared, and the aesthetics results were considered excellent, with no sequels. The surgical removal of the projectile of the temporomandibular joint combined with the postsurgical physiotherapy showed to be an efficient treatment to the present case.

Calcium phosphate cement in orbital reconstructions.

Treatment of facial trauma sequelae is a complex and challenging process. There is still controversy over suitable materials for orbital wall reconstruction. This study evaluated calcium phosphate cement (CPC) implants manufactured by rapid prototyping in the repair of orbital wall defects secondary to trauma. Computed tomographic scans of 5 patients were used for surgery planning and production of CPC implants. Implants were used to restore orbital wall anatomy, ocular alignment, and facial contour. Benefits resulting from the use of implants, such as a reduced operating time, patient response to biomaterial implantation, biomaterial integrity and stability, and patient satisfaction with treatment, were analyzed qualitatively. Our results suggest that CPC is an effective and safe material for orbital reconstruction because of its biocompatibility and easy production and placement.

Evaluation of optical density of bone defects filled with calcium phosphate cement and bioactive glass in rats.

PURPOSE: To evaluate new bone formation, by the analysis of optical density, in rat femoral defects filled with calcium phosphate cement (CPC) and bioactive glass (BG). METHODS: Twenty-one rats were divided into three groups, Group I (CPC), Group II (BG), and Group III (control), and assessed after 7, 15, and 30 days. Three bone cavities were made in the left femur and filled with CPC, BG, and no material (control). Digital images were obtained and the results were subjected to statistical analysis of variance (ANOVA), complemented by the Friedman and Kruskal-Wallis nonparametric tests, with a significance level of 5%. RESULTS: Regarding optical density, Group I showed statistical values significantly higher than Group III and also higher, although not statistically significant, than Group II, in all observation periods. When Groups II and III were compared, Group II showed higher optical density values, without statistically significant differences, in all periods. CONCLUSION: The biomaterials analyzed showed higher optical density in relation to the control group in all observation periods, calcium phosphate cement being the best option in the repair of bone defects, but without statistically significant differences in relation to bioactive glass.

Camouflage treatment for class III malocclusion combined with traction of an impacted maxillary central incisor.

This case report describes the treatment of a patient with an unerupted maxillary left central incisor, class III malocclusion with crossbite of the maxillary posterior teeth and lateral open bite. Treatment consisted of rapid maxillary expansion followed by anterior space opening, maxillary protraction and traction of the unerupted teeth with a light force system. Favorable results were obtained in terms of correcting incisor position and class III malocclusion. The results achieved remained stable throughout a 4-year retention period.