Effects of Orthognathic Surgery on Voice Characteristics.

PURPOSE: Orthognathic surgery not only corrects dentofacial deformities but also affects some vital structures involving voice production. The primary aim of this study was to analyze the effects of bimaxillary orthognathic surgery on voice characteristics of patients with class II and III skeletal deformities; the second aim was to evaluate possible associations among acoustic parameters, pharyngeal airway, and skeletal changes after surgery. MATERIALS AND METHODS: Using a prospective cohort study design, we enrolled a sample of patients who underwent bimaxillary orthognathic surgery in the university hospital between January 2018 and January 2019. Voice records and cone-beam computed tomography (CBCT) scans of the patients were acquired before surgery and 6 months after surgery. Pharyngeal airway volume, minimum cross-sectional area, hyoid bone position, and skeletal movements of the maxilla and mandible were assessed with Dolphin Imaging software using CBCT data as predictor variables. Acoustic analysis of voice samples (vowel/a/) were performed with Praat software as outcome variables. The within-group and between-group differences in data were analyzed using paired-sample and independent-sample t tests. The degree of relationship between voice and CBCT parameters was assessed using Pearson correlation and multiple regression analysis. RESULTS: The study sample comprised 33 patients; 14 patients had class II skeletal deformity and 19 patients had class III skeletal deformity. Orthognathic surgery in both patients with class II and III skeletal deformities resulted in significant changes in all the voice parameters (All P < .05). Only patients with class II skeletal deformity showed significant changes in airway parameters (increase; all P < .001) and hyoid bone positions (anterosuperior movement; P = .001 and P = .008, respectively). Multiple regression analysis showed that some specific structural changes significantly affected some specific acoustic parameters. CONCLUSIONS: Bimaxillary orthognathic surgery significantly changed the acoustic parameters of voice in patients with class II and III skeletal deformities. Some of the structural changes were significantly associated with some of the acoustic parameters.

Effectiveness of kinesio taping on postoperative morbidity after impacted mandibular third molar surgery: a prospective, randomized, placebo-controlled clinical study.

Objective Our study seeks to investigate the effectiveness of kinesio taping (KT) on postoperative morbidity compared to placebo and control groups after impacted third molar surgery. Methodology Sixty patients with impacted mandibular third molar were included in this prospective, randomized, placebo-controlled clinical study. After surgical extraction of the impacted tooth, patients were allocated into three groups (20 patients each): group 1 received KT (kinesio), group 2 received placebo taping (placebo), and group 3 received no taping (control). The groups were compared regarding facial swelling, pain and trismus. Swelling was evaluated using a tape measuring method. Pain was assessed by a visual analog scale and the number of analgesic tablets taken. Trismus was determined by measuring maximum mouth opening. Results In the KT group, all parameters reduced significantly on 2nd and 4th postoperative days compared to other groups; however, placebo and control groups revealed comparable outcomes. On 7th day, all groups showed comparable results. Conclusions The KT application is an effective method for reducing morbidity after impacted mandibular third molar surgery. However, placebo taping is not as effective as proper taping. Placebo taping shows similar results compared to no taping regarding facial swelling percentage, pain and trismus.

Effect of Botulinum Toxin Type A on Mandibular Fracture Healing: An Experimental Study in Rabbits.

PURPOSE: The effect of botulinum toxin type A (BTX-A) on fracture healing of the long bones is controversial, and no controlled clinical or experimental study has investigated the effect of BTX-A on mandibular fractures. The purpose of this study was to investigate whether BTX-A injection into the masseter muscles affects bone healing by reducing the displacing forces in an unfavorable mandibular fracture model. MATERIALS AND METHODS: Forty-eight male New Zealand white rabbits were used. Ten units of BTX-A was injected into each masseter muscle in the animals in the BTX-A group, whereas saline solution was injected in the animals in the control group. A unilateral osteotomy and fixation with a microplate were performed. Bone healing was evaluated by radiodensitometric, biomechanical, histologic, and histomorphometric methods after 21 days. RESULTS: The mean bone mineral density in the fracture area was significantly higher in the BTX-A group (P = .038). The mean failure load and bending modulus values were significantly higher in the BTX-A group than in the control group (P = .032 and P = .005, respectively). The mean histologic bone healing scores, bone volume-total volume values, and trabecular diameter values were significantly higher in the BTX-A group than in the control group (P = .001, P = .001, and P = .026, respectively). CONCLUSIONS: BTX-A application into the masseter muscles improves bone healing of a unilateral mandibular fracture in rabbits.

The relationship between neck pain and cervical alignment in patients with temporomandibular disorders.

Objective: To elucidate the impact of neck pain on cervical alignment in patients with TMDs. Method: Patients diagnosed with TMDs between November 2013 and November 2015 were included. All subjects underwent lateral cervical X-ray evaluation and completed the RDC/TMD Axis II Biobehavioral Questionnaire for TMDs. Patients with neck pain also completed the Neck Pain & Disability Scale (NPDS). Cervical lordosis angle was measured according to C2-C7 Cobb's method. Results: The mean cervical lordosis angle of the whole group (n = 60) revealed hypolordosis (10.9 ± 12.7°). Cervical lordosis angle did not differ between patients with (n = 28) and without (n = 32) neck pain (12.2 ± 12.8° versus 9.8 ± 12.7°, respectively; p = 0.46). TMD-related variables were not correlated with cervical alignment but were moderately correlated with NPDS score, with the exception of TMD-associated disability. Conclusion: Patients with TMDs have hypolordotic cervical malalignment (tendency toward kyphosis) regardless of neck pain.

Effectiveness of kinesio taping on postoperative morbidity after impacted mandibular third molar surgery: a prospective, randomized, placebo-controlled clinical study

Abstract Objective Our study seeks to investigate the effectiveness of kinesio taping (KT) on postoperative morbidity compared to placebo and control groups after impacted third molar surgery. Methodology Sixty patients with impacted mandibular third molar were included in this prospective, randomized, placebo-controlled clinical study. After surgical extraction of the impacted tooth, patients were allocated into three groups (20 patients each): group 1 received KT (kinesio), group 2 received placebo taping (placebo), and group 3 received no taping (control). The groups were compared regarding facial swelling, pain and trismus. Swelling was evaluated using a tape measuring method. Pain was assessed by a visual analog scale and the number of analgesic tablets taken. Trismus was determined by measuring maximum mouth opening. Results In the KT group, all parameters reduced significantly on 2nd and 4th postoperative days compared to other groups; however, placebo and control groups revealed comparable outcomes. On 7th day, all groups showed comparable results. Conclusions The KT application is an effective method for reducing morbidity after impacted mandibular third molar surgery. However, placebo taping is not as effective as proper taping. Placebo taping shows similar results compared to no taping regarding facial swelling percentage, pain and trismus.

Effects of size and insertion angle of orthodontic mini-implants on skeletal anchorage.

INTRODUCTION: The primary aim of this in vitro study was to compare the insertion torque (IT) and anchorage force (AF) values of 4 different sizes of orthodontic mini-implants with 2 different angles. The second aim was to evaluate the relationship between IT and AF values under different diameter, length, and insertion angle variables. METHODS: A total of 160 mini-implants, including 20 implants in each group, with 4 different sizes (1.6 × 8 mm, 1.6 × 10 mm, 2.0 × 8 mm, and 2.0 × 10 mm) at 2 different angles (70° and 90°), were inserted into bovine iliac bone segments. The IT and AF values leading to 1.5 mm deflection were compared. The correlations between IT and AF values under different variables were also analyzed. RESULTS: The mini-implants with greater diameter and length showed greater IT and AF values (P <0.05). The IT and AF values of mini-implants inserted at 70° angle were significantly greater than those of mini-implants inserted at 90° angle (P <0.001). Significant correlations were found between IT and AF values in all variables. CONCLUSIONS: The diameter, length, and insertion angle of orthodontic mini-implants have significant effects on IT and AF values. Insertion angle and diameter of mini-implants are more effective than implant length on skeletal anchorage. Significant correlations are present between IT and AF values of mini-implants regardless of their diameters, lengths, and insertion angles.

Comparison of autogenous and allograft bone rings in surgically created vertical bone defects around implants in a sheep model.

OBJECTIVES: The aim of this study was to compare autogenous and allograft bone rings in surgically created vertical bone defects. MATERIAL AND METHODS: Four male, 1-year-old sheep were used in this study. In each sheep, eight vertical bone defects 7 mm in diameter were created using trephine drill in the iliac wing. Autogenous and allograft bone rings 5 mm in height and 7 mm in diameter were used for vertical augmentation around implants. The study consisted of four groups according to the bone ring type and amount of vertical augmentation, autogenous 2 mm, allograft 2 mm, autogenous 4 mm, and allograft 4 mm. Two of the animals were sacrificed after 4 months, and the remaining two animals were sacrificed after 8 months. Undecalcified sections were prepared from harvested samples. Histological assessment and histomorphometric analysis were performed. RESULTS: Autogenous 2 mm group showed higher values than allograft 2 mm group, and autogenous 4 mm group showed higher values than allograft 4 mm group in terms of bone area and bone-to-implant contact (BIC) after 4 months. However, allograft 2 mm group showed higher bone area and BIC values than autogenous 2 mm group after 8 months. Also, autogenous 4 mm and allograft 4 mm groups showed comparable results after 8 months. Allograft 2 mm and allograft 4 mm groups showed higher bone area and BIC values at 8 months compared with 4 months. CONCLUSIONS: Allograft bone ring looks promising in augmentation of surgically created vertical bone defects around implants after 8 months of healing.

Effects of hyperbaric oxygen treatment on implant osseointegration in experimental diabetes mellitus.

OBJECTIVE: To evaluate whether hyperbaric oxygen (HBO) treatment has a favorable effect on implant osseointegration in diabetic rabbits. MATERIAL AND METHODS: An experimental diabetes model was induced in 32 New Zealand rabbits through IV injection of alloxan. After the state of diabetes had been confirmed, one dental implant was placed in the metaphysical region of each animal's tibia. After the implants' placements, the animals were divided into two groups. Half of the animals underwent HBO treatment, while the other group did not receive HBO treatment and served as the control group. The animals were euthanized at the 4th and 8th weeks. The osseointegration of the implants were compared by histomorphometry and resonance frequency analysis (RFA). RESULTS: The Bone Implant Contact (BIC) values were significantly higher in the HBO group than in the control group at the 4th week. There was no difference in the BIC values between the groups at the 8th week. There was no significant difference in the RFA scores between the groups both at the 4th and 8th weeks after the operation. CONCLUSION: Histomorphometry findings suggest that HBO has positive effect on implant osseointegration in the early healing period in diabetic rabbits. However, implant stability is not affected by HBO treatment.

Effects of low-level laser therapy on soft and hard tissue healing after endodontic surgery.

The aim of this prospective study was to examine possible benefits of low-level laser therapy (LLLT) on soft and hard tissue healing after endodontic surgery. Seventy-six endo-surgery cases on maxillary incisors were included. The patients were assigned randomly into control and laser groups. In the laser group, gallium-aluminum-arsenide (GaAlAs) diode laser irradiation (810 nm, 129 mW, 3.87 J/cm2) was performed immediately after surgery and daily for postoperative 7 days from buccal and palatal surfaces (5 min for each side). In the control group, patients were not subjected laser therapy. The patients were compared in terms of pain, clinical and radiological findings, and life quality indexes [Oral Health Impact Profile-14 (OHIP-14) and General Oral Health Assessment Index (GOHAI)]. Seventy-one patients completed the study (n = 37 for control group, n = 34 for laser group). The laser group showed better results in edema, wound healing, and the number of analgesic tablets used on the 1st, 3rd, and 7th postoperative days. Significant reduction in ecchymoses was observed in the laser group on the postop 3rd and 7th days. The patients had significantly lower pain on the 1st and 3rd postop days in laser group. The laser group showed significantly better results in OHIP-14 and GOHA indexes on postop days 1 and 3. The laser group showed significantly favorable results in terms of bone density, defect volume and area, and periapical index in the postop 3rd month. This study concluded that LLLT improved soft and hard tissue healing after endodontic surgery and also showed favorable effects on pain and life quality of patients especially in the early phase of healing period.

To what extent does hyaluronic acid affect healing of xenografts? A histomorphometric study in a rabbit model.

Among the many graft materials that have been used for the treatment of bone defects in oral and maxillofacial regions is xenograft. To improve osteoconductive effects of xenografts, they have been combined with various biocompatible materials, such as hyaluronic acid and bone morphogenetic protein. To determine bone-healing capacity of high molecular weight hyaluronic acid (HA) combined with xenograft in rabbit calvarial bone defects. Ten adult male New Zealand rabbits (mean weight 3 kg) were included in the study. Three 6-mm-diameter bicortical cranial defects were created on calvarial bone of all rabbits. These defects were filled as follows: a) xenograft; b) HA+xenograft; c) autograft. One month after the first operation, rabbits were sacrificed. Specimens were evaluated histomorphometrically. Considering multiple comparisons, differences regarding new bone were statistically significant between all groups (p<0.05). The volume of residual graft was significantly decreased in HA group compared to xenograft group (p=0.035). Marrow space, trabecular thickness (TbTh), trabecular width (TbWi), trabecular separation (TbSp), and number of node: number of terminus (NNd:NTm) in the autograft group were significantly better than xenograft and HA groups (p<0.05). However, regarding marrow space, TbTh, TbWi, TbSp, and NNd:NTm values, xenograft and HA groups showed similar results and the difference were not significant (p>0.05). These results support that high molecular weight hyaluronic acid could contribute to the healing of xenograft by improving the percentage of new bone formation and reducing the percentage of residual graft. However, HA did not significantly affect the quality of newly formed bone assessed by microarchitectural parameters.

Short Implants Versus Standard Implants: Midterm Outcomes of a Clinical Study.

INTRODUCTION: The aim of this study was to evaluate the midterm survival rate, marginal bone resorption (MBR), and stability of short implants and to compare the results with standard length implants. MATERIALS AND METHODS: A total of 38 patients were included. In total, 147 implants (Nucleoss Implants, Izmir, Turkey) were placed (86 short implants and 61 standard implants). Cement-retained metal-ceramic prostheses were fabricated. MBR was evaluated on periapical radiographs taken at implant placement, at the time of crown insertion and annually thereafter. The stability of the implants was evaluated by resonance frequency analysis. RESULTS: The 3- and 5-year cumulative survival rates for standard implants was 98.4% and for short implants was 96.5% (P = 0.644). The MBR of the short implants was significantly lower than that of the standard implants after 1, 2, and 3 years of loading (P < 0.05). No significant differences were found between 2 groups after 6 and 12 months of loading in terms of implant stability (implant stability quotient values) (P > 0.05). CONCLUSION: Within the limits of this study, it is concluded that short implants achieved similar results as standard implants after 3 to 5 years of loading.

Relationship between voice function and skeletal effects of rapid maxillary expansion.

OBJECTIVE: To evaluate the effects of rapid maxillary expansion (RME) on the vocal quality, maxillary central incisors, midpalatal suture, and nasal cavity in patients with maxillary crossbite. MATERIALS AND METHODS: Coronal CT scans of 30 subjects (14 boys, 16 girls; mean age, 12.01 ± 0.75) were taken before RME (T0), and at the end of the expansion phase (T1). Voice samples of all patients were recorded with a high-quality condenser microphone (RODE NT2-A) on a desktop computer at T0 and T1. Statistical analyses were performed using a paired-sample t-test. The degree of association between the changes in the voice parameters and nasal width was assessed with Pearson's correlation. RESULTS: RME treatment produced a significant increase in the transverse dimensions of the midpalatal suture and nasal cavity between T0 and T1 ( P < .05). The maximum F0 and jitter (%) results were shown to decrease statistically significantly from T0 to T1 ( P < .001 and P = .042, respectively). Between T0 and T1, shimmer (%) and shimmer (dB) exhibited statistically significant increases ( P = .037 and P = .019, respectively). CONCLUSIONS: After RME therapy, voice quality differences were found to be associated with increases in nasal width.

To what extent does hyaluronic acid affect healing of xenografts? A histomorphometric study in a rabbit model

ABSTRACT Among the many graft materials that have been used for the treatment of bone defects in oral and maxillofacial regions is xenograft. To improve osteoconductive effects of xenografts, they have been combined with various biocompatible materials, such as hyaluronic acid and bone morphogenetic protein. Objective: To determine bone-healing capacity of high molecular weight hyaluronic acid (HA) combined with xenograft in rabbit calvarial bone defects. Material and methods: Ten adult male New Zealand rabbits (mean weight 3 kg) were included in the study. Three 6-mm-diameter bicortical cranial defects were created on calvarial bone of all rabbits. These defects were filled as follows: a) xenograft; b) HA+xenograft; c) autograft. One month after the first operation, rabbits were sacrificed. Specimens were evaluated histomorphometrically. Results: Considering multiple comparisons, differences regarding new bone were statistically significant between all groups (p<0.05). The volume of residual graft was significantly decreased in HA group compared to xenograft group (p=0.035). Marrow space, trabecular thickness (TbTh), trabecular width (TbWi), trabecular separation (TbSp), and number of node: number of terminus (NNd:NTm) in the autograft group were significantly better than xenograft and HA groups (p<0.05). However, regarding marrow space, TbTh, TbWi, TbSp, and NNd:NTm values, xenograft and HA groups showed similar results and the difference were not significant (p>0.05). Conclusion: These results support that high molecular weight hyaluronic acid could contribute to the healing of xenograft by improving the percentage of new bone formation and reducing the percentage of residual graft. However, HA did not significantly affect the quality of newly formed bone assessed by microarchitectural parameters.

Effects of different loading protocols on the secondary stability and peri-implant bone density of the single implants in the posterior maxilla.

BACKGROUND: Immediate or early loading of dental implants becomes a clinically feasible concept. PURPOSE: The aim was to evaluate the effects of different loading protocols (immediate, early, and delayed) on secondary stability and peri-implant bone density of single implants in the posterior maxilla. MATERIALS AND METHODS: Thirty-nine implants (Dentium, South-Korea) were placed in 39 patients. After placement, implant stability values (ISQ) and baseline peri-implant bone density values derived from cone-beam computed tomography were recorded. Thirteen implants were included randomly in each loading groups. The secondary ISQ values were recorded during follow-up visits. Peri-implant bone density values were measured 1 year after placement again. Data was statistically analyzed. RESULTS: Immediate-loaded group showed the lowest ISQ values, 1 month after placement. During the next follow-up visits, delayed-loaded group showed the lowest ISQ values while other groups showed comparable results. Early loading increased the peri-implant bone density greater than the other groups. CONCLUSIONS: The peri-implant bone of early-loaded implants was significantly denser than that of immediate- and delayed-loaded implants, 1 year after placement. Density increment can be judged as the radiological findings of loaded-bone, which may also reduce the need for histomorphometric analysis of human biopsy to evaluate the bone reaction around the implants.

Vertical Bone Augmentation Using Bone Marrow-Derived Stem Cells: An In Vivo Study in the Rabbit Calvaria.

PURPOSE: To evaluate the bone regeneration capacity of bone marrow-derived stem cells (BMSCs) in vertical guided augmentation of bone tissue. MATERIAL AND METHODS: The calvaria of 20 rabbits were vertically augmented with autogenous bone graft (ABG); collagen/beta-tricalcium phosphate (ß-TCP) linked scaffold transplanted with 15 × 10 BMSCs; or scaffold alone (control). The augmentation materials were covered with stainless steel domes. BMSCs were isolated with Ficoll-Paque technique and applied directly without in vitro expansion. The newly formed bone was evaluated using radiodensitometric, histomorphometric, histological, and micro-computed tomographic (micro-CT) analyses after a 12-week healing period. The data excluding micro-CT assessments were compared statistically. RESULTS: Radiodensitometric and bone volume parameters demonstrated increased bone formation in both BMSC group and ABG group compared with control group (P < 0.01), but difference between the BMSC and ABG groups was not significant (P > 0.05). The mean histological scores for the BMSC, ABG, and control groups were 7.44 ± 1.03, 8.44 ± 0.81, and 6.00 ± 1.10, respectively, indicating significant difference among the groups (P < 0.05). CONCLUSION: BMSCs delivered with a collagen/ß-TCP linked scaffold can provide improved new bone formation that is comparable with autogenous bone block graft through vertical guided bone regeneration technique.

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws.

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a severe bone disease for which the pathogenetic mechanisms and risk factors are not fully understood. The present study evaluated the data of 652 patients with bone metastasis that had undergone treatment with biphosphonates. Subsequently, 24 patients with BRONJ and 20 control patients without BRONJ that were treated with zoledronic acid were enrolled. It was found that BRONJ occurred in 3.6% of patients. The mean age and the administration of dental treatment were found to be significantly associated with BRONJ development (P=0.049 and P=0.013, respectively). The cumulative dose median in the BRONJ group was found to be significantly higher compared with the cumulative dose average in the control group (P=0.037). In addition, at the time of BRONJ development, improvement in the disease was determined to be better in the BRONJ group than in the control group (P=0.031). The present study determined that age, the existence of dental extraction and the cumulative dose of zoledronate were all important risk factors in BRONJ development.

Effects of glucosamine-chondroitin combination on synovial fluid IL-1beta, IL-6, TNF-alfa and PGE2 levels in internal derangements of temporomandibular joint

BACKGROUND: The aim of the present study was to evaluate the effects of glucosamine-chondroitin sulphate combination on internal derangements of temporomandibular joint in clinical and biochemical manners. MATERIAL AND METHODS: This randomized clinical study included 31 cases reporting joint tenderness, in which disc displacement was detected on MR imaging. In all patients, synovial fluid sampling was performed under local anesthesia. In the study group, the patients were prescribed a combination of 1500 mg glucosamine and 1200 mg chondroitin sulphate, while patients in the control group were only prescribed 50 mg tramadol HCl (twice daily) for pain control. After 8 weeks, synovial fluid sampling was repeated in the same manner. The levels of pain, maximum mouth opening (MMO), synovial fluid IL-1ß, IL-6, TNF-alfa and PGE2 measured before and after pharmacological intervention were compared. RESULTS: The reduction in pain levels was significant in both groups. There was no significant difference between two groups in terms of pain reduction. The improvement in MMO was significant in the study group but it was not in the control group. The MMO improvement was significantly higher in the study group compared to the control group. In the study group, significant decrease was observed in PGE2 level, while the decreases in IL-1beta, IL-6 and TNF-alfa levels were not significant. In the control group, no significant decrease was observed in any of the inflammatory cytokines after 8 weeks, moreover IL-1ß and IL-6 levels were increased. Alterations of IL-1ß and IL-6 levels were significant in study group while TNF-alfa and PGE2 levels were not, compared to control group. CONCLUSIONS: In conclusion, these results might suggest that glucosamine-chondroitin combination significantly increases the MMO and decreases the synovial fluid IL1beta and IL6 levels in internal derangements of TMJ compared to tramadol. The modifications of synovial fluid TNF-α and PGE2 levels do not reach statistical significance. This combination also provides efficient pain relief in similar level with tramadol, a narcotic analgesic

Effects of glucosamine-chondroitin combination on synovial fluid IL-1ß, IL-6, TNF-α and PGE2 levels in internal derangements of temporomandibular joint.

BACKGROUND: The aim of the present study was to evaluate the effects of glucosamine-chondroitin sulphate combination on internal derangements of temporomandibular joint in clinical and biochemical manners. MATERIAL AND METHODS: This randomized clinical study included 31 cases reporting joint tenderness, in which disc displacement was detected on MR imaging. In all patients, synovial fluid sampling was performed under local anesthesia. In the study group, the patients were prescribed a combination of 1500 mg glucosamine and 1200 mg chondroitin sulphate, while patients in the control group were only prescribed 50 mg tramadol HCl (twice daily) for pain control. After 8 weeks, synovial fluid sampling was repeated in the same manner. The levels of pain, maximum mouth opening (MMO), synovial fluid IL-1ß, IL-6, TNF-α and PGE2 measured before and after pharmacological intervention were compared. RESULTS: The reduction in pain levels was significant in both groups. There was no significant difference between two groups in terms of pain reduction. The improvement in MMO was significant in the study group but it was not in the control group. The MMO improvement was significantly higher in the study group compared to the control group. In the study group, significant decrease was observed in PGE2 level, while the decreases in IL-1ß, IL-6 and TNF-α levels were not significant. In the control group, no significant decrease was observed in any of the inflammatory cytokines after 8 weeks, moreover IL-1ß and IL-6 levels were increased. Alterations of IL-1ß and IL-6 levels were significant in study group while TNF-α and PGE2 levels were not, compared to control group. CONCLUSIONS: In conclusion, these results might suggest that glucosamine-chondroitin combination significantly increases the MMO and decreases the synovial fluid IL1ß and IL6 levels in internal derangements of TMJ compared to tramadol. The modifications of synovial fluid TNF-α and PGE2 levels do not reach statistical significance. This combination also provides efficient pain relief in similar level with tramadol, a narcotic analgesic.

A clinical prospective study on alveolar bone augmentation and dental implant success in patients with type 2 diabetes.

OBJECTIVES: The objective of this prospective, controlled clinical study was to determine the outcomes of dental implant therapy with staged guided bone regeneration procedures in patients with type 2 diabetes. PATIENTS AND METHODS: Twenty-four patients were included in the study. Half of the patients were diagnosed with type 2 diabetes mellitus (group 1) while the other half (group 2) of the patients consisted of patients without diabetes. The edentulous maxillary anterior/premolar regions with sufficient vertical height but inadequate horizontal width were treated with staged guided bone regeneration technique and with one or two implant-supported fixed restorations. The patients were followed up at least for 12 months. The parameters that were evaluated were radiographic evaluations on CBCT images and periapical radiographs, histomorphometric analysis, resonance frequency analysis (RFA) and wound-healing parameters. The data were analyzed statistically. RESULTS: A total of 43 implants were placed in 24 patients (22 implants in group 1 and 21 implants in group 2). The survival rates of implants were 100% for both groups. The success rate of implants was 95% for group 1 and 100% for group 2. None of the parameters including CBCT findings, RFA values, success rates and wound-healing scores showed a significant difference between the two groups. CONCLUSION: Staged guided bone regeneration is a feasible augmentation procedure for the treatment of horizontal bone deficiencies of the maxillary anterior/premolar regions in well-controlled type 2 diabetic patients.