Experimental study on penetration of dental implants into the maxillary sinus at different depths.

OBJECTIVE: The purpose of this study was to investigate the effect of the dental implant penetration into the maxillary sinus cavity in different depths on implant and sinus health in a dog model. MATERIALS AND METHODS: The study sample included eight titanium dental implant placed in four female dogs immediately after extraction of the first maxillary molar in the palatal socket and assigned into four groups according to the protruding of implant tips (control group A = 0 mm, and study groups B, C, and D with protrusion of 1, 2, and 3 mm, respectively). The bone blocks of the implants were harvested 5 months postoperatively and evaluated by cone beam computed tomography (CBCT) and histological analysis. RESULTS: The whole groups showed no signs of inflammation during the 5-month period of the study. The tips of the implants in group B with penetrating depths of 1 mm were found to be fully covered with newly formed bone. The tips of the implants in group C with penetrating depths of 2 mm were exposed in the sinus cavity and showed partially new bone coverage, while depths of 3 mm in group D were found to have no bone formation and the dental implant fixture sites were communicated with the sinus cavity. No significant differences were found among the groups regarding implant stability. CONCLUSION: Despite the protrusion extents, penetration of dental implant into the maxillary sinus with membrane perforation does not compromise the sinus health and the implant in canine.

Comparison Between Physics and Conventional Forceps in Simple Dental Extraction.

BACKGROUND: Atraumatic dental extraction preserves bone, gingival architecture, and allows for the option of future or immediate dental implant placement. A number of tools and techniques have been proposed for minimally invasive tooth removal such as physics forceps. The biomechanical design of physics forceps decreases the incidence of root fracture, and maintains the buccal bone plate, which is essential for the proper healing of an immediately placed dental implant. PURPOSE: This study was conducted to evaluate the efficacy of physics forceps versus conventional forceps in simple dental extraction. PATIENTS AND METHODS: 200 adult patients seeking simple dental extraction were selected from the Outpatient Clinic in the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Mansoura University, Egypt. The selected patients were randomly allocated into two groups: group I: included 100 patients, in this group extraction was done using physics forceps, and group II: included 100 patients, in this group extraction was done using conventional forceps. RESULTS: In physics forceps group: crown fracture occurred in three cases (3 %), buccal bone fracture occurred in three cases (3 %), and root fracture occurred in 14 roots (8.5 %), while in conventional forceps group: crown fracture occurred in 10 cases (10 %), buccal bone fracture occurred in seven cases (7 %), and root fracture occurred in 27 roots (16.6 %). CONCLUSION: Physics forceps are innovative extraction instruments. By using them, it is possible to perform difficult extractions, with predictable results, and without need to reflect a flap. Using physics forceps decreases the incidence of crown, root, and buccal bone plate fractures, in comparison to the conventional forceps.

Assessment of articular disc displacement of temporomandibular joint with ultrasound.

PURPOSE: To assess pattern of articular disc displacement in patients with internal derangement (ID) of temporomandibular joint (TMJ) with ultrasound. MATERIALS AND METHODS: Prospective study was conducted upon 40 TMJ of 20 patients (3 male, 17 female with mean age of 26.1 years) with ID of TMJ. They underwent high-resolution ultrasound and MR imaging of TMJ. The MR images were used as the gold standard for calculating sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of ultrasound for diagnosis of anterior or sideway displacement of the disc. RESULTS: The anterior displaced disc was seen in 26 joints at MR and 22 joints at ultrasound. The diagnostic efficacy of ultrasound for anterior displacement has sensitivity of 79.3 %, specificity of 72.7 %, accuracy of 77.5 %, PPV of 88.5 %, NPV of 57.1 %, PLR of 2.9 and NLR of 0.34. The sideway displacement of disc was seen in four joints at MR and three joints at ultrasound. The diagnostic efficacy of ultrasound for sideway displacement has a sensitivity of 75 %, specificity of 63.6 %, accuracy of 66.7 %, PPV of 42.8, NPV of 87.5 %, PLR of 2.06, and NLR of 0.39. CONCLUSION: We concluded that ultrasound is a non-invasive imaging modality used for assessment of anterior and sideway displacement of the articular disc in patients with ID of TMJ.

Closure of oroantral fistula using titanium plate with transalveolar wiring.

BACKGROUND: Alloplastic materials such as tantalum, gold plates and foils, hydroxyapatite blocks have been used for closure of oroantral fistula (OAF). However, these materials are not widely accepted in routine surgical closure of OAF due to cost, difficult handling, increased rate of infection, and exfoliation. PURPOSE: To overcome the above drawbacks this study aimed to use titanium plates (0.3 mm) with transalveolar wiring fixation for closure of OAF. PATIENTS AND METHODS: Ten patients with OAFs who consented to undergo this trial were selected and treated under an outpatient basis in the Oral Surgery Department, Faculty of Dentistry, Mansoura University, Egypt. RESULTS: All OAFs were successfully treated with no eventful complications. CONCLUSION: This study concludes that titanium plates with transalveolar wiring fixation is an excellent technique for closure of OAF. The high success rate with this technique warrants its use for closure of OAF.