Accuracy of computer-guided implant surgery in partially edentulous patients: a prospective observational study.

PURPOSE: This study aims to evaluate the amount of distortion using computer-guided implant surgery with 3D printed surgical guides in limited edentulous spaces. MATERIALS AND METHODS: 25 bone level self-tapping implants (Straumann® BL and BLT) were randomly inserted in either distal or intercalary posterior mandibular edentulism using a fully digital protocol and 3D printed surgical guides. Amount of inaccuracy was evaluated after superimposing the 3 coordinates of virtually planned and final implant images, which were obtained using intra-oral scans and scan bodies. Four evaluation parameters were considered: origo-displacement, error depth, apical displacement and angle between the planned and the placed implant. RESULTS: The average of distortion was 0.71 mm for the origo-displacement, 0.36 mm for the error depth, 0.52 mm for the horizontal displacement and 3.34º for the error angle. CONCLUSION: The major reason of exclusion was CBCT artifacts. Results of this study were aligned with the results of previous studies concerning partially edentulous spaces. CAD/CAM manufacturing process did not result in significant distortion whilst the biggest part of distortions originated from the surgical process. The learning curve in computer-guided implant surgery presented an important source of inaccuracy.

A New Concept of Horizontal Bone Augmentation Using Collagen Bovine Bone Blocks Without Membrane at Implant Placement: A Preliminary Study.

Purpose: A buccal bone thickness (BBT) of at least 1.8-2 mm is necessary to ensure long-term implant stability, and a bone grafting procedure is commonly needed to restore this BBT. This study aims to prove the effectiveness of a novel bone augmentation technique in which minero-organic bone substitutes are solely used to restore adequate BBT, excluding the need for coverage membranes. Methods: Fifty partially edentulous patients having a residual bone width ranging between 5 and 6 mm were enrolled in this study. The horizontal buccal defects were grafted simultaneously at implant placement. Minero-organic collagen bovine bone blocks (CBBB) were placed on the outer side of the buccal bone wall, and adapted to the defect morphology through slow compressive movements. The grafted sites were not covered with any type of membrane nor stabilized with fixation pins. Cone-beam computed tomography scans were obtained pre-operatively, immediately post-surgery, and four months later. Scans were superimposed on the ITK-Snap software to measure the amount of bone gain and assess the percentage of CBBB resorption. Measurements were effectuated at four different levels apically to crestal level. Results: Radiographic findings showed BBT increase and CBBB resorption in all cases, four months post-grafting. A mean horizontal bone gain of 1.39 mm was calculated at a crestal level. Conclusion: Based on these findings, it appears that this novel and user-friendly bone grafting technique can achieve positive outcomes from both clinical and radiographic perspectives.

Comparison of Osseointegration in Novel Laser-Textured and SLA Implants.

Background: Osseointegration is defined as the direct structural and functional connection between neo-formed bone and dental implants. Among the parameters suggested to predominantly influencing the establishment of a successful osseointegration is the quality of the implant surface, which may enhance the strength and speed of this biomechanical process. Objective: The purpose of this study was to evaluate the ability of a novel laser-treated surface, compared to sandblasted, large-grit, acid-etched (SLA) surfaces, to enhance and accelerate implant integration in delayed implant placement.Methods: Thirty patients with two missing posterior teeth were enrolled in this study. Each patient received, at a randomly allocated site, an implant with a conventional SLA surface, and at a second site, an implant with laser-textured surface. A total of 60 tissue-level implants were subsequently placed. Implant stability (ISQ) was measured using resonance frequency analysis (RFA). ISQ was assessed at baseline (T0), 8 weeks (T1), and 12 weeks (T2) following implant placement. Results: There was a statistical difference in implant stability between laser-textured and SLA group at 12 weeks postoperatively. Implant stabilization showed a successful osseointegration with both surface types. Conclusion: Both laser and SLA surface treatments had positive impacts on implant stabilization following delayed placement. Laser-treated surfaces presented higher values of osseointegration at 3 months postoperatively.

Arsenic Trioxide-Induced Mandibular Osteomyelitis Associated with Mycotic Infestation: A Case Report.

Arsenic trioxide used in endodontic treatments has been shown to cause severe damages to surrounding bone and periodontal tissues. This report describes a case of alveolar osteomyelitis triggered by arsenic trioxide pulp devitalization and associated with mycotic infestation. Following clinical and radiological examinations, the concerned tooth was extracted, bone sequestrum was removed and granulation tissue was debrided. Histopathological biopsy examination, stained with hematoxylin/eosin, Grocott's silver methenamine and periodic acid-Schiff, confirmed the diagnosis of chemical osteomyelitis associated with fungal infestation. Six months postoperatively, normal bone healing was observed.

Inherited connective tissue diseases highlight macromolecular network interdependences in skin extracellular matrix: a histomorphometric study.

Mutation of just a single extracellular matrix protein, a receptor or enzyme involved in connective tissue metabolism is sufficient to cause systemic pathologies and failure of tissues that are subjected to strong mechanical stresses. Skin histological and computerized image analyses can provide a good qualitative and quantitative indication of these inherited connective tissue diseases. In this study, skin biopsies from young (10 to 25 years) and middle-aged patients (26 to 50 years) suffering from Ehlers-Danlos syndromes (EDS), Marfan syndrome (MS) or pseudoxanthoma elasticum (PXE) were studied after specific staining of both the collagen and elastic networks. Findings from the histomorphometric analyses conducted on skin sections of the patients with EDS, MS and PXE were compared to skin sections of healthy subjects from the same age groups. Our results show that both the collagen and the elastic networks were affected in all the studied pathological cases, but that the adverse changes to the elastic network in older patients were distinct from the physiological changes observed during aging process for healthy subjects. This degenerative process may be explained by an added phenomenon involving a general connective tissue proteolysis.

Characterisation of Zinc-bearing sulphate phases formed during the synthesis of phosphoric acid and Zinc removal by the ligands of Opuntia ficus-indica.

Phosphogypsum (PG) is a solid waste generated from phosphate fertilisers industries. It represents a serious threat to the aquatic and terrestrial environment because of its acidity and its high content in heavy metals and radionuclides. The aim of this work is to describe the formation of PG during the synthesis of the phosphoric acid, the entrapment of Zinc (Zn) in PG and its lixiviation in presence of a natural organic matter extracted as powder from the cladodes of Opuntia ficus-indica (OFI) using physical and chemical characterisation techniques such as FTIR, XRD, SEM-EDX, laser diffraction, and AAS. The formation of PG mainly occurs in the pH range between 4.6 and 3 and it accompanies the transformation of H2(PO4)- into phosphoric acid H3PO4. The maximal Zn incorporation within the PG was reached at pH 6 and decreased progressively with pH. Zinc was found to have a great tendency to migrate from PG particles to OFI's suspensions since a maximum Zn removal percentage of 93% was achieved.

The Zygomatic Buttress as an Efficient Intraoral Donor Site for Limited Maxillary Reconstructions: A Case Series and Brief Literature Review.

Limited maxillary defects are commonly grafted with bone blocks harvested from the symphysis or the ramus; harvesting a second surgical site in the mandible increases both operative time and patient's postoperative morbidity. To overcome these disadvantages, the zygomatic buttress (ZB) was suggested as an alternative maxillary source of autogenous bone. This intraoral donor site has a natural convex shape and can be accessed along with the recipient site through the same flap design. We report a case series describing this uncommon technique of bone harvesting from the zygomatic buttress to reconstruct limited alveolar defects in the maxilla.

Determination of the distribution and speciation of selenium in an argillaceous sample using chemical extractions and post-extractions analyses: application to the hydrogeological experimental site of Poitiers.

To better understand selenium's dynamics in environmental systems, the present study aims to investigate selenium speciation and distribution in black argillaceous sediments, partially fulfilling karstic cavities into the Hydrogeological Experimental Site of Poitiers. These sediments are suspected to be responsible for selenium concentrations exceeding the European Framework Directive's drinking water limit value (10 µg L(-1)) in some specific wells. A combination of a sequential extractions scheme and single parallel extractions was thus applied on a representative argillaceous sample. Impacts of the extractions on mineral dissolution and organic matter mobilization were followed by quantifying major cations and total organic carbon (TOC) in the aqueous extracts. The nature of the released organic matter was characterized using thermochemolysis coupled with gas chromatography-mass spectrometry (GC-MS). About 10 % of selenium from the black argillaceous studied matrix could be defined as 'easily mobilizable' when the majority (around 70 %) revealed associated with the aliphatic and alkaline-soluble organic matter's fraction (about 20 %). In these fractions, selenium speciation was moreover dominated by oxidized species including a mixture of Se(VI) (20-30 %) and Se(IV) (70-80 %) in the 'easily mobilizable' fraction, while only Se(IV) was detected in alkaline-soluble organic matter fraction.

Applying physicochemical approaches to control phosphogypsum heavy metal releases in aquatic environment.

One of the most important sources of solid waste in the Mediterranean Basin ecosystem originated from the phosphate fertilizer industries, which discharge phosphogypsum (PG) directly into aquatic environments or are stacked on stockpiles. The present study investigates metal release from PG under the influence of variable pH, increasing PG mass content, and complexing organic matter ligands. Major ions from PG leachates, grain size and charge, main functional groups along with metal leachability (Pb, Cd, Cr, Cu, and Zn) were determined using ion chromatography, laser diffraction, zetameter, Fourier transform infrared spectroscopy, and atomic absorption spectroscopy, respectively. The complete dissolution of PG recorded is at 2 g/L. Saturation and supersaturation with respect to PG may occur at concentrations of 3 and 4 g/L, respectively, revealing a clustering phenomenon leading to heavy metal encapsulation within the aggregates. Organic ligands such as citrate may trigger the cationic exchange within the PG suspension leading to ion release. As these factors are considered as specific process involving the release of contaminants from PG during storage under natural conditions, this study could set the foundations for PG remediation in aquatic environment. Organic ligands under controlled pH conditions could be utilized in treating fertilizer industrial wastes by taking into consideration the particularity of the receiving area, thus decreasing metal hazardous impact on natural media.

Clinical, histological, and histomorphometrical analysis of maxillary sinus augmentation using inorganic bovine in humans: preliminary results.

The aim of the present study was to evaluate bone formation after maxillary sinus augmentation using bovine bone substitute material Bio-Oss alone by means of clinical, histological, and histomorphometrical examination of human biopsies. Deproteinized bovine bone (DPBB, Bio-Oss) was used to fill cavities after elevation of the sinus mucosa following major sinus pneumatization. Twenty patients with edentulous posterior maxillae were treated with 20 sinus augmentation procedures using a 2-stage technique. Residual lateral maxillary bone height was less than 3 mm. Forty-nine Straumann endosseous implants were used to complete the implant-prosthetic rehabilitation. Forty cylinder-shaped bone biopsies were taken from the augmented maxillary region 8 months after grafting during the second-stage surgery before implant placement. All implants were loaded 3 months after insertion, and no failures were recorded. Histomorphometrical analysis showed an average percentage of newly formed bone of 17.6% (± 2.8%) and a proportion of residual bone substitute material of 29.9% (± 4.9%) of the total biopsy area. Intimate contact between newly formed bone and Bio-Oss was detected along 28.2% (± 6.8%) of the particle surfaces. The results also showed that in all cases, the DPBB granules had been interconnected by bridges of vital newly formed bone. Inorganic bovine bone appears to be biocompatible and osteoconductive, and it can be used with success as a bone substitute in maxillary sinus augmentation procedures.