Effects of installation depth on survival of an hydroxyapatite-coated Bicon implant for single-tooth restoration.

PURPOSE: The present retrospective study evaluated various implant surface factors associated with Bicon implant survival for single-tooth restoration in the healthy individual. PATIENTS AND METHODS: A retrospective cohort study design was used. A total of 613 Bicon (Bicon System, Boston, MA) implants (272 patients) were included. Because the use of hydroxyapatite (HA) coating has been controversial, the surface type was chosen according to the patient's preference. A total of 308 HA-coated implants and 305 titanium plasma-sprayed (TPS) implants were used. The macroanatomy of both implant types was identical. Patients who had systemic disease, poor quality bone, or removable prosthetics were excluded from the present study. A chart review was conducted to record age, gender, implant diameter, implant length, installation depth, installation location, and the use of bone grafting. Implant failure was recorded, and the data were analyzed using the chi(2) test and logistic regression analysis. RESULTS: The installation depth was an important prognostic factor in the HA-coated implants. The failure rate for the HA-coated implants installed at margin level and 2 mm below level was 10.29% and 3.01%, respectively (chi(2) = 6.035, P = .014). The implant length was an important prognostic factor for the TPS-treated implants. The failure rate recorded for the TPS-treated implants installed with a length of less than 10 mm and 10 mm or longer was 15.46% and 2.40%, respectively (chi(2) = 18.414, P < .001). CONCLUSION: Many factors can influence the failure rate of TPS and HA-coated Bicon implants. Among these, installation depth played an especially significant role in the success of HA-coated Bicon implants in the present study.

Inhibition of bone healing by pamidronate in calvarial bony defects.

OBJECTIVE: Pamidronate has been studied as a therapeutic drug for various osteopenic diseases. However, avascular osteonecrosis in the jawbone has been recently reported in patients receiving pamidronate. The objective of this study was to examine the effect of pamidronate on bone regeneration in a controlled animal model. MATERIALS AND METHODS: To determine the effect of parmidronate on bone healing in a local bony defect area, a rabbit calvarial bony defect model was used and poly L-lactide-co-glycolide (PLGA) used as a drug carrier material. Four defect groups were made in each rabbit calvaria and the defects were treated as follows: untreated bony defect (group 1), PLGA only (group 2), 2 mg of pamidronate with PLGA (group 3), and 3 mg of pamidronate with PLGA (group 4). Bone healing was evaluated by radiography and histology at 1, 2, 4, 6, and 8 weeks after surgery. RESULTS: In radiographic analysis, radiopacity was lower in pamidronate groups than non-operated rabbit calvarial bone at all observation points (P < .05). In histological analysis, the initial bone formation at 1 week was not different among groups, but it was much lower in the pamidronate groups than in the control or PLGA group after 2 weeks. Newly formed bone at 1 week underwent avascular necrosis after 2 weeks in both pamidronate groups. Avascular necrosis was not observed until 8 weeks in both topically applied pamidronate groups. CONCLUSION: Collectively, pamidronate inhibits bone healing in rabbit calvarial bony defect and it may explain the avascular necrosis of the jaws in patients receiving pamidronate.

Statistical correlation between pharyngitis and temporomandibular joint disease.

OBJECTIVE: The objective of this study was to evaluate the upper respiratory infection (URI) as an aggravating factor in the established temporomandibular joint (TMJ) disease. PATIENTS AND METHODS: Four hundred seventeen patients suffering from temporomandibular disorder (TMD) were selected and investigated by means of questionnaires and clinical examinations. After excluding the patients with only muscle disorders, 283 patients were included for the association study between TMJ disease and infectious conditions. The screened infectious conditions were otitis media, maxillary sinusitis/rhinitis, and pharyngitis/tonsillitis. The chi-square test was used to determine the association between variables and stepwise logistical regression was then used. RESULTS: The prevalence of maxillary sinusitis/rhinitis in TMD patients was 7.0%. The patients who had mouth-opening limitation were 9.93 times more likely to have maxillary sinusitis/rhinitis than those without ( P = .0004). The prevalence of tonsillitis/pharyngitis in TMD patients was 9.1%. The patients who had mouth-opening limitation were 3.50 times more likely to have tonsillitis/pharyngitis than those without it ( P = .0028). The patients who had TMJ capsulitis were 3.91 times more likely to have tonsillitis/pharyngitis than those without it ( P = .0028). CONCLUSION: The conclusion is made that pharyngitis/sinusitis is significantly associated with some clinical symptoms of TMD. The infection of closely related anatomical structures with TMJ may have an influence on TMJ symptoms. Thus, pharyngitis/sinusitis in the established TMD patients can be a significant warning sign for TMJ symptoms to appear shortly thereafter.

Hematogenous infection of the human temporomandibular joint.

Objective This study was designed to discover the relationship between bacteremia and the presence of specific bacterial species in the synovial fluid of the human temporomandibular joint (TMJ). Study design Sixteen volunteers (female to male, 1:2.2; average age, 30.00 +/- 9.93 years) who received operations via intraoral incision participated in this study. Samples from the blood and TMJ synovial fluid of the patients were taken preoperatively and postoperatively and analyzed by PCR assays with specific primers for the clinically important bacteria Staphylococcus aureus , Streptococcus mitis , and beta-hemolytic Streptococcus . Results PCR-based assays revealed the occurrence of S aureus in 68.8% and 50% of the total blood and synovial fluid samples collected immediately after the operations, which statistically differed from the preoperative samples ( P < .05). However, the frequency of the other bacteria, S mitis and beta-hemolytic Streptococcus , in pre- and postoperative blood samples had no such a difference ( P > .05). The chi-square test showed a significant association between the presence of S aureus in the blood and in TMJ synovial fluid (chi 2 = 6.409, P < .05), and the probability of hematogenous infection of the TMJ was estimated as 55.5%. Conclusion Hence, the data obtained provided evidence that the invasion of S aureus into TMJ synovial fluid was due to the presence of these bacteria in the blood. To our knowledge, this is the first report of the bacteremia-related mechanism of S aureus invasion in the human TMJ.

The presence of bacteria in the synovial fluid of the temporomandibular joint and clinical significance: preliminary study.

PURPOSE: The objective of this study was to find any relation between the presence of specific bacterial species in the synovial fluid of the temporomandibular joint (TMJ) and clinical parameters. PATIENTS AND METHODS: We studied 43 patients (male-to-female ratio, 1:1.69; average age, 34.37 +/- 14.55 years). Thirty-three patients had a displaced disc in the TMJ (DD group), and 10 patients did not have a displaced disc of the TMJ or any symptom related to TMJ disorders (NDD group). Clinical examinations were made to determine maximum mouth opening, joint sounds, previous trauma history, systemic disease, and TMJ pain. Six bacterial species that were reported in other studies were chosen to evaluate the presence of bacteria in the TMJ for this study. RESULTS: Mycoplasma genitalium was most frequently detected in synovial fluid (86.0%). Staphylococcus aureus, Mycoplasma fermentans/orale, Actinobacillus actinomycetemcomitans, and Streptococcus mitis were detected in 51.2%, 37.2%, 25.6%, and 7.0% of samples, respectively. beta-Hemolytic Streptococcus was not detected. The prevalence of S aureus was significantly higher in the DD group than in the NDD group (P <.05). The patients who had M. fermentans/orale were 5.40 times more likely to be younger than 30 years than were those without M. fermentans/orale (P <.05). Those with M. genitalium were 5.81 times more likely to be female than were those without M. genitalium (P <.05). CONCLUSION: The presence of S. aureus in TMJ synovial fluid was related to TMJ disorder symptoms and clinical parameters seemed to be influenced by bacterial presence in TMJ synovial fluid.

Ganglion cyst of the temporomandibular joint.

We report a case of cystic lesion in a 37-year-old woman. The patient had an oval-shaped lesion adjacent to the temporomandibular joint. Thick fibrotic tissue and muscle were observed microscopically, but the epithelium lining was not observed. The lesion was diagnosed as a ganglion cyst. The patient's general medical history was non-contributory. High performance liquid chromatography (HPLC) and mass spectrophotometry (MS) revealed some proteins from the fluid in the lesion, such as a filaggrin precursor, dystroglycan, a polyprotein of the hepatitis C virus, and proteins originating from bacteria. The follow-up examinations revealed no recurrence. The probable pathogenesis of the lesion is discussed.