Survival Rates of Implants That Have Compromised the Adjacent Teeth and the Associated Complications: An Opg Retrospective Study.

This retrospective study evaluated survival rates of implants compromising adjacent teeth and associated complications. Medical records and orthopantomographic images of 1132 patients and 1478 implants were retrospectively analyzed. Finally, 96 patients (52 females, 44 males) with 111 malpositioned implants were included in the study. The mean follow-up of the study was 32 ± 14 months. The patients were divided into 2 core groups: (1) adjacent teeth and dental implants were considerably close but tangent to each other (TAN), and (2) dental implant cutting the roots of the adjacent tooth (CUT). In addition, the CUT group was divided into 2 subcategories considering the possible cause of malangulation as angled implant (AI) or angled adjacent tooth (AT). Damage to adjacent teeth, future treatment requirements, and the survival rates of the implants were recorded. Among the 111 implants, 4 (3.6%) implants failed, all of which belonged to the CUT category and the AI subgroup. Among the 88 preoperatively vital adjacent teeth, root canal treatment was performed in 18 (20.5%) teeth, whereas 2 (2.3%) teeth were extracted due to malpositioned implanting in follow-ups. The placement of implants too close to the adjacent teeth and even cutting direction did not have a statistically significant effect on the survival rates of implants. However, this could cause adjacent teeth to undergo unnecessary root canal treatment or extraction. Patients with malpositioned adjacent teeth or dilacerated root(s) adjacent to the edentulous area are at a higher risk for malpositioned implant complications. Most implant malposition complications are observed in the first premolar region (37% cases). Therefore, more attention should be given while placing implants in the first premolar region.

Comparison of the effects of three different xenogeneic bone grafts used in sinus augmentation simultaneous with dental implant placement on the survival of the implants and the dimensional changes of the region.

BACKGROUND: Xenografts can be produced in various particle sizes by using different bone types. Currently, there is no consensus about the ideal type of xenograft for sinus augmentations, and this choice depends on the personal experience of clinicians. This retrospective study aimed to evaluate the effects of three different xenografts used in sinus augmentation simultaneously with implant placement on the survival of the implants and the dimensional changes of the region. METHODS: One hundred nine sinus augmentations and 164 implants were evaluated in 76 patients. Three different xenografts were used: 41 Gen-Os® (250-1000µm, Corticocancellous; Tecnoss, Giaveno, Turin, Italy), 35 Bio-Oss® (1000-2000µm, Cancellous; Geistlich Biomaterials italia S.r.l., Vicenza, Italy) and 33 Apatos-Cortical® (600-1000µm, Cortical; Tecnoss). The preoperative, postoperative, and follow-up (21±8.8 month) radiographs were evaluated for the dimensional changes and the implant survivals. The data were statistically analyzed. RESULTS: Among the implant failures; 3 (5.6%) in 53 implants in Apatos, 2 (3.6%) in 55 implants in Bio-Oss, 9 (16%) in 56 implants in Gen-Os, and 14 (8.5%) total implant failures were observed. This difference between the groups was statistically significant and was due to the high loss rate in the Gen-Os (P=0.044). There was a mean difference of -1.8±1.5mm between the measured bone heights on postoperative day (14.2±2.4mm) and the last follow-up (12.4±2.5 mm). While the loss of height was not affected due to the graft type (P=0.981), the general 12.6% vertical loss was statistically significant (P<0.0001), also the length of implants placed reduced this loss (P=0.036). CONCLUSIONS: Within the limits of this retrospective study, it can be concluded that: 1) The sinus augmentation procedures with thicker particle size grafts achieved higher success rate; and 2) over the time, 12.6% loss may occur in the height of grafted area.

Does Piezosurgery Decrease Patient Morbidity in Surgically Assisted Rapid Palatal Expansion Compared With Saw and Burrs?

PURPOSE: The present study compared the postoperative pain, edema, patient satisfaction, and operating time with the use of piezosurgery, a reciprocal microsaw, and conventional burrs in the surgically assisted rapid palatal expansion (SARPE) technique for the correction of transversal maxillary deficiency. The results of the present study may help clinicians minimize the postoperative complaints of patients after SARPE. PATIENTS AND METHODS: The present randomized single-blind study included patients who had undergone SARPE with piezosurgery, a reciprocating microsaw, or conventional burrs. To determine the facial norms and postoperative facial edema, 4 anatomic distances were measured on the patients' face using the modified flexible ruler method. The mean facial edema score was determined to evaluate and compare the overall edema among the groups. Two separate visual analog scales were used to assess patients' postoperative pain and intraoperative satisfaction. The duration of the osteotomies was recorded. Intragroup data were statistically analyzed via a t test, and intergroup data were analyzed via a nonparametric Kruskal-Wallis test. Spearman's correlation was used to evaluate the relationships among the variables. RESULTS: For the 80 patients, edema (second day: piezosurgery, 0.53 ± 0.34; microsaw, 0.61 ± 0.30; burrs, 0.94 ± 0.33; P < .001) and pain (piezosurgery, 2.3 ± 0.3; microsaw, 3.6 ± 0.4; burrs, 3.9 ± 0.6; P < .001) were greater for conventional burrs and microsaws, with statistically significant differences. Patient satisfaction (piezosurgery, 8.3 ± 0.3; microsaw, 5.5 ± 0.5; burrs, 5.1 ± 0.9; P < .001) was greater with piezosurgery. However, in the piezosurgery group, the duration of osteotomies was 50% greater (piezosurgery, 16.10 ± 3.30; microsaw, 11.05 ± 2.09; burrs, 11.2 ± 2.14; P < .001). CONCLUSIONS: The results from the present study have shown that piezosurgery is an effective method for minimizing facial edema and patient morbidity and increasing patient satisfaction during SARPE. Moreover, the use of conventional burrs and microsaws prolonged the duration of facial edema.

Evaluation of the survival of implant placement simultaneously with sinus augmentation: relationship in maxillary sinus pathologies.

OBJECTIVES: This retrospective study aimed to evaluate the effects of existing maxillary sinus pathologies on the survival rates of dental implants placed simultaneously with sinus augmentation. METHODS: Cone-beam computed tomography images of 88 patients (34 females, 54 males), who underwent sinus augmentation, were retrospectively analyzed and the patients were divided into two groups: with (pathology group) and without pathology (control group). All maxillary sinus pathologies were recorded and categorized into mucosal thickening ( ≥ 3 mm), antral pseudocyst (polypoid mucosal thickening), and complete opacification. Implant survival rates were evaluated after a mean follow-up period of 28.2 ± 9.8 months based on the patient's records and control radiographs. RESULTS: A total of 115 maxillary sinuses of 88 patients with 168 dental implants were included in the study. Maxillary sinus pathology was detected in 45 patients in the pathology group and 43 patients in the control group. In the pathology group, one implant was lost out of 82 implants during the 27.8 ± 9.5 months follow-up period, while in the control group, 5 implants were lost out of 86 implants during the 25.1 ± 10 months follow-up period. There was no statistically significant difference in the survival rates between the two groups. CONCLUSIONS: The study concluded that the presence of pathology in the maxillary sinus before surgery does not affect the survival rates of dental implants placed simultaneously with sinus augmentation. The most common pathology noted included mucosal thickening (61.4%), which was detected in 35 patients.

Biomechanical effects of implant number and diameter on stress distributions in maxillary implant-supported overdentures.

STATEMENT OF PROBLEM: Implant-supported overdentures (ISOs) are considered a good alternative to conventional removable dentures. However, varying rates of failure have been reported in some clinical studies. Excessive stress on surrounding tissues is one of the possible causes of implant failure. As stress is transmitted to the bone through the implant, careful planning, correct number of implants, and implant positioning are keys to ensuring appropriate stress distribution. However, research of the optimal number of implants necessary to support a maxillary ISO is insufficient. PURPOSE: The purpose of this in vitro finite element study was to determine the optimal implant location, number, and diameter to support a maxillary ISO. MATERIAL AND METHODS: Three-dimensional models of an atrophic maxilla, dental implants, and ball attachments were modeled, and different loading conditions were applied to simulate realistic conditions. Six models with different numbers and diameters of implants, including mini-dental implants and differently located implants, were formed, and stress values were compared by implementing a finite element analysis. RESULTS: The study showed that, as the implant number increased, decreased stress values were observed in peri-implant bone and implants in the maxillary ISO prosthesis. However, changes in implant diameter had no significant effect on stresses. CONCLUSIONS: Increasing the implant diameter was not advantageous; the use of mini-dental implants may be a viable alternative method. However, using 4 implants for maxillary ISOs is indicated.

Biomechanical comparison of sinus floor elevation and alternative treatment methods for dental implant placement.

OBJECTIVE: In this study, we compared the success of sinus lifting and alternative treatment methods in applying dental implants in cases lacking adequate bone due to pneumatization of the maxillary sinus. METHODS: In a computer environment, 3D models were created using computerized tomography data from a patient. Additionally, implants and abutments were scanned at the macroscopic level, and the resulting images were transferred to the 3D models. Five different models were examined: a control model, lateral sinus lifting (LSL), short dental implant placement (SIP), tilted implant placement (TIP) and distal prosthetic cantilever (DC) use. Vertical and oblique forces were applied in each model. The compression, tension and von Mises stresses in each model were analyzed by implementing a finite element analysis method. RESULTS: In our study, the LSL method was observed to be the closest to the control model. The TIP model showed high stress values under conditions of oblique forces but showed successful results under conditions of vertical forces, and the opposite results were observed in the SIP model. The DC model provided the least successful results among all models. CONCLUSIONS: Based on the results of this study, the LSL method should be the first choice among treatment options. Considering its successful results under conditions of oblique forces, the SIP method may be preferable to the TIP method. In contrast, every effort should be made to avoid the use of DCs.

Peripheral osteoma in an unusual location on the mandible.

Osteoma is a benign, slow-growing, painless, discrete lesion which is characterised with the proliferation of a compact or cancellous bone. Osteomas are rare on the jaws. Lesions of the mandible developed most often in the condyle, angle and margin. Osteoma developed on the genial tubercle area had only been reported in one case. A 50-year-old female patient has been admitted to our department with the symptom of a hard mass under the chin area. In extra-oral and radiographic examinations, a 1×1 cm size, round, palpable, immobile, radiopaque mass has been determined on the genial tubercle area. The lesion has been completely removed under local anaesthesia by extra-oral approach. Her recovery period was uneventful. Osteoma diagnosis was confirmed with histopathological examination. There is no recurrence at 3-year follow-up. The purpose of this case report is to present a peripheral osteoma case that occurred in the genial tubercle area which is an unusual place.

Familial florid osseous dysplasia: a report with review of the literature.

There are three types of osseous dysplasia: periapical cemental dysplasia (PCD), focal cemento-osseous dysplasia (FCD) and florid osseous dysplasia (FOD). While PCD is often observed in mandibular anterior teeth, FCD mainly affects mandibular posterior teeth. FOD, on the other hand, commonly involves both jaws. FOD is a type of sclerosing disease that is characterised by intense opaque masses and many areas with different densities. Genetic heritance of FOD is unusual, with only a few reported cases. We describe a case of FOD that affected three family members, discuss its clinical, radiological and histological characteristics, and review the literature.

Solitary plasmacytoma of the mandible: report of two cases.

Plasma cell neoplasms (plasmacytoma) are discrete, solitary masses of lymphoid neoplastic proliferations of B cells. Plasmacytomas comprise three groups: multiple myeloma, solitary plasmacytoma (SP) and extramedullary plasmacytoma. SP originates as a clone of transformed malignant plasma cells in the bone marrow. SP of the jaw is a rare condition; therefore diagnosis is quite difficult and often results in misdiagnosis. MM is a lymphoproliferative disease the prognosis of which is worse than SP. SP can progress to MM in a few months to years after diagnosis. In this regard, early diagnosis of the disease is of utmost importance. This article presents two cases of SP diagnosed in the mandible and documented with clinical, radiographic and histological findings.

Pilonidal sinus of the chin: mistreated as a dental fistula.

Pilonidal sinus is a chronic inflammatory condition associated with penetration of hair particles into the skin. It is rare in the chin area and, to our knowledge, there is only one such reported case. A 56-year-old man was previously admitted to a private clinic, with a hard mass on his anterior buccal sulcus. Three of the patient's teeth were extracted as the swelling was thought to be associated with a dental infection. Because the fistula did not resolve, the patient was referred to our department. Following radiological and clinical examinations, the hard mass was reached intraorally and hair shafts were seen inside it. The area was closed primarily after cleaning the inflammatory tissues and the hairs. The recovery period was uneventful. In this case report, we present a pilonidal sinus encountered in the chin area, the wrong treatment initially given to the patient and the subsequent treatment carried out by us.

Uncommon benign tumour of the skin: infraorbital pilomatricoma.

Pilomatricoma is a relatively rare tumour of the skin derived from primitive basal cells of epidermis that differentiate into hair matrix cells. It comprises approximately 1% of all benign skin tumours. The most common sites for pilomatricomas are the head, neck and upper extremities. A 44-year-old woman, admitted to our department, underwent an orthopantomography examination, which revealed a well-circumscribed 1.6×1.4 mm radiopaque mass superimposed between the medial wall of the right maxillary sinus and lateral wall of the nasal cavity. Clinically, it was firm and mobile, and remained attached to the underlying skin when palpated. A cone beam CT scan was performed to ascertain its location and anatomic relations. Subsequently, it was totally excised under local anaesthesia. Histopathological evaluation of the lesion reported it to be a pilomatricoma.