Five-Year Volumetric Evaluation of Periodontally Compromised Sites Restored by Immediate Implant Restorations.

The aim of the present study was the retrospective evaluation of the distance of the labial hard and soft tissue margins from the implant shoulder in 24 periodontally compromised sites that were restored by immediate implant restorations. Volumetric analysis was performed 5 years postoperatively using cone beam computed tomography with limited field of view. In all cases, a labial radiopaque plate component was apparent 5 years postoperatively coronal to the implant shoulder (3.1 ± 0.6 mm), supporting the soft tissue margin, which was extending above this level (5.2 ± 1.1 mm). In 12 of the sites, preoperative evaluation showed that this plate was missing at the time of implant placement.

Enhancement of bone regeneration with the combination of platelet-rich fibrin and synthetic graft.

INTRODUCTION: Platelet-rich fibrin (PRF) is a relatively new developed platelet concentrate with several benefits over platelet-rich plasma. The aim of this study was to compare healing properties of PRF and its combination with a ceramic synthetic material (graft) composed of hydroxyapatite and b-tricalcium phosphate in an animal model. METHODS: A bone deficit was surgically created in each femoral condyle of 15 New Zealand white rabbits. In each animal, 1 limb had (a) PRF only and the other (b) PRF plus synthetic graft material randomly implanted. Experimental animals were killed 3 months postoperatively. Histological and radiological examinations were made by means of computed tomography and peripheral quantitative computed tomography. RESULTS: Mean density of the healed bone was statistically significantly greater when synthetic material was used (P < 0.0005). Moreover, combination of PRF with the synthetic material resulted in more cortical and subcortical bone formation (P = 0.038 and P = 0.037, respectively). CONCLUSIONS: The addition of the ceramic material significantly increased the formation of new bone, providing a better substrate for bone regeneration.

Ultrasound anatomy of the cervical paravertebral space: a preliminary study.

PURPOSE: The aim of the study was to examine the ultrasound anatomy of the cervical paravertebral space in order to facilitate the implementation of sonographically guided regional anesthesia techniques for this region. METHODS: Twenty volunteers were recruited, and the anatomic components of the cervical paravertebral space were sonographically examined. The transducer was positioned in the axial and coronal plane at the posterior cervical triangle. The cervical transverse processes with their respective nerve roots, the deep cervical fascia and the paravertebral muscles were identified. RESULTS: There was excellent visualization of the C-3, C-4, C-5, C-6 and C-7 transverse processes in all cases. Excellent visualization of the scalene muscles, vertebral artery and deep cervical fascia was also achieved in all cases. Visualization of the levator of scapula muscle was difficult in 9 and excellent in 11 out of the 20 cases. In all cases, visualization of the C-1, C-2 and C-3 nerve roots was unfeasible. The identification of the C-4 nerve root was excellent in 3, difficult in 6 and unfeasible in 11 out of the 20 cases. The C-5, C-6 and C-7 nerve roots were excellently identified in all cases. The C-8 nerve root was identified only in 8 of the 20 cases. The cervical nerve roots also showed high variation, dividing into more than one branch as they exited the cervical transverse processes. CONCLUSION: Cervical paravertebral anatomy can be depicted with ultrasound imaging techniques. This could be highly clinically significant for the implementation of regional anesthesia techniques.

Is self-reported alcohol consumption associated with osteoporotic mandibular bone loss in women?

The aim of this study was to determine whether alcohol consumption would predict mandibular bone quality and quantity in a large European female population. In total, 672 middle-aged and elderly women (45-70 yr of age; standard deviation = 6) were recruited in the study. Alcohol consumption was recorded through a self-reported questionnaire. Mandibular cortical width was measured, by five observers, in the mental foramen region on panoramic radiographs. Mandibular bone density, expressed as aluminium thickness, was recorded on intra-oral radiographs. Alcohol consumption was associated with a reduction of mandibular bone density and cortical width. This association was higher in subjects with excessive alcohol consumption, defined in the present study as > 14 units consumed per week. This study showed reduced jaw-bone quality in older individuals and in those with increased alcohol consumption.

The mandibular cortex on radiographs as a tool for osteoporosis risk assessment: the OSTEODENT Project.

The aim of this study was to measure the accuracy of porosity of the mandibular cortex on dental panoramic radiographs (DPRs) in diagnosis of osteoporosis, alone and in combination with a clinical risk index. Six hundred seventy-one women (45-70yr) were recruited in the study, and dual-energy X-ray absorptiometry of the hip and lumbar spine was performed. A clinical index of osteoporosis risk (OSIRIS) and a DPR were obtained for each subject. The cortical appearance on the DPR was classified using the mandibular cortical index (MCI) by 5 observers. receiver operating characteristic (ROC) curve analysis was performed with calculation of area under the ROC curve (AUC) and sensitivity and specificity at various thresholds. Complete data were available for 653 subjects, of whom 21.6% had osteoporosis. The AUC for OSIRIS was 0.838. When used alone as the diagnostic test, MCI AUC for the 5 observers ranged from 0.560 to 0.670, significantly less than OSIRIS. Intraobserver and interobserver repeatability of MCI assessment was inconsistent. We conclude that MCI has limited value for osteoporosis diagnosis, being most appropriate as a method of fortuitous case-finding.