Influence of loading and drilling on marginal bone loss around implants with a Dynamic Bone Management design: A single-blind, randomised, 12-month clinical trial.

PURPOSE: To evaluate marginal bone loss 6 and 12 months after prosthetic loading of implants with Dynamic Bone Management (Straumann, Basel, Switzerland) through the implementation of different drilling protocols. MATERIALS AND METHODS: A balanced, randomised, single-blind clinical trial was conducted with four parallel experimental arms: immediate loading and under-drilling, immediate loading and complete drilling, early loading and under-drilling, and early loading and complete drilling. Forty-four implants with a Dynamic Bone Management design and with a diameter of 3.75 mm and a length of 10.00 mm were placed in healed mature bone (more than 6 months post-extraction). RESULTS: The mean primary stability achieved was 60.6 ± 12.2 implant stability quotient, with a range from 21 to 75, and no differences were observed when considering the drilling protocol used, bone type or location. Early loading resulted in a loss of 0.728 mm (standard error 0.212; 95% confidence interval 1.134 to -0.325; t value -3.440), whereas immediate loading did not result in any bone loss. When the interaction between the loading and drilling protocols was studied, performing the complete drilling protocol in conjunction with early implant loading was found to result in lower marginal bone loss, with a marginal bone gain effect of 0.814 mm (standard error 0.283; 95% confidence interval -0.274 to 1.353; t value 2.880). CONCLUSIONS: Use of the complete drilling protocol in conjunction with early implant loading resulted in the lowest marginal bone loss at 12 months.

Clinical study comparing alveolar distraction using the lead system and MODUS MDO 1.5/2.0.

This article compares 2 different alveolar distractors: Lead System (LS) and MODUS MDO 1.5/2.0 (M-MDO). This is a clinical retrospective study; 32 distractions were performed. We used the LS distractor (intraosseous) on 24 patients and the M-MDO (extraosseous) on the other 8. The variables included bone alveolar ridge height, alterations of the oral mucosa, number of distractors, implant survival, and complications. We also developed descriptive and univariate statistical analysis. The mean increase of bone height after performing the alveolar distraction was 6.15 mm, 5.74 mm with LS, and 8.36 mm with M-MDO (P < 0.0001). The survival rates of the implants in the intraosseous and extraosseous groups reached 100%. However, the use of M-MDO resulted in a significant defect in the alveolar mucosa during implant insertion (100%), an event that did not occur when using LS (P < 0.001). The most common complication in the intraosseous group was the tilting of the segment (25%), whereas, in the extraosseous group, the main difficulty was the rod interference with the opposing arch (75%). Bone defects after alveolar distraction appeared both in the intraosseous group (66.7%) and in the extraosseous group (50%). Both the LS and the M-MDO distractors are effective for alveolar bone distraction. The choice of one distractor over another depends on the clinical characteristics of each case, such as the size and shape of the defect, the patient's tolerance, the distance to the opposing arch, and the surgeon's experience.

Histopathological findings in oral lichen planus and their correlationwith the clinical manifestations

Objectives: To highlight the most characteristic histopathological findings of oral lichen planus and their correlationwith the clinical manifestations and forms.Study design: We performed a retrospective study of 50 biopsied and diagnosed cases of oral lichen planus obtainedover a period of 11 years, spanning from May 1998 to April 2009. We analyzed the age and sex of thepatient, type of lichen planus, location and different histopathological findings, comparing them with the clinicallesions.Results: Seventy eight percent of the patients are female and 22% are male, with an average age of 56.06 years forboth sexes. The most frequent clinical form is reticular, present in 78% of the cases, and the most common locationis the buccal mucosa, present in 70% of the patients. Hydropic degeneration of the basal layer and lymphocyticinfiltration in the subepithelial layer are observed in the entire sample. Signs of atypia were identified in 4% of thecases, but without dysplasic features. Other common histological findings were the presence of necrotic keratinocytes(92%), hyperplasia (54%), hyperkeratosis (66%), acanthosis (48%), and less frequently, serrated ridges (30%)and the presence plasma cells (26%) (AU)

Correlation between clinical and pathologic diagnosis in oral leukoplakia in 54 patients

The main aim of this study was to establish a correlation between the clinical and pathologic diagnosis of oralleukoplakia with a particular focus on epithelial dysplasia. We reviewed the medical records of 54 patients with a clinical and histologic diagnosis of oral leukoplakia who were seen at our center between 2002 and 2008. We found that the disease was more common in men (59.3%) than in women and we also detected a significantly greater prevalence of alcohol and tobacco consumption in men. The mean age of the patients was 62.57 years. Three patients had been histologically diagnosed with invasive cancer and 4 with carcinoma in situ. The most commonlesion site for leukoplakias with severe dysplasia and invasive carcinoma was the lateral aspect of the tongue, the floor of the mouth, and the gums. It is therefore essential to include these sites in the clinical examination to aidearly diagnosis. A higher degree of dysplasia should be suspected in non-homogeneous leukoplakias. While dysplasiais associated with a greater risk of malignant transformation, it is also important to monitor leukoplakias without dysplastic features as they can occasionally be the site of carcinoma (AU)

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Correlation between clinical and pathologic diagnosis in oral leukoplakia in 54 patients.

The main aim of this study was to establish a correlation between the clinical and pathologic diagnosis of oral leukoplakia with a particular focus on epithelial dysplasia. We reviewed the medical records of 54 patients with a clinical and histologic diagnosis of oral leukoplakia who were seen at our center between 2002 and 2008. We found that the disease was more common in men (59.3%) than in women and we also detected a significantly greater prevalence of alcohol and tobacco consumption in men. The mean age of the patients was 62.57 years. Three patients had been histologically diagnosed with invasive cancer and 4 with carcinoma in situ. The most common lesion site for leukoplakias with severe dysplasia and invasive carcinoma was the lateral aspect of the tongue, the floor of the mouth, and the gums. It is therefore essential to include these sites in the clinical examination to aid early diagnosis. A higher degree of dysplasia should be suspected in non-homogeneous leukoplakias. While dysplasia is associated with a greater risk of malignant transformation, it is also important to monitor leukoplakias without dysplastic features as they can occasionally be the site of carcinoma.