The effect of triangular cross-section neck design on crestal bone stability in the anterior mandible: A retrospective study with a 5-year follow-up.

OBJECTIVES: The objective of this study, which included a 5-year follow-up, was to compare peri-implant soft tissue health, crestal bone loss (CBL), and buccal bone thickness (BBT) around triangular cross-section neck (TN) or round neck (RN) implants, using cone-beam computed tomography. MATERIALS AND METHODS: This study was initially designed as a prospective 1-year randomized controlled study and then extended with a 5-year retrospective evaluation of clinical and radiographic records. In the initial 1-year study, a total of 20edentulous patients receiving 40 implants with similar diameters were randomly assigned to the RN or TN groups using a split-mouth design. Pocket probing depths (PPD), plaque index (PI), and gingival index (GI) were recorded at postoperative month 12. CBL and BBT at three levels (0, -2, and -4 mm) were evaluated 1 year after insertion. Five years after insertion, PPD, PI, GI, CBL, and BBT were recorded as patients were recalled for clinical and radiographic monitoring. RESULTS: Nineteen patients completed the study. After 5 years, no significant differences in PPD, PI, and GI scores and BBT values between the two groups (p > .05). The mean ± SD CBL values at the final follow-up visit were -0.71 ± 0.69 mm for TN and -1.03 ± 0.86 mm for RN (p < .01). CONCLUSIONS: These results suggest better crestal bone preservation using implants with TN when compared to RN after a 5-year follow-up. However, TN showed similar results to RN regarding peri-implant soft tissue health and BBT.

Effect of Residual Bone Height and Implant Macro-Design on Primary Stability in Sinus Floor Elevation: An Ex Vivo Study.

The objective was to evaluate the influence of residual bone height (RBH) and implant macro-design on the primary stability (PS) of implants using a simultaneous sinus floor elevation (SFE) and implant insertion model. Fresh bovine rib samples that resembled type-IV density that were confirmed by computerized tomography were prepared to represent 4 groups of varying RBHs (3, 6, 9, 15 mm). To simulate simultaneous implant insertion with SFE, 120 implants in different macro-designs (group R: NobelReplace; group P: NobelParallel; group A: NobelActive, Nobel Biocare, Gothenburg, Sweden) were randomly inserted at RBHs of 3, 6, 9, and 15 mm in each rib. The implant stability quotient (ISQ) was measured immediately after implant insertion. RBH and implant macro-design have an impact on ISQ values (P < .001). ISQ values were the highest with RBH of 15 mm, followed by RBHs of 9, 6, and 3 mm. (P < .001). There was no statistically significant difference between different implant macro-designs at RBHs of 3 and 15 mm regarding ISQ values (P = .111, P = .551). ISQ values of group P were higher than those of group R and group A at an RBH of 6 mm (P = .049, P = .029). ISQ values were also higher in group P compared to group A at an RBH of 9 mm (P = .006). A higher PS may be expected in sites with higher RBH, regardless of the macro-design. In addition, cylindric implant design may enhance the PS at RBHs of 6 and 9 mm in simultaneous implant insertion with SFE.

Efficacy of type-1 collagen cones in extraction sockets following surgical removal of semi-impacted mandibular third molars: a randomized controlled trial.

OBJECTIVES: Third molar extractions may affect the periodontal health of the adjacent second molars as well as the patient's comfort. The objective of this study was to evaluate the efficacy of type-1 collagen cone (CC) on periodontal health and postoperative sequelae following extraction of third molars with secondary healing. METHOD AND MATERIALS: This was a randomized, controlled, split-mouth clinical trial. Sixty mandibular third molars (30 patients) were subdivided according to side. A collagen cone was randomly inserted into one side and the other side was the control. Pain was evaluated using a visual analog scale. Trismus and facial swelling were determined on postoperative days 2, 7, and 30. The alveolar osteitis (AO) incidence was recorded on days 2 and 7. The Plaque Index, Gingival Index, clinical attachment level, and pocket probing depth of the second molars were evaluated at postoperative months 1, 3, and 6. RESULTS: No significant differences were found between groups regarding postoperative pain, trismus, facial swelling, or the incidence of AO. However, AO developed in 10% of control side cases, while no sign of AO was observed on the experimental side. Plaque Index, Gingival Index, and clinical attachment level were comparable in both groups. Pocket probing depths for the distobuccal surface of the second molar was significantly higher on the control side at 6 months (P = .017). CONCLUSION: Insertion of a type-1 collagen cone into an extraction socket did not show a significant clinical improvement in extraction socket healing and postoperative sequelae after the third molar extraction.

Comparison of the effects of articaine and bupivacaine in impacted mandibular third molar tooth surgery: a randomized, controlled trial.

BACKGROUND: The aim of this randomized, triple-blind trial was to determine the anesthetic, analgesic, and hemodynamic effects of articaine and bupivacaine in the extraction of impacted mandibular third molar teeth. METHODS: Twenty-six patients who underwent removal of bilaterally symmetric mandibular third molars were randomly assigned to articaine and bupivacaine groups in a split-mouth design. The onset of anesthetic action, intraoperative comfort, total amount of solution used, duration of postoperative anesthesia and analgesia, rescue analgesic use, postoperative pain, intraoperative bleeding, and hemodynamic parameters were evaluated. RESULTS: In the articaine group, the onset of anesthetic activity was faster, intraoperative comfort was greater, and effective anesthesia required less local anesthetic solution. The bupivacaine group showed a significantly longer duration of postoperative anesthesia and analgesia, in addition to lower visual analog scale values at 6 and 48 hours postoperatively. There were no significant differences between the two solutions regarding rescue analgesic medication use, intraoperative bleeding, or hemodynamics. CONCLUSION: Articaine showed greater clinical efficacy than bupivacaine in intraoperative anesthesia, achieving faster onset of anesthetic action and greater patient comfort while also requiring less reinforcement during surgery. However, bupivacaine was superior in terms of postoperative anesthesia, reducing postoperative pain due to its residual anesthetic and analgesic effects. Both anesthetic solutions led to similar hemodynamics at low doses in mandibular third molar surgery.

The effect of triangular cross-section neck design on crestal bone stability in the anterior mandible: A randomized, controlled, split-mouth clinical trial.

OBJECTIVES: This randomized controlled trial aimed to compare crestal bone loss (CBL) and buccal bone thickness (BBT) around triangular cross-section neck (TN) to round neck (RN) implants retaining mandibular overdentures one year after loading, using cone beam computed tomography (CBCT). MATERIAL AND METHODS: Twenty edentulous patients receiving 40 implants with similar diameters were randomly assigned to the RN and TN groups. Clinical buccal bone thickness (CBBT) around the implants was measured with a caliper at baseline. A resonance frequency analyzer was used to measure the implant stability quotient (ISQ) at the baseline and two months after insertion. Pocket probing depths (PPD), plaque index (PI), and gingival index (GI) were also recorded at postoperative months 2, 6, and 12. CBCT was used to evaluate proximal CBL and BBT at three levels (0, -2, and -4 mm) one year after loading. RESULTS: No implant loss was observed during the follow-up period. No significant differences in CBBT, ISQ values, and scores for PPD, PI, and GI between the two groups were observed at any time (p > .05). BBT was also comparable one year after loading (p > .05). The mean ± SD proximal CBL one year after loading was 0.58 ± 0.36 mm for TN and 0.91 ± 0.59 mm for RN (p < .01). CONCLUSIONS: This study found better crestal bone preservation in the implants with the novel neck design than conventional neck design in the anterior mandible after a follow-up of one year. However, it may not be clinically noticeable.

Peripheral Dentinogenic Ghost Cell Tumor of the Maxilla.

ABSTRACT: Dentinogenic ghost cell tumor (DGCT) is an uncommon locally invasive odontogenic tumor, representing 1.9% to 2.1% of all odontogenic tumors. The main microscopic features of DGCT are an ameloblastoma-like odontogenic epithelial proliferation with sheets of ghost cells and dentinoid material formation. The peripheral variant of this clinical rarity, which represents a less aggressive behavior than central lesions, mostly affects the anterior region of both jaws. In this case report, the authors present a DGCT that was observed in the maxillary posterior region in a 59-year-old female patient. The patient presented with pain and nodular swelling in the right maxillary molar region, which extended from the buccal vestibule to the edentulous area. Additionally, there was a destruction of the underlying bone, as seen radiographically. This case report includes the clinical, radiological, and histopathological features of the lesion, which was diagnosed as a peripheral DGCT without any evidence of recurrence in the 2 years after excision.

Correlation between preoperative pressure pain assessments and anxiety and postoperative pain in impacted lower third molar surgery.

OBJECTIVES: : The aim of this study was to evaluate correlations between anxiety and preoperative pressure pain assessments and postoperative pain and analgesic requirements in impacted lower third molar tooth surgery. MATERIALS AND METHODS: This prospective study enrolled 60 patients who underwent impacted lower third molar surgery. The preoperative State-Trait Anxiety Inventory-I (STAI-I), pressure pain threshold, and pressure pain tolerance scores were measured. At 2, 4, 6, 12, and 24 hours, and at 6 days following surgery, the patients scored their pain on the visual analogue scale and recorded their analgesic drug usage. The data were evaluated, and the results were statistically analyzed. RESULTS: Of the 60 patients, 38 were female. Mean age was 24.62±7.42 years. The study found no relationship between preoperative pressure pain assessments and postoperative pain (P>0.05). There was also no relationship observed between preoperative STAI-I scores and postoperative pain (P>0.05). However, there was a positive correlation between operation time and total medication taken (P<0.05). CONCLUSION: Preoperative pressure pain threshold, pressure pain tolerance, and anxiety level had no significant effects on postoperative pain and analgesic requirements in impacted lower third molar surgery.

Excision of Rare Intraosseous Traumatic Neuroma of the Mandible.

Traumatic neuroma is a non-neoplastic proliferative disorder of the nerve sheath in response to injury or surgery. Traumatic neuroma most frequently occurs in soft tissues and intraosseous involvement is uncommon. In this paper, we present a rare case of intraosseous traumatic neuroma of the inferior alveolar nerve leading to pain and paresthesia of the lower lip on the left side.

Primary diffuse large B-cell lymphoma of the mandible: A case report.

INTRODUCTION: Lymphomas are a heterogeneous group of malignant neoplasms of lymphocytes and their precursor cells. Lymphoma is seen 3.5% of all intraoral malignancies and is the second most common neoplasm after the squamous cell carcinoma in the head and neck region. Diffuse large B-cell lymphomas (DLBCL), which is a subtype of non-Hodgkin lymphoma, are seen mostly in the paraoral region. CASE PRESENTATION: An 82-year-old woman was referred with a localised swelling of the mandibular buccal mucosa for 3 months. Excisional biopsy revealed the diagnosis of DLBCL in the mandible and chemotherapy regimen started immediately. However, patient died during treatment. CONCLUSIONS: Non-Hodgkin's lymphomas would be late- or misdiagnosed in the perioral region that may result poor prognosis.

Knowledge, attitude and practice of dentists in Coronavirus disease 2019 pandemic in Turkey.

PURPOSE: The aim was to assess the knowledge, attitudes and anxiety of the dentists in relation to COVID-19. MATERIALS AND METHODS: This cross-sectional survey was conducted amongst 590 dentists employed in Turkey from March to April 2020. The electronic survey consisted of 22 questions related to demographic profile, knowledge, clinical practice and anxiety level of the participants towards dental management of COVID-19. The survey was sent to participants by email and mobile phone messages to be filled electronically. RESULTS: Majority of respondents pointed to aerosol (98.5%), saliva (90.6%) and mucosal contact (71.4%) as the transmission routes of COVID-19. Amongst all clinical symptoms of the disease questioned, fever (99.8%), dry cough (99.1%), fatigue (90.0%) were associated with COVID-19 by vast majority of population. 96.4% of respondents agreed the usage of gloves as personal protective equipment and it was followed by face shield (88.1%), disposable gown (83.4%), protective goggles (73.9%). Increased usage of FFP2/N95 (33.9%) and FFP3/N99 (10.9%) respirators, contrary to reduction of surgical mask usage (50.7%), were observed in aerosolgenerating procedures comparing to dental procedures without producing aerosol and these differences were highly significant (p<0.001, p=0.004, p<0.001). The mean anxiety level of respondents was 3.35 ± 1.18 (ranging from 0 to 5). CONCLUSION: These results demonstrated an adequate knowledge, especially in clinical symptoms of COVID-19 amongst dentists. However, the respirator usage rate in aerosol-generating procedures was not satisfactory which suggesting to necessity of dentists' education about pandemic.

Evaluation of biopsies of oral and maxillofacial lesions: a retrospective study.

OBJECTIVES: This study aimed to determine the prevalence of odontogenic cysts, tumors, and other lesions among reports in the archives of the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry affiliated with Kocaeli University collected over a four-year period. MATERIALS AND METHODS: In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Surgery from 2014 to 2018 were reviewed. Patient demographic information (age and sex) and lesion location were recorded and analyzed. RESULTS: From a total of 475 files reviewed, odontogenic cyst was confirmed in 340 cases (71.6%), and odontogenic tumor was confirmed in 52 cases (10.9%). Regarding odontogenic cyst type, the most common was radicular cyst (216 cases), followed by dentigerous cyst (77 cases) and odontogenic keratocyst (23 cases). Among odontogenic tumors, the most frequent was odontoma (19 cases), followed by ossifying fibroma (18 cases) and ameloblastoma (9 cases). Giant cell granuloma was also reported in 35 cases. CONCLUSION: The distribution pattern of odontogenic cysts and tumors in our retrospective study is relatively similar to that reported in the literature. Complete clinical reports for final diagnosis of these lesions and routine follow-up examinations are very important for treatment.