The Effect of Topical Application of Hyaluronic Acid on the Stability of Immediate Loaded Dental Implants in the Posterior Maxilla: Clinical and Animal Study.

Objective: To assess the effect of topically applied hyaluronic acid (HA) on the stability of immediately loaded implants in the posterior maxilla. Materials and Methods: For the clinical study, a total of 20 implants were placed in 14 patients seeking the replacement of missing single or multiple posterior maxillary teeth. The patients were randomly divided into two groups. In the clinical control group (CC group), 10 implants were placed and immediately loaded, while in the clinical study group (CS group), 10 implants were coated with HA immediately before placement and immediately loaded. All patients had implant stability clinically evaluated at implant placement time (T0) and 1 (T1), 3 (T3), and 6 (T6) months after loading. Peri-implant pocket depth and modified sulcus bleeding index were evaluated clinically at 6 months in all patients. Bone density was evaluated radiographically after 3 months. All the clinical and radiographic data were subjected to statistical analysis. For the animal study, a total of 12 implants were placed in the tibiae of six rabbits. For each rabbit, 1 implant without any applied HA was placed in the left tibia (AC group), and 1 implant coated with HA was placed in the right tibia (AS group). The rabbits were euthanized at 21 and 45 days after implant insertion. Results: There were no significant statistical differences between the two groups regarding implant stability, peri-implant pocket depth, modified sulcus bleeding index, or bone density from the palatal and apical aspects. However, there was a significant statistical difference in the bone density from the buccal aspect in favor of the study group. The animal study showed that the newly formed bone in the right tibiae showed improved quantity and quality of bone, as it had denser bone trabeculae and smaller marrow spaces compared to the left tibiae. Conclusion: In the clinical study, the application of hyaluronic acid had a superior effect on the buccal bone density around immediately loaded implants. In the animal study, hyaluronic acid had a synergistic effect on the quality and quantity of bone formation around dental implants.

Evaluation of Two Computerized Methods for Presurgical Volumetric Analysis in Secondary Alveolar Cleft Bone Grafting: A Prospective Study.

AIM: The purpose of this study is to evaluate presurgical computerized volumetric analysis in secondary alveolar cleft bone grafting (SABG) and the time taken for calculation using cone-beam computed tomography (CBCT) via two different software programs. MATERIALS AND METHODS: Twelve patients with unilateral alveolar clefts were investigated using CBCT. Two independent investigators did presurgical volumetric analysis for each patient's CBCT data using two different methods. Method A involved On-Demand 3D software (Cybermed Inc., Korea), while method B involved InVesalius 3 software (CTI, Brazil). The volume outcomes and time spent for measurements were compared between both software programs. Interobserver reliability and descriptive and t-test statistics were computed, and statistical significance was considered when p ≤ 0.05. RESULTS: There was not a statistically significant difference between clefts' volumetric measurements by the two methods via both investigators (p = 0.186 and 0.069). However, the difference in time taken for these measurements between the two methods was statistically significant (p < 0.001). Intraclass correlation coefficient (ICC) values indicated excellent interobserver reliability for measurements by method A (ICC ~ 0.998), and moderate reliability for method B (ICC ~ 0.626). CONCLUSIONS: Both software programs used in this study had comparable volumetric computation. Method B took much less calculating time than method A. The interobserver reliability was high for both methods. CLINICAL SIGNIFICANCE: These both investigated software programs may show a clinical implication for presurgical alveolar cleft volume measurement, thus reducing the surgical operating time and adequately selecting a donor site with a congruent sufficient amount of bone grafts.