The Interplay of Raloxifene and Sonochemical Bio-Oss in Early Maxillary Sinus Bone Regeneration: A Histological and Immunohistochemical Analysis in Rabbits.

The study aimed to assess the efficacy of using Raloxifene with ultrasonic processing to enhance Bio-Oss®, a bone graft substitute, for maxillary sinus bone height reconstruction. A total of 24 rabbit maxillary sinuses were distributed into three groups, each receiving different treatments: Bio-Oss® only, sonicated Bio-Oss, and sonicated Bio-Oss® with Raloxifene. Surgical procedures and subsequent histomorphometric and immunohistochemistry analyses were conducted to evaluate the bone formation, connective tissue, and remaining biomaterial, as well as the osteoblastic differentiation and maturation of collagen fibers. Results indicated that the sonicated Bio-Oss® and Bio-Oss® groups showed similar histological behavior and bone formation, but the Raloxifene group displayed inflammatory infiltrate, low bone formation, and disorganized connective tissue. The statistical analysis confirmed significant differences between the groups in terms of bone formation, connective tissue, and remaining biomaterial. In conclusion, the study found that while sonicated Bio-Oss® performed comparably to Bio-Oss® alone, the addition of Raloxifene led to an unexpected delay in bone repair. The findings stress the importance of histological evaluation for accurate bone repair assessment and the necessity for further investigation into the local application of Raloxifene. Future research may focus on optimizing bone substitutes with growth factors to improve bone repair.

Finite element analysis of low-profile reconstruction plates for atrophic mandibles: a comparison of novel 3D grid and conventional plate designs.

OBJECTIVES: This study aimed to compare the reconstruction with type 2.4 and three-dimensional (3D) grid plates relating the areas of weakness to anatomical regions of force incidence in atrophic mandibles with and without segmentation using finite element analysis (FEA). MATERIALS AND METHODS: Strength and force quality in the mandible were also determined. The atrophic mandible models with and without segmentation were divided into four groups, and the behavior of each plate was analyzed using finite element analysis. In the atrophic mandible without segmentation using the type 2.4 reconstruction plate, the highest stress concentration in the plate was observed in the posterior region of the mandibular body and in the grid type 3D reconstruction plate was observed in the mandibular angle. RESULTS: In the segmented atrophic mandible with the 2.4 reconstruction plate, higher stress concentration was observed in the mandibular segment defect. Analysis of the 3D grid-like reconstruction plate revealed that the geometry of the plate conferred greater stiffness to the assembly, as the most significant stress concentration was observed at the mandibular angle. CONCLUSION: The width of the plate design may influence the strength, not the thickness.

Harnessing the Power of PAOO and Invisalign: An Interdisciplinary Approach to Orthodontic Care.

The present article explores the benefits of combining periodontally accelerated osteogenic orthodontics (PAOO) with Invisalign for optimal orthodontic treatment outcomes. PAOO is an interdisciplinary dental technique that minimizes complications and accelerates tooth movement while enhancing various orthodontic treatments. In conjunction with Invisalign, PAOO provides a discreet and comfortable solution for patients seeking to improve their smile. The study presents two challenging cases successfully treated using this combined approach, emphasizing the technique's potential to reduce treatment times and improve orthodontic outcomes. The interdisciplinary approach of PAOO ensures long-term success and stability by preserving periodontal structures and addressing potential bony defects. By incorporating bone grafting materials, PAOO helps prevent common concerns in traditional orthodontic treatments, such as bony defects and gingival recession. Furthermore, the combination with Invisalign offers a more aesthetically pleasing and comfortable treatment experience, allowing patients to maintain their self-esteem and confidence throughout the treatment. Despite the potential advantages, dental professionals must manage patient expectations and address potential complications to ensure the best possible results. Overall, the integration of PAOO and Invisalign demonstrates a viable alternative for patients who do not want to proceed with orthognathic surgery, enhancing patient satisfaction and overall treatment outcomes.

Lower third molar displaced to lateral pharyngeal space after mandibular angle fracture: a case report.

The removal of displaced dental elements from deep anatomical spaces is a condition that requires the knowledge of the region and skills to perform the procedure. The lateral pharyngeal space contains important structures such as the internal carotid artery and close proximity with the cranium basis. The aim of this paper is to report a clinical case of a lower third molar displaced to the lateral pharyngeal space after a mandibular angle fracture and its treatment by surgical intervention. The tooth was removed under general anesthesia by direct approach and the fracture was reduced and fixed with a plate and screws. This case report illustrates the importance of an immediate procedure to avoiding severe complications and further damage to important anatomical structures.

Maxillary Sinus Elevation Surgery with ChronOS and Autogenous Bone Graft: Immunohistochemical Assessment of RUNX2, VEGF, TRAP, and Osteocalcin.

The purpose of this study was to evaluate a composite graft of ChronOS, a beta-tricalcium phosphate (ß-TCP), mixed 1:1 with an autogenous bone graft in human maxillary sinus augmentation. A total of 12 maxillary sinuses were grafted with an autogenous bone graft (control group), and 9 maxillary sinuses were grafted with ChronOS mixed 1:1 with an autogenous bone graft (test group). After 6 months, biopsy samples were obtained concurrent to the placement of dental implants and were subjected to histomorphometric and immunohistochemical analyses for Runt-related transcription factor 2 (RUNX2), vascular endothelial growth factor (VEGF), tartrate-resistant acid phosphatase, and osteocalcin. Histologic analysis of samples obtained from the test group revealed the presence of immature bone, while samples from the control group indicated lamellar bone formation. However, both types of bone grafts were well vascularized. The new bone formation averaged 25.4% ± 6.4% in the test group and 38.6% ± 10.5% in the control group (P = .001). Immunostaining of samples in the test group showed high cellular turnover. The outcomes of this study demonstrate a delay in bone formation but intense cellular differentiation after 6 months of bone graft healing in the test group. The amount of immature bone and the immunostaining for RUNX2 and VEGF provide evidence of an osteogenic pathway that can improve the bone formation rate.

Maxillary Sinus Elevation Surgery with ChronOS and Autogenous Bone Graft: Analysis of Histometric and Volumetric Changes.

The aim of this study was to compare the bone resorption rate and histometry of ChronOS, a beta-tricalcium phosphate (ß-TCP), mixed with autogenous bone grafts (1:1) with that of autogenous bone grafts alone in maxillary sinus elevation surgery. A total of 12 maxillary sinuses were grafted with an autogenous bone graft (control group) and 9 with ChronOS mixed with an autogenous bone graft (test group). Postoperative cone beam computed tomography (CBCT) was used to measure the initial graft volume after 15 days (T1), and 6 months later another CBCT scan was performed to evaluate the final graft volume (T2) and determine the graft resorption rate. The resorption outcomes were 45.7% ± 18.6% in the control group and 38.3% ± 16.6% in the test group (P = .17); the bone formation rate was 38.6% ± 10.5% in the control group and 25.4% ± 6.4% in the test group (P = .001). ChronOS mixed with autogenous bone graft demonstrated a resorption rate similar to that of the autogenous bone graft but with a difference in bone formation after 6 months.

Assessment of Satisfaction Level of Edentulous Patients Rehabilitated with Implant-Supported Prostheses.

PURPOSE: Edentulism usually leads to esthetic, functional, and emotional discomfort resulting in a loss of self-esteem and a decrease of the patient's quality of life. Dental implants provide new possibilities to ensure the comfort and efficacy of prosthetic rehabilitation. The aim of this study was to evaluate the satisfaction level of patients rehabilitated using the Brånemark protocol or overdenture implant-supported prostheses. MATERIALS AND METHODS: Fifty-two patients were rehabilitated using the Brånemark protocol and 23 using overdenture prostheses. Then, an adapted oral health-related quality of life questionnaire was administered in addition to a clinical exam to determine the condition of the dental implants and prostheses. The results for treatment expectation, understanding of the type of treatment, phonetic function, chewing comfort, pain, and self-esteem improvement were analyzed with Fisher exact test (P ≤ .05). RESULTS: Both treatments presented satisfaction of above 87%, with no statistical difference between them. Eighty-two percent of patients treated with overdenture prostheses and 80.8% of those treated with the Brånemark protocol had no complaint of pain (P = .087). CONCLUSION: The treatments analyzed in this study were highly satisfactory with regard to functional and esthetic factors, resulting in an increase in self-esteem and quality of life. The psychological factor is a complex variable in patient satisfaction that directly influences quality of life. Considering the desires of patients in choosing the type of prosthesis is critical to treatment success.

Five-year follow-up of modified implant-supported overdenture in an iliac crest autograft failure: clinical report.

The treatment of extensive pathologic lesions in the jaw, most of the time, can generate rehabilitation problems to the patient. The solid ameloblastoma is a locally invasive odontogenic tumor with a high recurrence rate. Its treatment is aggressive and accomplished through resection with safety margin. The criterion standard for reconstruction is autogenous bone, but it can provide a high degree of resorption, causing inconvenience to the patient because of lack of rehabilitative option. This study aimed to describe a patient with ameloblastoma treated through resection and reconstruction with autogenous bone graft, in which, after an extensive resorption of the graft was made, a modified bar was applied to support a prosthetic implant overdenture.