A Novel Zinc-Containing Palatal Stent and Topical Oxygen Therapy for Wound Protection and Healing Following Mucoperiosteal Flap Surgery in the Hard Palate: A Case Report.

In oral surgery, common surgical procedures such as the removal of impacted teeth, the treatment of intraosseous cysts and tumors, and endodontic surgery often require access through a palatal approach. Full-thickness flap surgery in the hard palate region can result in significant post-operative pain, swelling, and hematoma, adversely affecting the patient's function and well-being for several days. Moreover, post-operative infection can delay or compromise healing. Post-surgical traditional palatal stents have been shown to effectively reduce discomfort by minimizing swelling and pain during the early healing phases. Recent advances in materials with the incorporation of bioactive agents have led to the fabrication of a new generation of wound dressings that provide improved conditions for effective wound protection and healing. This case report illustrates the use of a novel, zinc-embedded, thermoplastic surgical polymer for the chairside fabrication of post-operative palatal stents. A 33-year-old female patient, who underwent mucoperiosteal flap surgery for the management of a nasopalatine duct cyst, was provided immediately post-surgery with a customized zinc-containing palatal stent. The bone defect was grafted using a fully resorbable synthetic bone substitute, and an oxygen and lactoferrin-releasing oral gel was provided post-operatively as an adjunct therapy. The innovative stent helped the patient maintain low levels of pain and minimal swelling during the initial post-operative period, resulting in uneventful healing, as documented during the one-week follow-up appointment. Further reviews at four weeks and six months post-surgery revealed successful healing and sensory recovery in the anterior palatal region. As emphasized in this report, the chairside fabrication of zinc-containing palatal stents for post-operative wound protection seems to constitute a valid, simple, time-saving, and cost-effective clinical solution. Moreover, the incorporation of zinc nanoparticles into the stent is of great clinical importance, potentially offering significant benefits in post-operative bacterial control and enhancement of the early-phase palatal soft-tissue healing.

Histological and Histomorphometric Evaluation of Implanted Photodynamic Active Biomaterials for Periodontal Bone Regeneration in an Animal Study.

Recently, our group developed two different polymeric biomaterials with photodynamic antimicrobial surface activity for periodontal bone regeneration. The aim of the present study was to analyze the biocompatibility and osseointegration of these materials in vivo. Two biomaterials based on urethane dimethacrylate (BioM1) and tri-armed oligoester-urethane methacrylate (BioM2) that additionally contained ß-tricalcium phosphate and the photosensitizer mTHPC (meso-tetra(hydroxyphenyl)chlorin) were implanted in non-critical size bone defects in the femur (n = 16) and tibia (n = 8) of eight female domestic sheep. Bone specimens were harvested and histomorphometrically analyzed after 12 months. BioM1 degraded to a lower extent which resulted in a mean remnant square size of 17.4 mm², while 12.2 mm² was estimated for BioM2 (p = 0.007). For BioM1, a total percentage of new formed bone by 30.3% was found which was significant higher compared to BioM2 (8.4%, p < 0.001). Furthermore, BioM1 was afflicted by significant lower soft tissue formation (3.3%) as compared to BioM2 (29.5%). Additionally, a bone-to-biomaterial ratio of 81.9% was detected for BioM1, while 8.5% was recorded for BioM2. Implantation of BioM2 caused accumulation of inflammatory cells and led to fibrous encapsulation. BioM1 (photosensitizer-armed urethane dimethacrylate) showed favorable regenerative characteristics and can be recommended for further studies.

A Case Report of Atraumatic Tooth Extraction Followed by Ridge Preservation for Implant-Supported Prosthetic Rehabilitation Using an Alloplastic Bone Graft.

Exodontia is a painful treatment that frequently causes the alveolar bone and surrounding soft tissues to be immediately destroyed and lost. With regard to the amount of resorption taking place after extraction, various treatment protocols aimed at preventing or decreasing alveolar ridge collapse have been presented over the past three decades. Ridge preservation is a clinical technique used to prevent the socket walls' bone resorption after tooth extraction. A 43­year­old female patient with a non-significant medical history visited the Department of Periodontology and Implantology with a chief complaint of a decayed tooth in the upper left back region (26) for three years and wants to get it replaced. The treatment option that was given to the patient was atraumatic extraction, followed by ridge preservation. A cautious and conservative treatment strategy is necessary to preserve the oral structures as they currently exist and are intact for a successful outcome; careful case selection and thorough treatment planning are crucial. Atraumatic tooth extraction is a procedure used to delicately remove a tooth while upholding the fundamental principles of preserving the surrounding bone and gingival structure. This will ultimately maximize the success of implant placement in terms of appearance and functionality.

A clinical study on the efficacy of hydroxyapatite - Bioactive glass composite granules in the management of periodontal bony defects.

BACKGROUND: In periodontal regeneration, several alloplastic materials are being used with a goal to reconstruct new osseous tissue in the infrabony defect sites. The present study was undertaken to evaluate the efficacy of hydroxyapatite-bioactive glass (HA:BG) composite granules in the management of periodontal bony defects. MATERIALS AND METHODS: A randomized control study was conducted. Subjects with infrabony defects were divided into three groups. Test Group 1 (n = 10): Defect site was treated with HA:BG, with a biodegradable membrane. Test Group 2 (n = 10): Defect site was treated with HAP, with a biodegradable membrane. Control group (n = 10): Defect site was treated with open flap debridement with a biodegradable membrane. RESULTS: The healing of defects was uneventful and free of any biological complications. The gain in clinical attachment level, reduction of probing pocket depth, and defect fill were statistically significant in all three groups. TG1 sites showed significant defect fill than TG2 and CG sites. CONCLUSION: The performance of HA:BG was better compared to HAP and open flap debridement for the reconstruction of infrabony defects.

Sinus elevation with an alloplastic material and simultaneous implant placement: a 1-stage procedure in severely atrophic maxillae.

AIMS AND OBJECTIVE: The aim of the study is to evaluate clinically and radiographically the long term success of one-stage direct (lateral) sinus lift procedure using alloplastic bone graft material and bio-absorbable membrane in conjunction with two stage implant placement in atrophic partially edentulous posterior maxilla. MATERIALS AND METHODS: One stage direct maxillary sinus lift in conjunction with two stage implant placement was carried out in 12 patients at 13 sites. All the patients were partially edentulous with posterior maxillary alveolar ridge height of >5 mm and were in the age group of 20-50 years. Bioactive glass putty, bio-absorbable collagen membrane and 3.75 × 11.5 mm implants were used. Loading of implants was done 6 months after placement of implants. Patients were evaluated clinically and radio-graphically 6, 18, 30 months after placement of implants to assess increase in residual ridge height, peri-implant condition (marginal bone loss, plaque and gingival index) and implant stability. RESULTS: Maxillary first molar was the most common site (69.23 %) for sinus lift and implant placement. Caries was the most common cause (76.92 %) for loss of tooth. Increase in residual ridge height ranged from (71.43 to 133.33 %) as measured by Denta-Scan. Implant survival rate was 100 %. Marginal bone loss ranged from 0.68 to 1.22 mm. Implant stability was measured by periotest (-2.7 to -3.6). Only one patient had perforation of sinus membrane, but it was sealed satisfactorily by bio-absorbable membrane. CONCLUSION: One stage lateral sinus lift procedure with alloplastic bone graft material in combination with 2 stage implant placement has a predictable outcome in patients with severe resorption of posterior maxilla.

The Effect of New Bone Formation of Onlay Bone Graft Using Various Graft Materials with a Titanium Cap on the Rabbit Calvarium

0.05).SUMMARY: This result suggests that autogenous bone is the best choice for new bone formation, but when autogenous bone graft is in limited availability, alloplastic and xenogenic bone graft also can be an alternative bone graft material to use with a suitably guided membrane.