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Language Journal of Clinical and Experimental Dentistry. 2016. Vol. 8, no. 2
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- Myositis ossificans of the masseter muscle: a rare location. Report of a case and review of literature(2016) Fité-Trepat, Laia; Martos Fernández, Míriam; Alberola Ferranti, Margarita; Romanini-Montecino, Carolina; Sáez Barba, Manel; Bescós Atín, SocorroBackground: Myositis Ossificans is a rare heterotopic bone formation within a muscle being the masticatory muscles exceptionally involved. In most cases there is a previous trauma, bearing in mind that there may be many other etiologies. CT scan and panoramic radiographs along with histological findings are essential diagnostic aids. Case Desciption: we report a rare case of MO of masseter muscle in 49 years-old woman after repetitive wisdom tooth infection with the discussion of clinical, radiological and histological features. Clinical Implications: MO is a rare disease of masticatory muscles being the masseter the most frequently affected. Wide surgical excision with free margins is the treatment of choice although close postoperative monitoring it’s essential to avoid relapses.
- Posttraumatic carotid-cavernous fistula: pathogenetic mechanisms, diagnostic management and proper treatment. A case report(2016) Marín Fernández, A.B.; Cariati, Paolo; Román-Ramos, María; Fernández Solís, José; Martínez Lara, IdelfonsoCarotid-cavernous fistulas are an uncommon diseases characterized by abnormal communications between arteries and veins located in the cavernous sinus. According with Barrow´s classification they could be divided in two groups: direct and indirect. The typical symptoms showed by theses pathologies are: pulsating exophthalmos and orbital blow. The present study describes a case of direct posttraumatic carotid-cavernous fistula in a 26 years old man. Furthermore, we present the images that we used to make the diagnosis. In this light, we decided to treat this case with endovascular approach after considering several therapeutic options. The aim of the present report is twofold. First, we examine the importance of the proper management of the direct posttraumatic carotid-cavernous fistula. Second, we describe this rare syndrome with the goal of proposing suitable treatments.
- Solitary central osteoma of mandible in a geriatric patient: report and review(2016) Nilesh, Kumar; Bhujbal, Ravi B.; Nayak, Ajay G.Solitary central osteomas of jaw are extremely rare lesions with only few previously documented cases. This paper reports a case of large solitary central osteoma involving mandible symphysis- parasymphysis region in an elderly female patient. A brief review of similar cases reported in the literature is also provided in this paper.
- Osteolipoma of buccal mucosa: case report and literature review(2016) Raviraj, Jayam; Kumar-Bokkasam, Vijay; Suresh, Dirasantchu; Venkata, SumanOsteolipoma affecting oral cavity is indeed rare. We hereby report a case of osteolipoma affecting buccal mucosa. A review of literature of osteolipoma of oral cavity, particularly on radiographic/imaging findings was done. Only 16 cases of Osteolipoma of oral cavity are reported in the literature. The radiographic findings of our case, i.e. multiple dense homogenous radio-opaque structures was reported earlier only in one case [out of 16] of osteolipoma of oral cavity
- Treatment of oral mucositis due to chemotherapy(2016) Chaveli López, Begonya; Bagán Sebastián, José VicenteIntroduction: The management of oral mucositis is a challenge, due to its complex biological nature. Over the last 10 years, different strategies have been developed for the management of oral mucositis caused by chemotherapy in cancer patients. Material and Methods: An exhaustive search was made of the PubMed-Medline, Cochrane Library and Scopus databases, crossing the key words “oral mucositis”, “prevention” and “treatment” with the terms “chemotherapy” and “radiotherapy” by means of the boolean operators “AND” and “NOT”. A total of 268 articles were obtained, of which 96 met the inclusion criteria. Results: Several interventions for the prevention of oral mucositis, such as oral hygiene protocols, amifostine, benzidamine, calcium phosphate, cryotherapy and iseganan, among others, were found to yield only limited benefits. Other studies have reported a decrease in the appearance and severity of mucositis with the use of cytoprotectors (sucralfate, oral glutamine, hyaluronic acid), growth factors, topical polyvinylpyrrolidone, and low power laser irradiation. Conclusions: Very few interventions of confirmed efficacy are available for the management of oral mucositis due to chemotherapy. However, according to the reviewed literature, the use of palifermin, cryotherapy and low power laser offers benefits, reducing the incidence and severity of oral mucositis – though further studies are needed to confirm the results obtained.
- The effect of radiotherapy on survival of dental implants in head and neck cancer patients(2016) Shugaa-Addin, Bassam; Al-Shamiri, Hashem M.; Al-Maweri, Sadeq A.; Tarakji, BasselObjectives: To explore the current literature of the survival of dental implants in irradiated head and neck cancer patients considering the role of implant location, bone augmentation, dose of radiation and timing of implant placement. Study Design: Pubmed search was conducted to identify articles published between January 2000 and December 2014 and presenting data of dental implant survival with radiotherapy in head and neck cancer patients. Studies on animal subjects and craniofacial implants were excluded. Results: 18 articles out of 27 were eligible for inclusion in this systematic review. 12 out of 18 studies reported favorable outcome of dental implants and radiotherapy with survival rates between 74.4% and 97%. Seven out of ten studies comparing the survival rates according to site of implant placement reported that implants were found to osseointegrate with greater success in the irradiated mandible than irradiated maxilla. 5 studies which compared implant survival in irradiated native bone versus irradiated grafted bone reported that irradiated grafted bone showed a significantly reduced dental implant survival rate in comparison to irradiated native bone. 6 out of 18studies in which radiation doses exceeded 70 Gy reported lower survival rates of dental implants in comparison to the studies in which radiation doses were ≤70Gy. Higher survival rates were reported in 2 studies in which implants placement was before radiotherapy in comparison to the remaining 16 studies in which implants placement was after radiotherapy. Conclusions: Dental implants may be affected by radiotherapy especially when they are placed in maxilla, in grafted bone, or after radiation, however, they remain a functional option for rehabilitation of head and cancer patients. More prospective cohort studies and randomized controlled trails are still needed to draw more evidence based conclusions
- The central odontogenic fibroma: how difficult can be making a preliminary diagnosis(2016) Pippi, Roberto; Santoro, Marcello; Patini, RomeoCentral odontogenic fibroma (COF) is a rare benign odontogenic tumor derived from the dental ectomesenchymal tissues. A 16-year-old Caucasian female patient was referred by her dentist for a radiolucent asymptomatic area associated with the crown of the impacted lower right third molar. A preliminary diagnosis of a follicular cyst was supposed. The lesion was surgically removed under general anesthesia together with the impacted tooth. The microscopic diagnosis of the excised tissue revealed an odontogenic fibroma. No clinical or radiographic signs of recurrence were found five years after surgical excision. Despite the various differential diagnoses of homogeneous unilocular and well delimited radiolucencies of the jaws, enucleation with peripheral curettage, without any other pre-operative imaging exams or biopsies, can be considered as the treatment of choice.
- In vitro comparative study on the friction of stainless steel wires with and without Orthospeed (JAL 90458) on an inclined plane(2016) Alió Sanz, Juan José; Claros-Stucchi, Miguel; Albaladejo Martínez, Alberto; Iglesias-Conde, Carmen; Alvarado Lorenzo, AlfonsoBackground: During the treatment of orthodontics, in the mechanics of slide, there takes place friction, which they reduce the slide of the arch across bracket. Therefore, clinical there takes place an increase of the time of treatment. There are different the technologies that try to reduce this friction, as the self-ligating braces. The purpose of this study was to research the in vitro behavior of JAL 90458 as a buffering agent which reduces friction between brackets and stainless steel arch wires of different cross sections and sizes. Material and Methods: Three types of stainless steel wires with different cross sections and three types of ligatures were used with and without JAL 90458 to measure the friction according to the time and distance traveled by the brackets on an inclined plane with two angulations. The Kruskal-Wallis one-way analysis of variance by ranks was applied to determine the degree of friction between the group using and the group not using the product ( P ≤ .05). Results: Separate analysis of the arch wires, ligatures and angulation with and without the compound revealed statistically significant differences between the groups, showing that friction was reduced significantly when JAL 90458 was used ( P ≤ .01). The 0.021x0.025” arch wires and the arch wires attached using elastic ligatures produce the least resistance to sliding among all of those analyzed when the product was not used ( P ≤ .05). Conclusions: The results show that JAL 90458 reduces friction independently of arch wire cross section, type of ligature and angulation of the measuring instrument.
- Various forms of tobacco usage and its associated oral mucosal lesions(2016) Naveen-Kumar, Boddu; Tatapudi, Ramesh; Sudhakara Reddy, R.; Alapati, Satish; Pavani, Kotha; Sai-Praveen, Kotu-NagavenkataBackground: To study the various forms of tobacco usage and its associated oral mucosal lesions among the patients attending Vishnu Dental College Bhimavaram. Material and Methods: An observational cross-sectional study was conducted in a total of 450 patients who were divided into three groups based upon type of tobacco use, as Group-1 Reverse smoking, Group-2 Conventional smoking, Group-3 Smokeless tobacco group and each group consists of 150 subjects. Results: Reverse smoking was observed to be more prevalent among old females with smoker’s palate and carcinomatous lesions being the most common. Conventional smoking was observed more in male patients with maximum occurrence of leukoplakia and tobacco associated melanosis. Smokeless tobacco habit was predominantly seen in younger males. Habit specific lesions like tobacco pouch keratosis, Oral Submucous Fibrosis (OSMF), Quid induced lichenoid reaction were noticed in smokeless tobacco habit group except for erythroplakia which was noticed only in conventional smoking group and it was not significant statistically . Conclusions: In the present study it was found that the usage of reverse smoking habit was most commonly seen in females and this habit is practiced in and surrounding areas of Bhimavaram with more occurrence of carcinoma compared to conventional smoking and smokeless tobacco.
- Clinical evaluation of neodymium-iron-boron (Ne2Fe14B) rare earth magnets in the treatment of mid line diastemas(2016) Prasad, Mandava; Manoj-Kumar, Mitta; Gowri-Sankar, Singaraju; Chaitanya, Nellore; Vivek-Reddy, Ganugapanta; Venkatesh, NettamBackground: To evaluate the closure of midline diastema using the Neodymium-Iron-Boron magnets and to compare the treatment duration of midline diastemas with the use of magnets compared to regular orthodontic treatment. Materials and Methods: Thirty patients with age group 12 to 30 years with the midline diastema ranging from 0.5 to 3mm were selected. These patients were divided into two groups. Diastema closure in one group was accomplished by conventional method, in other group was done with Ne 2 Fe 14 B magnets. These magnets were fitted to the labial surfaces of the maxillary central incisors such a way that the opposite poles of the magnets face each other. At each appointment, study models and radiographs were taken for study subjects and the midline diastema was measured using digital vernier calipers on the study models obtained. Descriptive statistics carried out using Paired t-test . Results: Subjects treated with Ne 2 Fe 14 B magnets showed a significant difference compared to fixed orthodontic appliance subjects with respect to time of closure, rate of space closure and incisal inclination. Significant difference between 2 groups with reduction of 64.6 days in time to diastema closure in subjects treated with Ne 2 Fe 14 B magnets ( P <0.05). Conclusions: Ne 2 Fe 14 B magnets more efficient in complete closure of mid line diastema in less duration of time.
- Marginal integrity of low-shrinkage and methacrylate-based composite resins: effect of three different hemostatic agents(2016) Khoroushi, Maryam; Shirban, Farinaz; Sahraneshin-Samani, MahsaBackground: Moisture control is very important in restorative procedures in dentistry. Use of hemostatic agents helps control moisture; however, they might result in changes on enamel and dentin surfaces, affecting composite resin bond quality. The aim of this in vitro study was to evaluate the marginal microleakage of two different composite resins with the use of three different hemostatic agents. Material and Methods: Standardized Class V cavities were prepared on the buccal and lingual surfaces of 48 premolars with cervical margins 1 mm apical to the cementoenamel junction (CEJ). The samples were randomly divided into 8 groups. In groups 1 to 4, an etch-and-rinse adhesive (Adper Single Bond) was applied as the bonding system, followed by exposure to different hemostatic agent: group 1: no hemostatic agent (control); group 2: ViscoStat; group 3: ViscoStat Clear; and group 4: trichloracetic acid, as hemostatic agents. The cavities were restored with Z-250 composite resin. In group 5 to 8 Silorane System Adhesive (Filtek P90 Adhesive) was applied as a bonding agent, followed by exposure to different hemostatic agents in a manner similar to that in groups 1to 4. The cavities were restored with Filtek P90, a low-shrinkage composite resin. The samples in each group were evaluated for dye penetration under a stereomicroscope at ×36 after 24 hours and a 500-round thermocycling procedure at enamel and dentin margins. Statistical analysis was carried out using Kruskal-Wallis and Mann-Whitney tests (α=0.05). Results: Z-250 composite resin exhibited significantly higher dentin microleakage scores compared to Filtek P90 ( P = 0.004). Trichloracetic acid increased dentin microleakage with Filtek P90 ( P =0.033). Conclusions: Under the limitations of this in vitro study, application of hemostatic agents did not affect microleakage of the two tested composite resins except for trichloracetic acid that increased marginal microleakage when used with Filtek P90.
- Effect of glycine pretreatment on the shear bond strength of a CAD/CAM resin nano ceramic material to dentin(2016) Ceci, Matteo; Pigozzo, Marco; Scribante, Andrea; Beltrami, Riccardo; Colombo, Marco; Chiesa, Marco; Poggio, ClaudioBackground: The purpose of this study was to evaluate the effect of glycine pretreatment on the shear bond strength between dentin and a CAD/CAM resin nano ceramic material (LavaTM Ultimate Restorative), bonded together with adhesive cements using three different luting protocols (total-etch; self-etch; self-adhesive). Material and Methods: Thirty cylinders were milled from resin nano ceramic blocks with CAD/CAM technology. The cylinders were subsequently cemented to the exposed dentin of 30 bovine permanent mandibular incisors. The specimens were assigned into six groups of five teeth each according to luting procedure and dentin pretreatment. In the first two groups (A1, A2) 10 cylinders were cemented using a total-etch protocol; in groups B1 and B2, 10 cylinders were cemented using a self-etch protocol; in groups C1 and C2, 10 cylinders were cemented using a self-adhesive protocol; in groups A1, B1 and C1 the dentinal surface was also treated with glycine powder. All cemented specimens were submitted to a shear bond strength test. Statistical analysis was performed with Stata 9.0 software. Results: ANOVA showed the presence of significant differences among the various groups ( P <0.0001). Conclusions: Glycine did not change the different bond strength demonstrated by the various luting protocols tested. Conventional resin composite cements used together with a self-etch adhesive reported the highest values. However the use of glycine seems to increase the bond strength of self-adhesive resin cements.
- Continuous neurophatic orofacial pain: a retrospective study of 23 cases(2016) Sotorra Figuerola, Dídac; Sánchez Torres, Alba; Valmaseda Castellón, E.; Gay Escoda, CosmeBackground: To determine the clinical characteristics of Continuous Neuropathic Orofacial Pain in patients that suffer Persistent Idiopathic Facial Pain (PIFP), Painful Post-Traumatic Trigeminal Neuropathy (PPTTN) or Burning Mouth Syndrome (BMS) and to describe their treatment. Material and Methods: A retrospective observational study was made, reviewing the clinical history of the patients diagnosed with Continuous Neuropathic Orofacial Pain between 2004 and 2011 at the Orofacial Pain Unit of the Master of Oral Surgery and Implantology of the University of Barcelona and at the Orofacial Pain Unit of the Teknon Medical Center of Barcelona. Results: The average age of the patients with Continuous Neuropathic Orofacial Pain was 54.5, with a clear female predominance (86.9%, n=20). Of all patients, 60.9% (n=14) were suffering a PIFP, 21.7% (n=5) had a BMS and 17.4% (n=4) were presenting a PPTTN. The pain quality described by the patients with Continuous Neuropathic Orofacial Pain was oppressive (43.47%, n=10), widely represented by patients with PIFP, and burning (39.13%, n=9) being the only quality that described patients with BMS. The treatment carried out with the patients was only pharmacologic. The most used drugs for the treatment of PIFP and PPTTN were clonazepam (50%, n=9) and amitriptyline (44.44%, n=8). However, a 55.5% (n=10) of the patients with PIFP or PPTTN required the association of two or more drugs for a correct pain control. All the patients with BMS responded satisfactorily to clonazepam. Conclusions: Continuous Neuropathic Orofacial Pain is a little known condition among the general population, physicians and dentists. This favors a late diagnosis and inaccurate treatments which entail unnecessary suffering. It is important to inform both the general population and health professionals concerning this painful condition.
- Effectiveness of intra-alveolar chlorhexidine gel in reducing dry socket following surgical extraction of lower third molars: a pilot study(2016) Requena-Calla, Silvana; Funes-Rumiche, ItaloBackground: Dry socket is one of the most studied complications in dentistry and several studies have sought an effective and safe method for its prevention and treatment. The aim of this study was to evaluate the effectiveness of intra-alveolar gel chlorhexidine in preventing dry socket after the surgical removal of third molars. Material and Methods: The sample involved the treatment of 40 patients who required extraction of third molars impacted, which were randomly assigned to research groups: experimental group (chlorhexidine gel 0.12%) and control group (placebo gel). Performed the extraction was administered 1 mL of chlorhexidine gel or 1 mL of placebo gel within the socket. The removal of suture was on the fifth postoperative day in which the presence or absence of dry socket was evaluated. Results: No relationship between the appearance of dry socket after application of chlorhexidine gel or placebo gel (X 2 test, p = 0.311) was found. However, significant differences (U Mann-Whitney test, p = 0.036) in the pain presented on the fifth postoperative day were evident (VAS). Conclusions: The administration of intra-alveolar chlorhexidine gel 0.12% could generate a better response to postoperative pain after the removal of third molars.
- The role of serum biomarkers in the diagnosis and prognosis of oral cancer: a systematic review(2016) Fernández-Olavarria, Ana; Mosquera Perez, Regina; Díaz Sánchez, Rosa María; Serrera Figallo, María Angeles; Gutiérrez Pérez, José Luis; Torres Lagares, DanielIntroduction: Oral cancer is one of the causes of major morbidity and mortality in the world although incidence varies in the different geographical locations and races. Advances in molecular biology and cancer research have allowed elucidating serum biomarkers to improve diagnostic methods. The aim of this article systematic review is to highlight the utility and clinical value of serum biomarkers in the diagnosis and prognosis of oral cancer. Material and Methods: A systematic literature review using PubMed (MEDLINE databases) revealed a total of 140 articles related to this topic. Of those articles, 29 were included in the final review. We included articles published in English in the last five years, developed in human as cases and controls studies, retrospective or prospective studies and specific studies that analyzed a certain biomarker in serum. Results: All of the studies include in this systematic review found significant differences in patients. Of those articles included, 2 used biomarkers to determinate cancerous phenotype, 11 mentioned their results were associated with worse prognosis and overall survival, 4 correlated biomarker concentration to clinical stages, 4 concluded it could be a helpful in diagnosis and 8 studies did not find a clear utility of the analysed biomarker. Due to differences in the presentation of data, meta-analysis was not possible. Conclusions: Biomarker use for diagnosis and prognosis is supported by clinical and scientific evidence is relevant. Nevertheless, after selecting a certain biomarker, monitoring protocols should be established in oral and maxillofacial surgeons teams so as we have a correct understanding of biological values.
- Prognostic value of matrix metalloproteinase-9 expression in oral squamous cell carcinoma and its association with angiogenesis(2016) Andisheh Tadbir, Azadeh; Mardani, Maryam; Pourshahidi, Sara; Nezarati, Kamran; Bahadori, ParisaBackground: Breakdown of extracellular matrix (ECM) is one of the important hallmarks of cancer progression which facilitates the invasion of tumoral cells to the surrounding tissue. Matrix metalloproteinases (MMPs) can degrade various components of the ECM and basement membrane. The aim of this study was to determine the role of matrix metalloproteinases-9 protein in the biologic behavior of oral squamous cell carcinoma (OSCC) and its relation with tumor angiogenesis. Material and Methods: In this study 42 OSCC and 15 normal epithelium were reviewed by immunohistochemical staining for matrix metalloproteinases-9 and CD105. Results: Matrix metalloproteinases-9 expression was detected in 32 OSCC specimens (76.1%), with 28 specimens (66.6%) showing moderate or strong expression. We observed that the expression level of matrix metalloproteinases-9 was positively correlated with the status of lymph node metastasis (N0vs. N1) ( P =0.00), and clinical stage (I-II vs. III-IV) in OSCC patients. Microvessel density in intratumoral tissue has an association with lymph node metastasis and advanced clinical stage ( P =0.003 and p =0.01, respectively). We observed that tumors with matrix metalloproteinases-9 overexpression had a higher microvessel density counts compared with tumors with absent or focal immunostaining (16.2±5.6 vs 10.3±3.5 respectively, P =0.03). Conclusions: In conclusion present results demonstrate the marked expression of matrix metalloproteinases-9 and CD105 in OSCC and suggest that the expression of these markers is associated with tumor progression and could offer additional information about the aggressiveness of OSCC. In addition a significant relationship was noted between microvessel density count and expression of matrix metalloproteinases-9 which suggest that MMP9 expression may be closely related to tumor angiogenesis
- Evaluation of three different rotary systems during endodontic retreatment: analysis by scanning electron microscopy(2016) Vidal, Flávia-Teixeira; Nunes, Eduardo; Horta, Martinho Campolina Rebello; Freitas, Maria-Rita-Lopes-da; Silveira, Frank-FerreiraBackground: Endodontic therapy is considered a series of important and interdependent steps, and failure of any of these steps may compromise the treatment outcome. This study aimed to evaluate the effectiveness of three different rotary systems in removing obturation materials during endodontic retreatment using scanning electron microscopy (SEM) analysis. Material and Methods: Thirty-six endodontically treated teeth were selected and divided into 3 groups of 10 and 1 control group with 6 dental elements. The groups were divided according to the rotary system used for removing gutta-percha, as follows: G1: ProTaper system; G2: K3 system; G3: Mtwo system; and G4: Control group. Thereafter, the roots were split and the sections were observed under SEM, for analysis and counting of clear dentinal tubules, creating the variable “degree of dentinal tubule patency” (0: intensely clear; 1: moderately clear; 2: slightly clear; 3: completely blocked). The data were subjected to the Friedman and Kruskal-Wallis statistical tests. Results: No differences were observed in the “degree of dentinal tubule patency” neither between the root thirds (to each evaluated group) nor between the groups (to each evaluated third). Nevertheless, when the three root thirds were grouped (providing evaluation of all root extension), the “degree of dentinal tubule patency” was lower in G1 than in G3 ( p <0.05), but showed no differences neither between G1 and G2 nor G2 and G3. Conclusions: No technique was able to completely remove the canal obturation material, despite G1 having shown better results, although without significant difference to G2
- Comparison of working length control consistency between hand K-files and Mtwo NiTi rotary system(2016) Krajczár, Károly; Varga, Enikő; Marada, Gyula; Jeges, Sára; Tóth, VilmosBackground: The purpose of this study was to investigate the consistency of working length control between hand instrumentation in comparison to engine driven Mtwo nickel-titanium rotary files. Material and Methods: Forty extracted maxillary molars were selected and divided onto two parallel groups. The working lengths of the mesiobuccal root canals were estimated. The teeth were fixed in a phantom head. The root canal preparation was carried out group 1 (n=20) with hand K-files, (VDW, Munich, Germany) and group 2 (n=20) with Mtwo instruments (VDW, Munich, Germany). Vestibulo-oral and mesio-distal directional x-ray images were taken before the preparation with #10 K-file, inserted into the mesiobuccal root canal to the working length, and after preparation with #25, #30 and #40 files. Working lenght changes were detected with measurements between the radiological apex and the instrument tips. Results: In the Mtwo group a difference in the working competency ( p <0.05) could be noticed only in the vestibulo- oral direction from #10 to #40 file. The hand instrument group showed a significant difference in working length competency for each larger file size ( p <0.05) (ANOVA). Regression analysis in the hand instrumentation group indicated a working length decrease with a mean of 0,2 mm after each consecutive file size ( p <0.01). Conclusions: The outcome of our trial indicated a high consistency in working length control for root canal preparation under simulated clinical condition using Mtwo rotary files. Mtwo NiTi rotary file did therefore proved to be more accurate in comparison to the conventional hand instrumentation.
- Use of leukocyte and platelet-rich fibrin (L-PRF) in periodontally accelerated osteogenic orthodontics (PAOO): clinical effects on edema and pain(2016) Muñoz, Francisco; Jiménez, Constanza; Espinoza, Daniela; Vervelle, Alain; Beugnet, Jacques; Haidar, ZiyadBackground: Demand for shorter treatment time is common in orthodontic patients. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a somewhat new surgical procedure which allows faster tooth movement via combining orthodontic forces with corticotomy and grafting of alveolar bone plates. Leukocyte and Platelet-Rich Fibrin (L-PRF) possess hard- and soft-tissue healing properties. Further, evidence of pain-inhibitory and anti- inflammatory potential is growing. Therefore, this study explores the feasibility, intra- and post-operative effects of using L-PRF in PAOO in terms of post-operative pain, inflammation, infection and post-orthodontic stability. Material and Methods: A pilot prospective observational study involving a cohort of 11 patients was carried out. A Wilcko’s modified PAOO technique with L-PRF (incorporated into the graft and as covering membrane) was performed with informed consent. Post-surgical pain, inflammation and infection were recorded for 10 days post- operatively, while the overall orthodontic treatment and post-treatment stability were followed up to 2 years. Results: Accelerated wound healing with no signs of infection or adverse reactions was evident. Post-surgical pain was either “mild” (45.5%) or “moderate” (54.5%). Immediate post-surgical inflammation was either “mild” (89.9%) or “moderate” (9.1%). Resolution began on day 4 where most patients experienced either “mild” or no inflammation (72.7% and 9.1%, respectively). Complete resolution was achieved in all patients by day 8. The average orthodontic treatment time was 9.3 months. All cases were deemed stable for 2 years. Conclusions: L-PRF is simple and safe to use in PAOO. Combination with traditional bone grafts potentially accelerates wound healing and reduces post-surgical pain, inflammation, infection without interfering with tooth movement and/or post-orthodontic stability, over a 2 years period; thus alleviating the need for analgesics and anti-inflammatory medications.
- Effect of retention design of artificial teeth and implant-supported titanium CAD-CAM structures on fracture resistance(2016) Ladetzki, Kristin; Mateos Palacios, Rocío; Pascual Moscardó, Agustín; Selva Otaolaurruchi, Eduardo J.Background: For implant-supported hybrid prostheses, high mastication forces and reduced acrylic resin thickness over a metal substructure often cause failures arising from tooth or resin fractures. To assay fracture resistance of artificial teeth and resin in implant-supported hybrid prostheses in relation to the titanium structure and retention design supporting teeth. Material and Methods: 40 specimens bearing incisors were divided into four groups according to the titanium structure supporting the teeth and the type of load force applied: Group I (Control; n=10): Application of static loading to ten incisors set over a metal structure with internal retention. Group II (Control; n=10): Application of static loading to ten incisors set over a metal structure with external retention. The remaining study specimens (n=20) were subjected to 120,000 masticatory and thermal cycles in a chewing simulator. Afterwards, static loading was applied until the point of fracture using an Instron machine. Group III (Study; n=10): Application of dynamic and static loading to ten incisors set over a metal structure with internal retention. Group IV (Study; n=10): Application of dynamic and static loading to ten incisors set over a metal structure with external retention. Data obtained for the four groups was analyzed and compared, determining the type of fracture (cohesive or adhesive) using a reflected light microscope. Results: Statistical analysis confirmed that there were significant differences in fracture resistance between the four groups. External retention was found to have more fracture resistance than the internal retention. Conclusions: Hybrid prostheses with titanium substructures and external retention obtained significantly better results than samples with internal retention.
