Efikasnost i sigurnost 4% artikaina sa epinefrinom za gornji prednji i srednji alveolarni nervni blok primenom kompjuterski kontrolisanog sistema i standardnog pristupa za primenu anestetičkog rastvora - prospektivna, randomizovana, kontrolisana, dvosturko slepa, ukrštena klinička studija

Bacground/Aim. The efficient dental anesthesia, which is related to the clinically adequate depth, duration and the width of anesthetic field, is an important prerequisite for successful dental treatment. The aim of this study was to investigate and compare the pulpal anesthesia and cardiovascular parameters after the anterior middle superior alveolar (AMSA) nerve block with 4% articaine with epinephrine administered by conventional cartridge-syringe and computer-controlled local anesthetic delivery system (CCLADS). Methods. This controlled double-blind cross-over randomized clinical study included 38 healthy volunteers. Efficacy of pulpal anesthesia after the AMSA nerve block was evaluated by measuring a success rate, onset and duration of pulpal anesthesia, using an electrical pulp tester. The parameters of cardiovascular function (systolic and diastolic blood pressure, heart rate) were monitored noninvasively. Results. Successful pulpal anesthesia of all tested teeth was obtained in 57.9% participants with CCLADS and in 44.7% participants with conventional syringe. The onset time was not significantly different between two investigated groups. The pulpal anesthesia duration was not significantly different neither within nor between investigated groups. The systolic and diastolic blood pressures were significantly decreased in both investigated groups, in comparison with the baseline values. Heart rate significantly decreased within CCLADS from 10th to 30th minute when compared to baseline. Conclusion. The efficacy of pulpal anesthesia and safety of cardiovascular profile of 0.6 mL of articaine with epinephrine (1:100.000) delivered with CCLADS were improved in comparison to the conventional syringe delivery. Significant changes of cardiovascular function were not observed.Uvod/Cilj. Efikasna zubna anestezija u pogledu klinički adekvatne dubine, trajanja i širine anestetičkog polja je važan preduslov za uspešno zubno lečenje. Cilj rada bio je ispitivanje i upoređivanje parametra anestezije zubne pulpe i kardiovaskularnih parametra posle gornje prednje i srednje alveolarne (AMSA) sprovodne anestezije postignute 4% artikainom sa epinefrinom, primenom standardne karpulbrizgalice i kompjuterski kontrolisanog sistema za primenu anestetičkog rastvora (CCLADS). Metode. U ovom randomizovanom, prospektivnom, kontrolisanom, dvostruko slepom ukrštenom kliničkom istraživanju učestvovalo je 38 ispitanika. Kvalitet anestezije zubne pulpe posle AMSA anestezije praćen je na osnovu uspešnosti, latentnog perioda i trajanja anestezije zubne pulpe, primenom električnog pulp-testera. Parametri kardiovaskularne funkcije (sistolni i dijastolni krvni pritisak, srčana frekvencija) praćeni su neinvazivno, primenom aparata za monitoring. Rezultati. Uspešna anestezija zubne pulpe svih ispitivanih zuba bila je prisutna kod 57,9% ispitanika posle kod CCLADS i kod 44,7% ispitanika posle primene standardne karpul-brizgalice. Latentni period i trajanje anestezije zubne pulpe nisu se značajno razlikovali između ispitivanih grupa. Sistolni i dijastolni pritisak bili su značajno sniženi u praćenim vremenskim intervalima u odnosu na početne vrednosti. Srčana frekvencija je bila značajno snižena kod CCLADS grupe od 10 do 30 minuta u odnosu na početne vrednosti. Zaključak. Kontrolisanom kompjuterizovanom primenom (CCLADS) 0,6 mL 4% artikaina sa epinefrinom (1:100,000) za AMSA sprovodnu anesteziju, postignut je bolji kvalitet anestezije zubne pulpe u odnosu na primenu artikaina sa epinefrinom standardnom karpul brizgalicom. Nisu uočene bitne promene funkcija kardiovaskularnog sistema

Arterial supply of the trigeminal ganglion, a micromorphological study

Background: In this study, we explored the specific microanatomical properties of the trigeminal ganglion (TG) blood supply and its close neurovascular relationships with the surrounding vessels. Possible clinical implications have been discussed. Materials and methods: The internal carotid and maxillary arteries of 25 adult and 4 foetal heads were injected with a 10% mixture of India ink and gelatin, and their TGs subsequently underwent microdissection, observation and morphometry under a stereoscopic microscope. Results: The number of trigeminal arteries varied between 3 and 5 (mean 3.34), originating from 2 or 3 of the following sources: the inferolateral trunk (ILT) (100%), the meningohypophyseal trunk (MHT) (100%), and from the middle meningeal artery (MMA) (92%). In total, the mean diameter of the trigeminal branches was 0.222 mm. The trigeminal branch of the ILT supplied medial and middle parts of the TG, the branch of the MHT supplied the medial part of the TG, and the branch of the MMA supplied the lateral part of the TG. Additional arteries for the TG emerged from the dural vascular plexus and the vascular network of the plexal segment of the trigeminal nerve. Uniform and specific intraganglionic dense capillary network was observed for each sensory trigeminal neuron. Conclusions: The reported features of the TG vasculature could be implied in a safer setting for surgical approach to the skull base, in relation to the surrounding structures. The morphometric data on TG vasculature provide anatomical basis for better understanding the complex TG blood supply from the internal and external carotid arteries

Histomorphometric evaluation of bone regeneration using autogenous bone and beta-tricalcium phosphate in diabetic rabbits

Background/Aim. The mechanism of impaired bone healing in diabetes mellitus includes different tissue and cellular level activities due to micro- and macrovascular changes. As a chronic metabolic disease with vascular complications, diabetes affects a process of bone regeneration as well. The therapeutic approach in bone regeneration is based on the use of osteoinductive autogenous grafts as well as osteoconductive synthetic material, like a β-tricalcium phosphate. The aim of the study was to determine the quality and quantity of new bone formation after the use of autogenous bone and β-tricalcium phosphate in the model of calvarial critical-sized defect in rabbits with induced diabetes mellitus type I. Methods. The study included eight 4-month-old Chincilla rabbits with alloxan-induced diabetes mellitus type I. In all animals, there were surgically created two calvarial bilateral defects (diameter 12 mm), which were grafted with autogenous bone and β-tricalcium phosphate (n = 4) or served as unfilled controls (n = 4). After 4 weeks of healing, animals were sacrificed and calvarial bone blocks were taken for histologic and histomorphometric analysis. Beside descriptive histologic evaluation, the percentage of new bone formation, connective tissue and residual graft were calculated. All parameters were statistically evaluated by Friedman Test and post hock Wilcoxon Singed Ranks Test with a significance of p < 0.05. Results. Histology revealed active new bone formation peripherally with centrally located connective tissue, newly formed woven bone and well incorporated residual grafts in all treated defects. Control samples showed no bone bridging of defects. There was a significantly more new bone in autogeonous graft (53%) compared with β-tricalcium phosphate (30%), (p < 0.030) and control (7%), (p < 0.000) groups. A significant difference was also recorded between β-tricalcium phosphate and control groups (p < 0.008). Conclusion. In the present study on the rabbit grafting model with induced diabetes mellitus type I, the effective bone regeneration of critical bone defects was obtained using autogenous bone graft.Vojnosanitetski pregled (2016), 73(12): 1132-113

Uticaj hirurške tehnike ugradnje i mikro i makro dizajna implantata na njihovu stabilnost u bočnom segmentu gornje vilice

Sufficient primary implant stability is very important factor that affects long-term implant success and depends on diameter and length of the implant, shape of implant body, features of implant threads (macro design), surgical technique used as well as on the quality and quantity of the available jaw bone. Primary stability is hard to achieve in posterior maxilla due to low density of bone in this region. Since the quality and quantity of the jaw bone are factors that are already present, the effect of surgical techniques, implant's macro and micro designs on improvement of implant stability in low-density bone were assessed in this doctoral dissertation. The aim was to investigate and compare implant stability between self-tapping and non self-tapping implants inserted in low-density bone following lateral bone condensing or standard surgical techniques. Also, to investigate and compare implant stability between implants with hydrophobic and hydrophilic surfaces inserted into the low-density bone. Experimental and clinical study were performed. In the „in vitro“ study, pig ribs with uniform thickness of corticalis of 2 mm were used to simulate jaw bone type D3 or D4 according to Carl and Misch classification. With regards to surgical technique (lateral bone condensing or standard surgical technique) and implant macro design (self-tapping and non self-tapping), bone samples were randomly divided into 4 test groups to allow investigation of all possible combinations of the tested factors. Implant stability was measured in thermostat controlled water bath using Resonance Frequency Analysis (RFA) as a method of measurement. A total of 46 patients (26 females and 20 males) with a mean age of 39.3 years were included in the clinical study and they received a total of 144 implants in the following way: 48 self-tapping implants (24 following lateral bone condensation and 24 following standard surgical technique), 48 non self-tapping implants (24 following lateral bone condensation and 24 following standard surgical technique), 24 implants with hydrophilic surface and 24 implants with hydrophobic surface following standard surgical technique...Odgovarajuća primarna stabilnost implantata je osovni faktor koji utiče na dugotrajan uspeh endoosealnih implantata, što zavisi od dijametra i dužine implantata, oblika tela implantata, karakteristika navoja implantata (makro dizajn), primenjene hirurške tehnike, kao i od kvaliteta i količine raspoložive kosti. Primarnu stabilnost implantata je teško postići u bočnim segmentima gornje vilice zbog male gustine kosti u ovoj regiji. Kako su kvalitet i količina kosti faktori koji su već prisutni, u ovoj doktorskoj disertaciji ispitivan je uticaj različitih hirurških tehnika, makro i mikro dizajna implantata na poboljšanje stabilnosti implantata u kosti male gustine. Cilj doktorske disertacije je bio ispitati i uporediti vrednosti implantne stabilnosti između implantata sa samourezujućim i neurezujućim navojima ugrađenih nakon preparacije ležišta metodom lateralne kondenzacije i standardnom tehnikom u kost male gustine. Takođe, ispitati i uporediti vrednosti implantne stabilnosti između implantata sa hidrofobnom i implantata sa hidrofilnom površinom ugrađenih u kost male gustine. Preduzeta su eksperimentalna i klinička istraživanja. U sprovedenoj „in vitro“ studiji korišćena su svinjska rebra uniforme debljine koritkalnog sloja od 2 mm radi simulacije klase D3 i D4 po Carl-u i Misch-u humane vilične kosti. Prema hirurškoj tehnici za peparaciju ležišta implantata (lateralna kondenzacija kosti i standardna tehnika) i makro dizajnu implantata (samourezujući i neurezujući), uzorci kosti su metodom slučajnog izbora bili podeljeni u 4 grupe čime je bilo omogućeno ispitivanje svih kombinacija testiranih faktora. Merenje implantatne stabilnosti vršeno je u termostatom kontrolisanom vodenom kupatilu metodom analize rezonantne frekvencije (engl. Resonance Frequency Analysis RFA). U kliničku studiju je bilo uključeno ukupno 46 pacijenata (26 ženskog i 20 muškog pola) prosečne starosti 39.3 godina i kod njih je ugrađeno ukupno 144 implantata i to: 48 samourezujućih implantata (24 u ležišta preparirana lateralnom kondenzacijom kosti i 24 u ležišta preparirana standardnom tehnikom), 48 neurezujućih implantata (24 u ležišta preparirana lateralnom kondenzacijom kosti i 24 u ležišta preparirana standardnom tehnikom), 24 implantata hidrofilne i 24 implantata hidrofobne površine u ležišta preparirana standardnom tehnikom..

Effect of surgical technique and implant micro and macro design on stability of implants placed in posterior maxilla

Odgovarajuća primarna stabilnost implantata je osovni faktor koji utiče na dugotrajan uspeh endoosealnih implantata, što zavisi od dijametra i dužine implantata, oblika tela implantata, karakteristika navoja implantata (makro dizajn), primenjene hirurške tehnike, kao i od kvaliteta i količine raspoložive kosti. Primarnu stabilnost implantata je teško postići u bočnim segmentima gornje vilice zbog male gustine kosti u ovoj regiji. Kako su kvalitet i količina kosti faktori koji su već prisutni, u ovoj doktorskoj disertaciji ispitivan je uticaj različitih hirurških tehnika, makro i mikro dizajna implantata na poboljšanje stabilnosti implantata u kosti male gustine. Cilj doktorske disertacije je bio ispitati i uporediti vrednosti implantne stabilnosti između implantata sa samourezujućim i neurezujućim navojima ugrađenih nakon preparacije ležišta metodom lateralne kondenzacije i standardnom tehnikom u kost male gustine. Takođe, ispitati i uporediti vrednosti implantne stabilnosti između implantata sa hidrofobnom i implantata sa hidrofilnom površinom ugrađenih u kost male gustine. Preduzeta su eksperimentalna i klinička istraživanja. U sprovedenoj „in vitro“ studiji korišćena su svinjska rebra uniforme debljine koritkalnog sloja od 2 mm radi simulacije klase D3 i D4 po Carl-u i Misch-u humane vilične kosti. Prema hirurškoj tehnici za peparaciju ležišta implantata (lateralna kondenzacija kosti i standardna tehnika) i makro dizajnu implantata (samourezujući i neurezujući), uzorci kosti su metodom slučajnog izbora bili podeljeni u 4 grupe čime je bilo omogućeno ispitivanje svih kombinacija testiranih faktora. Merenje implantatne stabilnosti vršeno je u termostatom kontrolisanom vodenom kupatilu metodom analize rezonantne frekvencije (engl. Resonance Frequency Analysis RFA). U kliničku studiju je bilo uključeno ukupno 46 pacijenata (26 ženskog i 20 muškog pola) prosečne starosti 39.3 godina i kod njih je ugrađeno ukupno 144 implantata i to: 48 samourezujućih implantata (24 u ležišta preparirana lateralnom kondenzacijom kosti i 24 u ležišta preparirana standardnom tehnikom), 48 neurezujućih implantata (24 u ležišta preparirana lateralnom kondenzacijom kosti i 24 u ležišta preparirana standardnom tehnikom), 24 implantata hidrofilne i 24 implantata hidrofobne površine u ležišta preparirana standardnom tehnikom...Sufficient primary implant stability is very important factor that affects long-term implant success and depends on diameter and length of the implant, shape of implant body, features of implant threads (macro design), surgical technique used as well as on the quality and quantity of the available jaw bone. Primary stability is hard to achieve in posterior maxilla due to low density of bone in this region. Since the quality and quantity of the jaw bone are factors that are already present, the effect of surgical techniques, implant's macro and micro designs on improvement of implant stability in low-density bone were assessed in this doctoral dissertation. The aim was to investigate and compare implant stability between self-tapping and non self-tapping implants inserted in low-density bone following lateral bone condensing or standard surgical techniques. Also, to investigate and compare implant stability between implants with hydrophobic and hydrophilic surfaces inserted into the low-density bone. Experimental and clinical study were performed. In the „in vitro“ study, pig ribs with uniform thickness of corticalis of 2 mm were used to simulate jaw bone type D3 or D4 according to Carl and Misch classification. With regards to surgical technique (lateral bone condensing or standard surgical technique) and implant macro design (self-tapping and non self-tapping), bone samples were randomly divided into 4 test groups to allow investigation of all possible combinations of the tested factors. Implant stability was measured in thermostat controlled water bath using Resonance Frequency Analysis (RFA) as a method of measurement. A total of 46 patients (26 females and 20 males) with a mean age of 39.3 years were included in the clinical study and they received a total of 144 implants in the following way: 48 self-tapping implants (24 following lateral bone condensation and 24 following standard surgical technique), 48 non self-tapping implants (24 following lateral bone condensation and 24 following standard surgical technique), 24 implants with hydrophilic surface and 24 implants with hydrophobic surface following standard surgical technique..

Effect of surgical technique and implant micro and macro design on stability of implants placed in posterior maxilla

Odgovarajuća primarna stabilnost implantata je osovni faktor koji utiče na dugotrajan uspeh endoosealnih implantata, što zavisi od dijametra i dužine implantata, oblika tela implantata, karakteristika navoja implantata (makro dizajn), primenjene hirurške tehnike, kao i od kvaliteta i količine raspoložive kosti. Primarnu stabilnost implantata je teško postići u bočnim segmentima gornje vilice zbog male gustine kosti u ovoj regiji. Kako su kvalitet i količina kosti faktori koji su već prisutni, u ovoj doktorskoj disertaciji ispitivan je uticaj različitih hirurških tehnika, makro i mikro dizajna implantata na poboljšanje stabilnosti implantata u kosti male gustine. Cilj doktorske disertacije je bio ispitati i uporediti vrednosti implantne stabilnosti između implantata sa samourezujućim i neurezujućim navojima ugrađenih nakon preparacije ležišta metodom lateralne kondenzacije i standardnom tehnikom u kost male gustine. Takođe, ispitati i uporediti vrednosti implantne stabilnosti između implantata sa hidrofobnom i implantata sa hidrofilnom površinom ugrađenih u kost male gustine. Preduzeta su eksperimentalna i klinička istraživanja. U sprovedenoj „in vitro“ studiji korišćena su svinjska rebra uniforme debljine koritkalnog sloja od 2 mm radi simulacije klase D3 i D4 po Carl-u i Misch-u humane vilične kosti. Prema hirurškoj tehnici za peparaciju ležišta implantata (lateralna kondenzacija kosti i standardna tehnika) i makro dizajnu implantata (samourezujući i neurezujući), uzorci kosti su metodom slučajnog izbora bili podeljeni u 4 grupe čime je bilo omogućeno ispitivanje svih kombinacija testiranih faktora. Merenje implantatne stabilnosti vršeno je u termostatom kontrolisanom vodenom kupatilu metodom analize rezonantne frekvencije (engl. Resonance Frequency Analysis RFA). U kliničku studiju je bilo uključeno ukupno 46 pacijenata (26 ženskog i 20 muškog pola) prosečne starosti 39.3 godina i kod njih je ugrađeno ukupno 144 implantata i to: 48 samourezujućih implantata (24 u ležišta preparirana lateralnom kondenzacijom kosti i 24 u ležišta preparirana standardnom tehnikom), 48 neurezujućih implantata (24 u ležišta preparirana lateralnom kondenzacijom kosti i 24 u ležišta preparirana standardnom tehnikom), 24 implantata hidrofilne i 24 implantata hidrofobne površine u ležišta preparirana standardnom tehnikom...Sufficient primary implant stability is very important factor that affects long-term implant success and depends on diameter and length of the implant, shape of implant body, features of implant threads (macro design), surgical technique used as well as on the quality and quantity of the available jaw bone. Primary stability is hard to achieve in posterior maxilla due to low density of bone in this region. Since the quality and quantity of the jaw bone are factors that are already present, the effect of surgical techniques, implant's macro and micro designs on improvement of implant stability in low-density bone were assessed in this doctoral dissertation. The aim was to investigate and compare implant stability between self-tapping and non self-tapping implants inserted in low-density bone following lateral bone condensing or standard surgical techniques. Also, to investigate and compare implant stability between implants with hydrophobic and hydrophilic surfaces inserted into the low-density bone. Experimental and clinical study were performed. In the „in vitro“ study, pig ribs with uniform thickness of corticalis of 2 mm were used to simulate jaw bone type D3 or D4 according to Carl and Misch classification. With regards to surgical technique (lateral bone condensing or standard surgical technique) and implant macro design (self-tapping and non self-tapping), bone samples were randomly divided into 4 test groups to allow investigation of all possible combinations of the tested factors. Implant stability was measured in thermostat controlled water bath using Resonance Frequency Analysis (RFA) as a method of measurement. A total of 46 patients (26 females and 20 males) with a mean age of 39.3 years were included in the clinical study and they received a total of 144 implants in the following way: 48 self-tapping implants (24 following lateral bone condensation and 24 following standard surgical technique), 48 non self-tapping implants (24 following lateral bone condensation and 24 following standard surgical technique), 24 implants with hydrophilic surface and 24 implants with hydrophobic surface following standard surgical technique..

Effect of surgical technique and implant micro and macro design on stability of implants placed in posterior maxilla

Odgovarajuća primarna stabilnost implantata je osovni faktor koji utiče na dugotrajan uspeh endoosealnih implantata, što zavisi od dijametra i dužine implantata, oblika tela implantata, karakteristika navoja implantata (makro dizajn), primenjene hirurške tehnike, kao i od kvaliteta i količine raspoložive kosti. Primarnu stabilnost implantata je teško postići u bočnim segmentima gornje vilice zbog male gustine kosti u ovoj regiji. Kako su kvalitet i količina kosti faktori koji su već prisutni, u ovoj doktorskoj disertaciji ispitivan je uticaj različitih hirurških tehnika, makro i mikro dizajna implantata na poboljšanje stabilnosti implantata u kosti male gustine. Cilj doktorske disertacije je bio ispitati i uporediti vrednosti implantne stabilnosti između implantata sa samourezujućim i neurezujućim navojima ugrađenih nakon preparacije ležišta metodom lateralne kondenzacije i standardnom tehnikom u kost male gustine. Takođe, ispitati i uporediti vrednosti implantne stabilnosti između implantata sa hidrofobnom i implantata sa hidrofilnom površinom ugrađenih u kost male gustine. Preduzeta su eksperimentalna i klinička istraživanja. U sprovedenoj „in vitro“ studiji korišćena su svinjska rebra uniforme debljine koritkalnog sloja od 2 mm radi simulacije klase D3 i D4 po Carl-u i Misch-u humane vilične kosti. Prema hirurškoj tehnici za peparaciju ležišta implantata (lateralna kondenzacija kosti i standardna tehnika) i makro dizajnu implantata (samourezujući i neurezujući), uzorci kosti su metodom slučajnog izbora bili podeljeni u 4 grupe čime je bilo omogućeno ispitivanje svih kombinacija testiranih faktora. Merenje implantatne stabilnosti vršeno je u termostatom kontrolisanom vodenom kupatilu metodom analize rezonantne frekvencije (engl. Resonance Frequency Analysis RFA). U kliničku studiju je bilo uključeno ukupno 46 pacijenata (26 ženskog i 20 muškog pola) prosečne starosti 39.3 godina i kod njih je ugrađeno ukupno 144 implantata i to: 48 samourezujućih implantata (24 u ležišta preparirana lateralnom kondenzacijom kosti i 24 u ležišta preparirana standardnom tehnikom), 48 neurezujućih implantata (24 u ležišta preparirana lateralnom kondenzacijom kosti i 24 u ležišta preparirana standardnom tehnikom), 24 implantata hidrofilne i 24 implantata hidrofobne površine u ležišta preparirana standardnom tehnikom...Sufficient primary implant stability is very important factor that affects long-term implant success and depends on diameter and length of the implant, shape of implant body, features of implant threads (macro design), surgical technique used as well as on the quality and quantity of the available jaw bone. Primary stability is hard to achieve in posterior maxilla due to low density of bone in this region. Since the quality and quantity of the jaw bone are factors that are already present, the effect of surgical techniques, implant's macro and micro designs on improvement of implant stability in low-density bone were assessed in this doctoral dissertation. The aim was to investigate and compare implant stability between self-tapping and non self-tapping implants inserted in low-density bone following lateral bone condensing or standard surgical techniques. Also, to investigate and compare implant stability between implants with hydrophobic and hydrophilic surfaces inserted into the low-density bone. Experimental and clinical study were performed. In the „in vitro“ study, pig ribs with uniform thickness of corticalis of 2 mm were used to simulate jaw bone type D3 or D4 according to Carl and Misch classification. With regards to surgical technique (lateral bone condensing or standard surgical technique) and implant macro design (self-tapping and non self-tapping), bone samples were randomly divided into 4 test groups to allow investigation of all possible combinations of the tested factors. Implant stability was measured in thermostat controlled water bath using Resonance Frequency Analysis (RFA) as a method of measurement. A total of 46 patients (26 females and 20 males) with a mean age of 39.3 years were included in the clinical study and they received a total of 144 implants in the following way: 48 self-tapping implants (24 following lateral bone condensation and 24 following standard surgical technique), 48 non self-tapping implants (24 following lateral bone condensation and 24 following standard surgical technique), 24 implants with hydrophilic surface and 24 implants with hydrophobic surface following standard surgical technique..

Implant stability in posterior maxilla: bone-condensing versus bone-drilling: a clinical study

Objective. The aim of this clinical trial was to compare primary and secondary stability of implants placed by bone condensing versus the standard drilling technique in the posterior edentulous maxilla. Study design. Forty-eight SLA Straumann implants 4.1 x 10 mm (Institut Straumann AG, Waldenburg, Switzerland) were placed into edentulous maxillary posterior region in the same positions bilaterally, using the bone condensation technique for one and the standard technique for the other side. Implant stability measurements were performed immediately after implant placement, as well as every week for the next 6 weeks by use of resonance frequency analysis (RFA). Data were analyzed using Mann-Whitney U and Wilcoxon tests. Results. After bone condensing, significantly higher implant stability was recorded immediately after surgery as well as during the whole observation period of 6 weeks compared with bone-drilling technique (Mann-Whitney U test, P lt .000). Conclusions. The bone-condensing technique can be recommended as an alternate surgical approach for implant site preparation in reduced bone density to achieve greater implant stability in the posterior maxilla. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: 557-563

Apical root-end filling with tricalcium silicate-based cement in a patient with diabetes mellitus: A case report

Introduction. The material used for root-end filling has to be biocompatible with adjacent periapical tissue and to stimulate its regenerative processes. Tricalcium silicate cement (TSC), as a new dental material, shows good sealing properties with dentin, high compression strengths and better marginal adaptation than commonly used root-end filling materials. Although optimal postoperative healing of periapical tissues is mainly influenced by characteristics of end-root material used, it could sometimes be affected by the influence of systemic diseases, such as diabetes mellitus (DM). Case report. We presented apical healing of the upper central incisor, retrofilled with TSC, in a diabetic patient (type 2 DM) with peripheral neuropathy. Standard root-end resection of upper central incisor was accompanied by retropreparation using ultrasonic retrotips to the depth of 3 mm and retrofilling with TSC. Post-operatively, the surgical wound healed uneventfully. However, the patient reported undefined dull pain in the operated area that could possibly be attributed to undiagnosed intraoral diabetic peripheral neuropathy, what was evaluated clinically. Conclusion. Although TSC presents a suitable material for apical root-end filling in the treatment of chronic periradicular lesions a possible presence of systemic diseases, like type 2 DM, has to be considered in the treatment outcome estimation