Evaluation of implant stability simultaneously placed with sinus lift augmented with putty versus powder form of demineralized bone matrix in atrophied posterior maxilla

Background: Rehabilitation of edentulous posterior maxilla with dental implants is a challenging problem in oral and maxillofacial surgery due to alveolar resorption and excessive pneumatisation of maxillary sinus. This study was designed to compare the efficacy of Putty Versus Powder Form of Demineralized Bone Matrix (DBM) augmented in lifted maxillary sinus in atrophied posterior maxilla with evaluating the implant stability simultaneously placed with both of them. Patients and Methods: sixty four implants were placed in twelve patients in the period between 2013 and 2016. Lateral approach, open window method for sinus lift with peizosurgical unit and placement of Putty or Powder Form of DBM were carried out simultaneously with implant placement. The implant success was defined when the prosthesis had been delivered and followed for 18 months without infection, pain, marginal bone loss and the implant stability quotient (ISQ) of each implant was measured using resonance frequency analysis. Results: Radiographic bone formation was evident in all 12 patients, and all implants were stable after 18 months of placement. No statistically significant differences were observed in marginal bone loss around the implants between the powder and the putty groups at 6 months (p ¼ 0.60), 12 months (p ¼ 0.85) and 18 months (0.49). The difference between ISQ values in both groups was only significant at the baseline (p ¼ 0.023). Conclusion: Sinus lifting with simultaneous implant placement could be used to treat atrophic maxilla with initial stability obtained by using taper designed implants and with minimal intraoperative complication susing peizosurgery. No statistically significant differences in the stability were observed between implants placed with both putty and powder forms of DBM

Collagen turnover induced by cellular connective tissue cytokines of drug induced gingival overgrowth and hereditary gingival fibromatosis (Histological and immunohistochemical comparative study)

Background: Gingival overgrowth (GO) is usually associated with multiple factors including immunosuppressive agents as cyclosporine (CsA) and Tacrolimus (TAC), and hereditary gingival fibromatosis (HGF). Objective: To compare the expression of TGF-b1, PDGF, TIMP-1 and MMP-9 at the molecular and cellular levels in patients receiving (CsA or TAC) and patients manifested (HGF), to cast some light on the pathogenic mechanism potentially involved in the collagen (COL) turnover of both conditions. Subjects: and methods: Gingival tissue samples were obtained from patients undergoing therapy with CsA (n ¼ 6), TAC (n ¼ 6), HGF (n ¼ 3) as well as control tissues from systemically healthy control (n ¼ 6). Tissue sections were immune-stained by labeled streptavidin-biotin (DAB) technique, using monoclonal antibodies against TGF-b1, PDGF-b, TIMP-1 and MMP-9. Results: comparison of type of expression among the studied groups, showed significant diffuse expression of TGF-b1 and PDGF-b in group I and II with P value ¼ 0.58 and 0.38 respectively. The expression of MMP-9 was significantly diffuse in TAC or CsA group when compared to HGF group with P value ¼ 0.38, mean while there was a significant diffuse expression of TIMP-1 in HGF group when compared to TAC or CsA group with P value ¼ 0.38. Conclusions: In conclusion the biological mechanisms behind the drug induced gingival overgrowth (DIGO) and HGF is targeting COL turnover but in different ways. Also, this may explain the need for periodic surgical correction of the gingival form and architecture in HGF cases, unlike the DIGO which can be overcame by replacement of CsA by TAC with improvement of oral healt

Maternal chronic oral infection with periodontitis and pericoronitis as a possible risk factor for preeclampsia in Egyptian pregnant women (microbiological and serological study).

Background: Several studies have hypothesized that oral infection may increase the risk of preeclampsia. We explore the relationship between chronic oral infection and the risk of preeclampsia in Egyptian pregnant women. Methodology: Forty preeclamptic women with periodontitis and/or pericoronitis (group I) and 40 control subjects having periodontitis and/or pericoronitis (group II) were subjected to microbiological assessment of subgingival plaque, pseudo-pocket and placental samples. TNF-a was determined in gingival crevicular fluid (GCF), saliva and serum by ELISA and real time PCR. Results: There was no statistically significant difference between the two groups as regards to subgingival plaque and pericoronal pseudo-pocket organisms revealed by culture and PCR. The total number of anaerobes in blood and placental samples was higher in preeclamptic group than controls. There was a statistically significant difference between the two groups as regards to the level of TNF-a by ELISA in serum (P-value ¼ 0.021). Conclusion: There was a relationship between chronic oral infection and preeclampsia, so treatment of oral infection during pregnancy may represent a novel approach and preventive strategy that reduce oral bacterial load which would decrease the incidence of preeclampsia