Ameloblastoma: Present and Future Concepts of Managing

Ameloblastoma is a benign odontogenic tumor of epithelial origin with locally aggressive behavior. It affects a broad age range of patients and it is most commonly found in the mandible, especially posterior area. The majority of ameloblastomas are conventional (multicystic), which are more difficult to eradicate than the unicystic or peripheral types. Although most of ameloblastoma cases can be treated predictably with radical surgical treatment, the management of recurrent and metastasizing ameloblastomas remains a major challenge. Surgical treatment is standard, but the extent of resection is controversial. Radical resection with segmental and marginal mandibulectomy or curettage and enucleation with better quality of life, but with higher recurrence rate. Besides the conventional surgical treatment, novel therapy options like neoadjuvant molecular targeted therapy and decompression in young patients could make a significant improvement in the management of the disease. The aim of this chapter was to determine the present and future concepts of treatment and discuss significant factors responsible for recurrence

Implantoprotetičko zbrinjavanje kompjutorski navođenom implantologijom (M-guide): prikaz slučaja

Correct implant positioning poses a major challenge in modern dentistry and mismatch between the planned and final implant position is one of the most common treatment complications. A surgical guide or a template is a ‘’transmission device’’ which enables the implant placement in the intended position as accurate as possible. Case study: A woman aged 60 came into dental office to resolve a single tooth loss in regions 15 and 24. Radiographic analysis and clinical examination showed a lack of transversal space in the regions of implantation. Considering the fact of having a narrow area available for implantation, a computer-guided implant therapy using the M-Guide system was selected. The treatment plan was a prosthetic restoration involving the placement of two implants in areas 15 and 24 and the fabrication of zirconium oxide crowns. After digital planning, a fully guided surgical protocol was performed. Immediately after implantation, a temporary suprastructure and temporary crowns were placed. After a period of osseointegration, a definitive prosthetic restoration was made.Uvod: Pravilno pozicioniranje implantata velik je izazov u suvremenoj dentalnoj medicini, a nesklad između njegova planiranoga i konačnoga položaja jedna je od najčešćih terapijskih komplikacija. Kirurška vodilica ili šablona „prijenosno je sredstvo“ kojim se postiže što vjernije postavljanje implantata u planirani položaj. Prikaz slučaja: Žena u dobi od 60 godina došla je u ordinaciju radi sanacije pojedinačne bezubosti u regijama 15 i 24. Radiološkom analizom i kliničkim pregledom ustanovljen je manjak transverzalnoga prostora u regijama implantacije. Zbog manjka prostora za implantaciju izabrana je kompjutorski vođena implantoprotetička terapija s pomoću sustava M-Guide. Plan terapije bio je izraditi protetički rad koji uključuje postavljanje dvaju implantata u područja 15 i 24 i izradu cirkonij-oksidnih krunica. Nakon digitalnog planiranja pripremljen je potpuno navođeni kirurški protokol. Odmah poslije implantacije postavljena je privremena suprastruktura i privremeni protetički rad. Nakon oseointegracije pristupilo se izradi definitivnoga protetičkog rada

Computer guided implantology

Reprodukcija položaja, kuta i dubine implantata na način kako je odabrano i planirano u dijagnostičkoj fazi predstavlja najveći izazov za doktora dentalne medicine i upravo je nepravilno postavljanje implantata jedna od najčešćih komplikacija terapije. Svrha ovog preglednog rada je napraviti analizu postojeće literature o prednostima i nedostatcima kompjutorski vođene implantološke terapije te odrediti ograničenja i kliničku uporabljivost takve terapije. Prikazan je razvoj koncepta kirurške vodilice, od konvencionalnih kirurških šablona sve do kompjutorski planiranih i izrađenih kirurških vodilica. Sukladno napretku kirurških vodilica opisan je i razvoj kompjutorske tomografije i interaktivnih softvera koji omogućuju obradu podataka potrebnih za planiranje i provođenje terapije. Najveća pozornost dana je tehnikama kompjutorski vođene implantacije te su istaknute prednosti i mane pojedinih tehnika. Pregledom literature zaključuje se da nema statistički značajnih razlika u rezultatima konvencionalne i kompjutorski vođene implantološke terapije. Ipak, pravilno indicirana kompjutorski navođena implantacija donosi neke prednosti i osigurava kliničaru siguran i predvidljiv ishod terapije.Reproducing the position, direction, and depth of an implant as planned at the diagnostic stage is the biggest challenge for a dentist and it is precisely the incorrect placement of implants that is one of the most common complications of therapy. The aim of this thesis is to analyze the existing literature written on the subject of advantages and disadvantages of computer-guided implant therapy and to determine the limitations and clinical applicability of such therapy. The development of the surgical guide concept is presented, from conventional surgical templates to computer-designed and manufactured surgical guides. In accordance with the development progress of surgical guides, the development of computed tomography and interactive software, which enables the processing of data necessary for planning and implementation of therapy, is described. The greatest attention was given to the advantages and disadvantages of certain computer-guided implantation techniques. After reviewing the literature it is concluded that there are no statistically significant differences between the results of conventional and computer-guided implant therapy. Nevertheless, properly indicated computer-guided implant placement brings some benefits and provides the clinician with a safe and predictable outcome of therapy

Computer guided implantology

Reprodukcija položaja, kuta i dubine implantata na način kako je odabrano i planirano u dijagnostičkoj fazi predstavlja najveći izazov za doktora dentalne medicine i upravo je nepravilno postavljanje implantata jedna od najčešćih komplikacija terapije. Svrha ovog preglednog rada je napraviti analizu postojeće literature o prednostima i nedostatcima kompjutorski vođene implantološke terapije te odrediti ograničenja i kliničku uporabljivost takve terapije. Prikazan je razvoj koncepta kirurške vodilice, od konvencionalnih kirurških šablona sve do kompjutorski planiranih i izrađenih kirurških vodilica. Sukladno napretku kirurških vodilica opisan je i razvoj kompjutorske tomografije i interaktivnih softvera koji omogućuju obradu podataka potrebnih za planiranje i provođenje terapije. Najveća pozornost dana je tehnikama kompjutorski vođene implantacije te su istaknute prednosti i mane pojedinih tehnika. Pregledom literature zaključuje se da nema statistički značajnih razlika u rezultatima konvencionalne i kompjutorski vođene implantološke terapije. Ipak, pravilno indicirana kompjutorski navođena implantacija donosi neke prednosti i osigurava kliničaru siguran i predvidljiv ishod terapije.Reproducing the position, direction, and depth of an implant as planned at the diagnostic stage is the biggest challenge for a dentist and it is precisely the incorrect placement of implants that is one of the most common complications of therapy. The aim of this thesis is to analyze the existing literature written on the subject of advantages and disadvantages of computer-guided implant therapy and to determine the limitations and clinical applicability of such therapy. The development of the surgical guide concept is presented, from conventional surgical templates to computer-designed and manufactured surgical guides. In accordance with the development progress of surgical guides, the development of computed tomography and interactive software, which enables the processing of data necessary for planning and implementation of therapy, is described. The greatest attention was given to the advantages and disadvantages of certain computer-guided implantation techniques. After reviewing the literature it is concluded that there are no statistically significant differences between the results of conventional and computer-guided implant therapy. Nevertheless, properly indicated computer-guided implant placement brings some benefits and provides the clinician with a safe and predictable outcome of therapy

Mechanical Properties of 3D-Printed Occlusal Splint Materials

Data regarding the mechanical properties of three-dimensionally (3D) printed materials for occlusal splint manufacturing are scarce. The aim of the present study was to evaluate the flexural strength and surface hardness of modern 3D-printed occlusal splint materials and compare them with two control groups, namely, milled and conventional cold-polymerized occlusal splint materials. A total of 140 rectangular specimens were manufactured for the present study. The specimens were prepared in accordance with the International Organization for Standardization standards (ISO 20795-1:2013). Five 3D-printed (NextDent Ortho Rigid, Dental LT Clear, Dentona Flexisplint, Cosmos Bite Splint, and ProArt Print Splint), one milled (ProArt CAD Splint), and one cold-polymerized (ProBase Cold) occlusal splint materials were used to determine flexural strength and surface hardness values. The three-point flexure test was used for the determination of flexural strength values, while Vickers hardness was measured to determine surface hardness. Ten specimens (n = 10) of each material were tested using these procedures. One-way ANOVA and Tukey’s post-hoc test were used to analyze the obtained results (α = 0.05). The values of flexural strength ranged from 46.1 ± 8.2 MPa to 106 ± 8.3 MPa. The Vickers hardness values ranged from 4.9 ± 0.5 VHN to 20.6 ± 1.3 VHN. Significant differences were found among the tested materials (p < 0.0001). The milled and cold-polymerized materials yielded higher values for both flexural strength (only one 3D-printed resin had comparable results to cold-polymerized acrylics) and surface hardness. There are differences in the mechanical properties of the various tested occlusal splint materials. The flexural strength of most of the 3D-printed materials and their surface hardness values are still inferior when compared to the milled or cold-polymerized materials

Antimicrobial Efficacy and Permeability of Various Sealing Materials in Two Different Types of Implant–Abutment Connections

The presence of a microgap along an implant–abutment connection (IAC) is considered the main disadvantage of two-piece implant systems. Its existence may lead to mechanical and biological complications. Different IAC designs have been developed to minimise microleakage through the microgap and to increase the stability of prosthodontic abutments. Furthermore, different sealing materials have appeared on the market to seal the gap at the IAC. The purpose of this study was to evaluate the antimicrobial efficacy and permeability of different materials designed to seal the microgap, and their behaviour in conical and straight types of internal IACs. One hundred dental implants with original prosthodontic abutments were divided into two groups of fifty implants according to the type of IAC. Three different sealing materials (GapSeal, Flow.sil, and Oxysafe gel) were applied in the test subgroups. The contamination of implant–abutment assemblies was performed by a joint suspension containing Candida albicans and Staphylococcus aureus. It was concluded that the IAC type had no significant influence on microleakage regarding microbial infection. No significant difference was found between the various sealing agents. Only one sealing agent (GapSeal) was found to significantly prevent microleakage. A complete hermetic seal was not achieved with any of the sealing agents tested in this study

Sealing Efficacy of the Original and Third-Party Custom-Made Abutments—Microbiological In Vitro Pilot Study

Implant–abutment connection (IAC) is a key factor for the long-term success and stability of implant-supported prosthodontic restoration and its surrounding tissues. Misfit between prosthodontic abutment and implant at the IAC leads to technical and biological complications. Two kinds of prosthodontic abutments are currently available on the market: original and third-party abutments. The aim of this pilot study was to test and compare the internal fit (gap) at the implant–abutment interface depending on the abutment fabrication method based on microbial leakage in static conditions and the need for the use of gap sealing material. Two groups of 40 implants were formed on the basis of the type of abutment. In each of the groups of two implant systems, two subgroups of 10 implants were formed. The tested subgroups consisted of 10 implants with sealing material and a negative control subgroups consisting of 10 implants without any sealing material. The test material, GapSeal (Hager and Werken, Duisburg, Germany) was applied in the test subgroups. The implant–abutment assemblies were contaminated with a solution containing Staphylococcus aureus and Candida albicans for 14 days under aerobic conditions. Results showed that there was no statistically significant difference regarding the microbial leakage between the original and third-party custom-made abutments, regardless of the use of sealing material. It can be concluded that the abutment fabrication method has no significant influence on sealing efficacy regarding the bacterial and fungal leakage in static conditions

Mesenchymal Stem Cells Based Treatment in Dental Medicine: A Narrative Review

Application of mesenchymal stem cells (MSC) in regenerative therapeutic procedures is becoming an increasingly important topic in medicine. Since the first isolation of dental tissuederived MSC, there has been an intense investigation on the characteristics and potentials of these cells in regenerative dentistry. Their multidifferentiation potential, self-renewal capacity, and easy accessibility give them a key role in stem cell- based therapy. So far, several different dental stem cell types have been discovered and their potential usage is found in most of the major dental medicine branches. These cells are also researched in multiple fields of medicine for the treatment of degenerative and inflammatory diseases. In this review, we summarized dental MSC sources and analyzed their treatment modalities with particular emphasis on temporomandibular joint osteoarthritis (TMJ OA)