Primena balon-katetera u hirurgiji maksilarnog sinusa - prikaz slučaja

Introduction: The postoperative drainage and the postoperative bleeding from maxillary sinus cavity have been controlled after functional sinus surgery. It has usually been done using the band of iodize gauze squeezed through the temporary opening in the vestibular mucosa or through the inferior meatal antrostomy. The aim of this study was to present the use of balloon-catheter in maxillary sinus surgery intendend for control of postoperative drainage and bleeding. Case report: Balloon-catheter was used in one female who was treated for anemia after chemotherapy and with allergy to iodine. It was inserted into the sinus cavity through the temporary inferior meatal antrostomy and removed five days after surgery without any postoperative discomforts and complications especially in this risk group of patients. Conclusion: The balloon-catheter surgery method used in risk group of patients improved the quality of postoperative period without significant complications.Uvod: U postoperativnom periodu, posle revizije sluzokože maksilarnog sinusa, potrebno je obezbediti odgovarajuću drenažu i kontrolu mogućeg postoperativnog krvarenja. To se najčešće se izvodi trakom jodoform gaze koja se izvlači kroz privremeno načinjen otvor na sluzokoži forniksa suprotne strane ili kroz trajni otvor u donjem nosnom hodniku. Cilj ovog rada je bio da se prikaže primena balon-katetera radi postoperativne drenaže maksilarnog sinusa i kontrole postoperativnog krvarenja. Prikaz bolesnika: Ovaj postupak je urađen kod osobe ženskog pola, prethodno lečene hemioterapijom, sa prisutnom anemijom i alergijom na jod. Balon-kateter je plasiran u sinusnu šupljinu kroz arteficijelno učinjen otvor u donjem nosnom hodniku, a zatim je primarno zarastanje operativne regije osigurano pojedinačnim i madrac šavovima. Postoperativni tok je protekao uredno. Balon-kateter je uklonjen petog postoperativnog dana. Zaključak: Zapaženo je da primena balon-katetera značajno utiče na kvalitet postoperativnog toka, bez izazivanja postoperativnih komplikacija, i to posebno u rizičnoj grupi pacijenata

Klinička primena kalcijum-sulfata u regenerativnoj terapiji koštanih defekata: prikaz slučaja

It is well known that a variety of materials has been used to fill bone defects after oral surgery procedures. In this study, we showed 2 patients with large osseus defects after oral surgery procedures which were filled with calcium sulphate. The use of this alloplastic material should indicate on effective bone regeneration therapy.Poznato je da su za popunjavanje koštanih defekata posle oralno-hirurških intervencija korišćeni različiti materijali. U ovom radu prikazana su 2 pacijenta sa većim koštanim defektima nastalim posle oralnohirurških intervencija u koje je postavljen kalcijum-sulfat. Primena ovog aloplastičnog materijala značajno utiče na uspešnu regenerativnu terapiju koštanih defekata

Analgesic efficacy of 0.75% ropivacaine for lower third molar surgery

Introduction: Since there is no data concerning local analgesic efficacy of ropivacaine for lower third molar surgery, the aim of this doubleblind study was to compare local anaesthetic parameters and postoperative analgesic requirements after the use of ropivacaine and bupivacaine for the inferior alveolar nerve block. Materials and Method: 20 healthy patients were equally randomized into the ropivacaine (0.75%, 2 ml) or bupivacaine (0.5%, 2 ml) groups. The onset and duration of anaesthesia (the lower lip numbness and pinprick test) and intensity of anaesthesia (visual analogue and verbal rating scales) were determined. The postoperative pain reports and analgesic requirements were also recorded. Results: There were no significant differences concerning parameters of the achieved anaesthesia. 2 patients in the bupivacaine group felt postoperative pain without the need for pain medication. Conclusion: Ropivacaine is suitable for achieving local anaesthesia in lower third molar surgery, especially when prolonged analgesia is desired

Is beta-tricalcium phosphate combined with type i collagen effective for human socket preservation prior to implant placement? A case report

The authors report the use of synthetic beta-tricalcium phosphate with type I collagen immediately after tooth extraction for simple socket preservation indicated in the pre-implant management of alveolar bone. The bone material was used without a barrier membrane and forming a mucoperiosteal flap. Clinical examination revealed solid new bone formation with no changes in vertical and horizontal dimensions 9 months after the socket preservation. Immunohistochemical analysis demonstrated presence of active osteonectine-positive cells. The new bone formed after the use of beta-tricalcium phosphate and type I collagen in the socket preservation method can allow dental implant placement and implant loading

Preimplantološka priprema ekstrakcione alveole deproteinizovanom goveđom kosti i kalcijum-sulfatom

Background. Different materials are used to prevent the resorption of alveolar bone. The aim of this report was to show the radiographical and histological results prior to implant insertion, when a deproteinized bovine bone mineral (BioOss) and calcium-sulphate were placed into the extraction socket immediately after the tooth removal. Case report. A 22-year-old woman was scheduled for the removal of the second lower molar when the extraction socket was filled with BioOss covered with calcium-sulphate as a resorbable membrane. Primary closure of the surgical site was performed. Radiography was done 4 and 12 months later. One year after the surgery, when the implant was inserted, a biopsy of the new regenerated bone was obtained for the histological evaluation. The lamellar bone was evident using both materials. The resorption of BioOss was slow and the connective tissue was observed. Conclusion. Both materials had biocompatible and oseoconductive properties. One year after the grafting procedure, we observed the lamellar bone and partial resorption of BioOss, while calciumsulphate showed no significant effect as a resorbable membrane.Uvod. Primenom različitih materijala sprečava se resorpcija koštanog tkiva na mestu izvađenog zuba. Cilj rada je bio da se prikažu rezultati radiografske i histološke analize posle kombinovane primene deproteinizovane goveđe kosti (BioOss) i kalcijum-sulfata postavljenih u alveolu neposredno posle vađenja zuba, a radi planirane ugradnje endosealnog implantata. Prikaz bolesnika. Posle vađenja donjeg drugog molara, kod bolesnice stare 22 godine, u alveolu je postavljen BioOss prekriven kalcijum-sulfatom u funkciji resorptivne membrane. Operativna regija je primarno ušivena. Kontrolni radiografski snimci urađeni su posle četvrtog i dvanaestog meseca. Godinu dana kasnije, neposredno pre ugradnje implantata, uzet je isečak novoformiranog koštanog tkiva za histološku analizu. Uočeno je stvaranje zrele lamelarne kosti, pri čemu je resorpcija BioOss bila usporena. Takođe, uočeno je i prisustvo vezivnog tkiva. Zaključak. Oba materijala su pokazala biokompatibilnost i oseokonduktivni efekat, stvaranje lamelarne kosti i delimičnu resorpciju BioOss-a godinu dana posle njihove primene. Prisutno vezivno tkivo je pokazalo da kalcijum-sulfat nije ispunio u potpunosti zahteve resorptivne membrane

Nezaštićeni koštani autotransplantati u prednjem segmentu gornje vilice - stepen resorpcije i klinički rezultati

Background/Aim. The use of autogenous bone grafts for augmentation of the resorbed alveolar ridge is still considered the gold standard in implant dentistry. The aim of this study was to analyze the resorption rate of autogenous bone block grafts from the retromolar region placed in the frontal segment of the upper jaw unprotected by barrier membranes, to assess the stability of implants placed into the grafted bone, as well as to monitor its changes during the healing period. Methods. The study included 18 patients with a total of 20 grafted sites. The residual alveolar ridge was measured before and after the augmentation and prior to implant placement. All implants were restored with provisional crowns within 48 hours after the placement. Implant stability was assessed using resonance frequency analysis. Results. The average period from ridge augmentation to reentry was 5.4 months (range 4-6 months) . At reentry the healed alveolar ridge had a mean width of 6.1 ± 1.27 mm. The mean calculated width gain was 3.04 ± 1.22 mm. The overall surface resorption of block grafts was 0.68 ± 0.69 mm (18.85%). At the time of implant placement the mean value of implant stability quotient (ISQ) was 71.25 ± 5.77. The lowest ISQ values were noted after three weeks of healing, followed by a gradual increase until week 12. After 12 weeks implants showed significantly higher ISQ values compared to primary stability (p lt 0.05 Wilcoxon signed ranks test). During the 3-years followup period no cases of implant loss were recorded. Conclusion. Despite a significant resorption of bone grafts, it was possible to place implants in all the cases and to use the immediate loading protocol without affecting implant survival rate.Uvod/cilj. Primena autogenih koštanih graftova (implantata) za uvećavanje smanjenog (resorbovanog) alvelarnog grebena još uvek se smatra zlatnim standardom u implantologiji. Cilj ove studije bio je analiza stepena resorpcije autolognih koštanih blok transplantata nezaštićenih barijernim mebranama, uzetih iz retromolarnog predela mandibule i postavljenih u frontalni segment gornje vilice, procena stabilnosti implantata ugrađenih u povećanu regiju, kao i praćenje promene implantne stabilnosti tokom perioda oseointegracije. Metode. U studiju je bilo uključeno 18 pacijenata sa ukupno 20 autotransplantata. Širina rezidualnog alveolarnog grebena merena je pre i posle postavljanja transplantata, kao i neposredno pre ugradnje implantata. Svi implantati su opterećeni privremenim nadoknadama 48 sati nakon ugradnje. Stabilnost implantata procenjivana je primenom analize rezonantne frekvencije. Rezultati. Srednje vreme između uvećavanja grebena i ugradnje implantata iznosilo je 5,4 (4-6) meseci. Pre ugradnje implantata srednja vrednost širine grebena iznosila je 6,1 ± 1,27 mm, a povećanja širine grebena u odnosu na vrednosti pre uvećanja 3,04 ± 1,22 mm. Površinska resoprcija grafta iznosila je 18,85% (0,68 ± 0,69 mm). Srednja vrednost koeficijenta implantne stabilnosti (ISQ) u momentu ugradnje iznosila je 71,25 ± 5,77. Najniže vrednosti ISQ zabeležene su u trećoj nedelji nakon ugradnje, što je bilo praćeno postepenim porastom do dvanaeste nedelje zarastanja. Nakon dvanaest nedelja vrednosti ISQ bile su statitički značajno više od vrednosti u momentu ugradnje (p lt 0,05 Wilcoxon test). Tokom trogodišnjeg perioda praćenja nije bilo izgubljenih implantata. Zaključak. Bez obzira na značajan stepen resorpcije autotransplantata, kod svih pacijenata bilo je moguće ugraditi implantate u uvećani greben, kao i primeniti protokol ranog opterećenja bez uticaja na stepen preživljavanja implantata

Efficacy of computer-controlled articaine delivery for supplemental intraoral anaesthesia

Objective. The aim of this study was to investigate quality and safety of supplemental intraoral anesthesia - periodontal ligament anaesthesia (PDL) and intraseptal anaesthesia (ISA) after computer-controlled articaine delivery. Method. 54 ASA I volunteers randomly divided into 2 groups participated in this study. 0.4 ml of 4% articaine with 1:100.000 epinephrine were randomly administered with computer-controlled local anaesthetic delivery system on the mesial and distal side of maxillary lateral incisor for ISA or PDL. An electric pulp tester was used to test the pulpal anaesthesia, in 2-minute cycles for 60 minutes. Anaesthesia was considered successful when 2 or more consecutive no-response at 80 readings were obtained. Soft-tissue anaesthesia was measured by pin-prick test. Results. Success rates for ISA and PDL were 77.8% and 55.6% respectively, but difference was not statistically significant (p>0.05). Duration of complete pulpal anaesthesia was significantly longer (p lt 0.05) with the ISA in comparison to the PDL. The width of anesthetizied field was significantly greater (p lt 0.05) with the ISA than with the PDL, both for attached gingiva and oral mucosa. No side effects were recorded during the study. Conclusion. The results of this study indicate that the ISA technique is successful in obtaining complete pulpal anaesthesia of upper lateral incisors and soft-tissue anaesthesia in this area

Dekompresija kao delotvorni primarni pristup radikularnoj cisti u maksilarnom sinusu

Introduction. Therapeutic approach to jaw cysts may depend on their dimensions and localization. Enucleation of cystic lesion is not always preferable in the first act, especially if large cysts are in close proximity to important anatomical structures. The aim of this paper was to present the outcome of the treatment protocol comprising preoperative decompression and subsequent enucleation of a large maxillary cyst. Case re-port. A 21-year-old male patient with large asymptomatic radicular cyst in the right maxillary sinus was presented to our clinic. Conebeam computed tomography (CBCT) showed a large cyst, which perforated the right anterior maxillary wall by 1.5 cm, and was in the intimate contact with the orbital floor. Surgical treatment of the cystic lesion comprised: preoperative decompression with biopsy in the first act and enucleation, performed under general anesthesia, 6 months after the observation period. Conclusion. Decompression with subsequent enucleation proved to be effective treatment of large radicular cyst in maxillary sinus with low-morbidity.Uvod. Terapijski pristup cistama vilice može zavisiti od njihovih dimenzija i lokalizacije. Enukleacija cistične lezije često nije pogodna u prvom aktu ako se velika cista nalazi u blizini važnih anatomskih struktura. Cilj ovog rada bio je da se prikaže ishod lečenja velike ciste u maksilarnom sinusu koji je podrazumevao preoperativnu dekompresiju i odloženu enukleaciju. Prikaz bolesnika. Prikazan je bolesnik, star 21 godinu, sa velikom, asimptomatskom, radikularnom cistom u maksilarnom sinusu. Radiografska dijagnostika pomoću cone-beam kompjuterizovane tomografije (CBCT), pokazala je prisustvo velike cistične lezije koja je probila prednji maksilarni zid (1,5 cm) i bila u bliskom kontaktu sa podom orbite. Hirurški tretman cistične lezije uključio je preoperativnu dekompresiju i biopsiju u prvom aktu i enukleaciju u opštoj anesteziji nakon 6 meseci. Zaključak. De-kompresija i odložena enukleacija pokazale su se efikasnim terapijskim pristupom kod lečenje velike radikularne ciste maksilarnog sinusa uz mali morbiditet