Closure of large oroantral fistula with resorbable collagen membrane: Case report

Oroantral fistula is pathologic communication between oral cavity and maxillary sinus, usually localized between antrum and buccal vestibulum. Persisting OAF always causes chronic maxillary sinusitis. A technique for closure of a large oroantral fistula with resorbable collagen membrane is described

Ugrožena protetička rehabilitacija usled fibrozne i koštane hiperplazije gornje vilice - prikaz pacijenta

Normal bone healing after tooth extraction includes the following steps: blood clot forming, granulation, bone forming and final bone reorganization. In clinical settings connective tissue infiltration of extraction socket can result in fibrous scar formation rather than bone healing. Local and systemic factors seem to be major contributors to the occurrence of erratic socket healing. The aim of this case report was to describe oral-surgery treatment of a patient with inadequate bone and soft supportive tissue for prosthetic rehabilitation. Surgical procedure and recovery are presented, including final complete denture rehabilitation.Nakon vađenja zuba obično slede brza organizacija koaguluma, formiranje granulacionog tkiva, osteoida, a zatim i zrele lamelarne kosti. Međutim, klinički se neretko može sresti infiltracija ekstrakcione alveole vezivnim tkivom, uz stvaranje fibroznog ožiljka umesto novostvoren kosti. Za to su odgovorni brojni lokalni i sistemski faktori koji doprinose nepravilnom zarastanju ekstrakcione alveole. Cilj ovog rada je bio da se opiše oralnohirurško lečenje pacijenta s neodgovarajućim stanjem koštanog i mekog nosećeg tkiva gornje totalne proteze. Prikazani su hirurški postupak i postoperacioni tok, zaključno s konačnim odgovarajućim protetičkim zbrinjavanjem pacijenta, koji je doveo do pravilnog zarastanja rane i time zadovoljavajuće protetičke rehabilitacije

Inadequate prosthetic rehabilitation caused by fibrous and bone hyperplasia of maxilla: Case report

Normal bone healing after tooth extraction includes the following steps: blood clot forming, granulation, bone forming and final bone reorganization. In clinical settings connective tissue infiltration of extraction socket can result in fibrous scar formation rather than bone healing. Local and systemic factors seem to be major contributors to the occurrence of erratic socket healing. The aim of this case report was to describe oral-surgery treatment of a patient with inadequate bone and soft supportive tissue for prosthetic rehabilitation. Surgical procedure and recovery are presented, including final complete denture rehabilitation

C-reaktivni protein kao inflamatorni marker u proceni efikasnosti lečenja akutnih dentogenih infekcija

Introduction. Clinical presentation of acute odontogenic infections may vary, while adequate evaluation of its severity is of great importance for determination of appropriate and effective therapy. Objective. The aim of the present study was to monitor changes of C-reactive protein (CRP) levels, to correlate its values with symptoms of different acute odontogenic infections (AOI), and to monitor the effectiveness of the applied therapy. Methods. Fifty-four patients with AOI were included in the study. Eighteen patients with good drainage and normal body temperature were treated only by surgical incision without using antibiotics. Twenty-two patients with poor drainage after incision and normal body temperature were treated by surgical incision and antibiotics. Fourteen patients with elevated body temperature were treated by incision and antibiotics, irrespective of the quality of the drainage. CRP levels were measured on admission, on the 3rd and 7th day after therapy initiation. Results. On admission CRP levels were higher in AOI with elevated body temperature compared to poorly and well-drained AOI. There were no differences in CRP levels between well and poorly drained AOI on admission. On the 3rd day, a decline in the CRP levels was evident in all three groups of patients, and there was no difference among the groups. On the 7th day, the CRP levels normalized in all groups. Conclusion. CRP levels correlate well with the severity and resolution of AOI and could be used as a reliable parameter in monitoring the effectiveness of AOI therapy.Uvod. Klinička slika akutne dentogene infekcije (ADI) je raznolika, a pravilna procena težine ADI od velikog značaja za određivanje odgovarajuće i efikasne terapije. Cilj rada. Cilj rada je bio da se uporede vrednosti i promene nivoa C-reaktivnog proteina (CRP) s kliničkim simptomima ADI različitog stepena težine tokom lečenja bolesnika, te na taj način utvrdi efikasnost primenjene terapije. Metode rada. Istraživanjem su obuhvaćena 54 pacijenta sa ADI. Osamnaest pacijenata sa dobrom drenažom nakon incizije i normalnom telesnom temperaturom lečeno je bez antibiotika. Dvadeset dva pacijenta s lošom drenažom nakon incizije i normalnom telesnom temperaturom lečena su incizijom i antibioticima. Četrnaest pacijenata s povišenom telesnom temperaturom lečeno je incizijom i antibioticima bez obzira na kvalitet drenaže. Nivo CRP je meren na prijemu, trećeg i sedmog dana od početka primene terapije. Rezultati. Na početku lečenja nivo CRP bio je veći kod bolesnika s povišenom telesnom temperaturom u poređenju s ostalim ispitanicima. Na početku lečenja nije bilo razlike u nivou CRP između ispitanika sa dobrom i lošom drenažom. Trećeg dana uočeno je smanjenje nivoa CRP u sve tri grupe ispitanika bez ikakve razlike. Sedmog dana nivo CRP se normalizovao u svim grupama. Zaključak. Nivo CRP je u dobroj korelaciji sa stepenom težine i povlačenjem dentogene infekcije, tako da može biti pouzdan parametar u proceni efikasnosti lečenja ADI

Acute toxicity assessment of defense secretions of Megaphyllum bosniense (Verhoeff, 1897) and M. unilineatum (C. L. Koch, 1838) (Diplopoda, Julida) on Artemia salina.

INTRODUCTION: Different orders within the class Diplopoda possess a variety of chemical compounds in their defense secretions: quinones, phenolics, alcohols, aldehydes, ketones, esters, alkaloids, cyanogenic compounds. Defensive secretions of species from the order Julida are regarded as the most complex within Diplopoda, and they are blends of several classes of chemical com- pounds: quinones, esters and ketones. Numerous biological activities of these secretions have been reported: antimicrobial, antioxidative, antineurodegenerative, cytotoxic and embryotoxic on zebrafish. Besides zebrafish embryos, Artemia salina is one of the common model organisms in toxicity assessment which has not been used for screening of toxicity of millipedes’ defensive secretions. OBJECTIVES: The main goal of this study was to examine the toxic effects of defensive secretions of two species from the order Julida [Megaphyllum bosniense (MBO) and M. unilineatum (MUN)] using Artemia salina (ARC test). METHOD / DESIGN: Adult individuals of M. bosniense were collected during April and May of 2021 on Mt. Avala, near Belgrade, while adults of M. unilineatum were collected during the same period in the Krnjača, suburb of Belgrade. After the capture, millipedes were kept in plastic boxes containing ground cover from the collecting site. The boxes were regularly sprayed with water to maintain high humidity. Due to the fact that the sample was female-biased, defensive secretions of female specimens were used for further analyses. Excretion of defensive secretions was elicited from glands of mentioned species via mechanical stress in closed glass vials. Secretions collected from both species were dissolved in 10 ml of hexane, concentrated under reduced pressure in a rotary evaporator (Rotavapor R-210, Buchi) at 40°C to a dry residue, and redissolved in 50% dimethylsulphoxide (DMSO). The stock concentration of extracts used in ARC test was 20 mg/mL. Before treatments, eggs of A. salina were incubated for 72h with constant lighting and aeration. For the purposes of the experiment, stage II and III larvae were used (separated by phototaxis in 300 ml of seawater). In a plate with 24 wells, 900 μl of seawater with larvae (10-15 per well) was placed and then 100 μl of tested extracts (range of concentrations 0,1 mg/mL - 0,003125 mg/mL) was added. Potassium dichromate (K2Cr2O7) was used as a positive control and DMSO was used as solvent control. The total number of individuals per well was counted after 24h and 48h, as well as the number of living and dead individuals. These data were used for esti- mation of survival rate and determination of LC50 value. The experiment was done in triplicate. RESULTS: Our results show that secretions from both species exhibit a toxic effect on the survival of the chosen model organism, with the MBO extract showing weaker activity in comparison with MUN extract. The LC50 value after 24h was about the same for both species (LC50=73,23 μg/mL for MBO and LC50=68,56 μg/mL for MUN). The LC50 value for MBO after 48h was 47,18 μg/ mL, while LC50 value in the same period for MUN was 29,12 μg/mL. Positive control (LC50= 13,5 μg/mL) showed three times stronger effects in relation to MBO and twice as strong when compared to MUN extract. It has also been shown that the num- ber of surviving individuals decreases with increasing concentration of tested extracts and the increasing incubation time. CONCLUSIONS: The defense secretions of both tested millipede species show toxic effects in the ARC test. It is shown that MBO extract has a weaker toxic effect than the MUN extract. This result can be linked with the fact that esters of long-chain fatty acids are dominant compounds in MBO, while MUN is almost exclusively benzoquinone-based. Esters detected in MBO are generally regarded as low-toxic compounds, but with the potential to interact with compounds from other chemical classes. However, as MBO achieved toxic effects and many esters that are detected in MBO are new natural products and their biological potential is unknown, further extensive studies are needed to determine their toxicological potential

Defensive secretions of millipedes Megaphyllum unilineatum (C. L. Koch, 1838), Pachyiulus hungaricus (Karsch, 1881) and Cylindroiulus boleti (C. L. Koch, 1847) (Diplopoda, Julida) as antimicrobial agents in the inhibition of biofilms of Pseudomonas aeruginosa PAO1 and Staphylococcus aureus

INTRODUCTION: In recent years, the emphasis of the scientific community has been placed on the invention of new antimicrobial agents due to the increasing resistance of bacteria to antibiotics. However, serious global health concern is focused on bacterial biofilms, a complex structure of a microbiome made up of colonies of bacteria or individual bacterial cells in a group, attached to a surface. Bacterial biofilms are highly resistant to antimicrobial agents and grow on the surfaces of medical implants such as sutures, catheters, and dental implants. Given that plants and animals are a valuable source of natural biologically active products, they are a good basis for finding new antimicrobial and antibiofilm agents. Bacterial strains of Pseudomonas aerug- inosa PAO1 and Staphylococcus aureus are known for biofilm production and cause opportunistic and chronic infections in humans, some of which are due to biofilm production. Due to their characteristic way of life, millipedes (Diplopoda) are char- acterized by a diverse and complex defense against predators, which includes the secretion of various chemical compounds that are toxic, repellent, or tasteless to predators. Analyzes have shown that millipedes produce chemical compounds such as phenols, alkaloids, quinones, terpenoids, cyanogenic compounds, and fatty acid esters, which showed antimicrobial ac- tivity, among other. Representatives of the order Julida, which are frequent in Republic of Serbia, produce defense secretions that are chemically very complex (the most complex within Diplopoda) and exhibit antimicrobial, antioxidant, and neurode- generative potential, so they represent a good basis for the invention of new antibiofilm agents. OBJECTIVES: Objectives are to determine the inhibition of biofilm formation and degradation of the formed biofilm of P. aeruginosa PAO1 and S. aureus by defense secretions of selected millipede species from the family Julidae as well as to determine their anti- microbial activity. METHOD / DESIGN: Biofilm formation was quantified by the crystal violet staining method, while antimicrobial activity was examined using the broth dilution minimum inhibitory concentration (MIC) test. RESULTS: Defensive secretions of Megaphyllum unilineatum (MUN), Pachyiulus hungaricus (PHU), and Cylindroiulus boleti (CBO) showedantimicrobial activity against S. aureus with MIC values of 0.03, 0.06, and 0.06 mg/mL, respectively. On P. aeruginosa PAO1, defense secretions did not show antimicrobial activity even at the highest tested concentration of 1 mg/mL for MUN while for PHU and CBO the MIC was 1 mg/mL, which is most likely due to the high resistance of this bacterial strain. The antibiofilm effect was observed in all tested defense secretions and was more pronounced against S. aureus than against P. aeruginosa PAO1. The strongest biofilm inhibition of S. aureus was at the highest tested concentrations (2 × MIC) with percentages of inhibition of CBO: 88.6%, PHU: 73.7%, and MUN: 67.2%. Degradation of already formed S. aureus biofilm was shown at lower tested defensive secretions concentrations (MIC/4), about 40% of biofilm degradation for MUN and PHU and about 30% for CBO. The strongest inhibition of P. aeruginosa PAO1 biofilm formation was observed at the highest tested concentrations of defensive secretions, 1 and 0.5 mg/mL for PHU (82 and 54%), and CBO (64.3 and 38.5%) while MUN had the strongest activity at the lowest tested concentration of 0.06 mg/mL (34.3%). All examined defense secretions had similar degradation activity of P. aeruginosa PAO1 biofilm with stronger activity at lower tested concentrations (about 30%). Defensive secretions of MUN and PHU extracted in DMSO solvent showed a stronger antibiofilm effect compared to the same ethanol extracts. CONCLUSIONS: The defense secretions of MBO, PHU, and CBO show a good basis for further investigations of their use as antimicrobial agents, especially against S. aureus

Anatomical study of the pterygopalatine fossa pertinent to the maxillary nerve block at the foramen rotundum

The anatomy of the pterygopalatine fossa pertinent to the technique of maxillary nerve block at the foramen rotundum was investigated and the ability of inexperienced surgeons to apply the required angles of the injection needle to the sagittal plane in a clinical environment. In 85 dried human skulls the volume, length, width and depth of 159 intact pterygopalatine fossae were measured. The frequency of reaching the sphenopalatine foramen using a 20 G spinal needle advanced from the frontozygomatic angle through the pterygomaxillary fissure was determined. 49 oral surgery postgraduates aligned the injection needle with angles of 60 degrees and 80 degrees to the sagittal plane of a volunteer's head. The dimensions of the pterygopalatine fossa were inconsistent; volume (0.1-1 cm(3)), width (1-9 mm) and depth (6-22 mm) showed the greatest variations. An enlarged sphenoidal process and a narrow pterygomaxillary fissure ( lt 2 mm) were found in 15% and 8%, respectively. The sphenopalatine foramen was reached successfully in 75%. Postgraduates in oral surgery were highly accurate in the assessment of the 60 and 80 angles to the sagittal plane. A previously described technique of blocking the maxillary nerve at the foramen rotundum was adjusted and recommendations given to overcome anatomical obstacles

Resonance Frequency Analysis as a Reliable Criterion for Early Loading of Sandblasted/Acid-Etched Active Surface Implants Placed by the Osteotome Sinus Floor Elevation Technique

Purpose: This study was intended to investigate, through resonance frequency analysis (RFA), the stability of implants placed in an early loading protocol via the osteotome sinus floor elevation technique in the posterior maxilla. All implants featured a sandblasted/acid-etched active surface. Materials and Methods: An early loading protocol was considered for patients in whom implants with a sandblasted, large-grit/acid-etched active surface (SLActive) were placed in the posterior maxilla by the osteotome sinus floor elevation technique. Implant stability, which was measured by RFA at surgery and at weekly intervals for the following 6 weeks, was used as the most significant inclusion criterion. At the end of the stability observation period, only implants with a stability quotient of 65 or higher were loaded. Implants were followed for 2 years. Results: Twenty-seven patients received 42 implants, 40 of which were subjected to an early loading protocol 6 weeks after placement. Two years after loading, all 40 implants were surviving, without clinically or radiographically detectible complications. Conclusion: An early loading protocol can be used for SLActive implants placed in the posterior maxilla via the osteotome sinus floor elevation technique if their stability is confirmed by RFA. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:718-72