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

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

The closure of oroantral communications with resorbable PLGA-coated beta-TCP root analogs, hemostatic gauze, or buccal flaps: A prospective study

Objective. The aim of this study was to compare the treatment of oroantral communications (OACs) with bioresorbable root analogs made of poly(lactide-co-glycolide) (PLGA)-coated beta-tricalcium phosphate (beta-TCP), hemostatic gauze or a buccal flap technique. Study design. In this prospective clinical study, 30 patients with oroantral communications were randomly assigned to a treatment. Clinical success, vestibular depth at the defect site, pain, and swelling were monitored. Results. The OAC closure was successful in all cases. The vestibular depth stayed constant in the groups treated with the PLGA-beta-TCP composite or hemostatic gauze. In contrast, a vestibular depth reduction of 1.2 +/- 0.2 mm was observed in the buccal flap group, indicating atrophy of the alveolar ridge in these patients. Furthermore, pain and swelling were more pronounced in this group. Conclusion. Closures of OACs with PLGA-beta-TCP composite or hemostatic gauze are reliable minimally invasive methods that minimize atrophy of the alveolar ridge, swelling, and pain compared with a buccal flap technique. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 844-850

Evaluation of Primary Stability of Self-Tapping and Non-Self-Tapping Dental Implants. A 12-Week Clinical Study

Purpose: The aim of this study was to investigate the relationship between surgical techniques and implant macro-design (self-tapping/non-self-tapping) for the optimization of implant stability in the low-density bone present in the posterior maxilla using resonance frequency analysis (RFA). Materials and Methods: A total of 102 implants were studied. Fifty-six self-tapping BlueSkyBredent (R) (Bredent GmbH &, Senden, Germany) and 56 non-self-tapping Standard Plus Straumann (R) (Institut Straumann AG (R), Waldenburg, Switzerland) were placed in the posterior segment of the maxilla. Implants of both types were placed in sites prepared with either lateral bone-condensing or with bone-drilling techniques. Implant stability measurements were performed using RFA immediately after implant placement and weekly during a 12-week follow-up period. Results: Both types of implants placed after bone condensing achieved significantly higher stability immediately after surgery, as well as during the entire 12-week observation period compared with those placed following bone drilling. After bone condensation, there were no significant differences in primary stability or in implant stability after the first week between both implant types. From 2 to 12 postoperative weeks, significantly higher stability was shown by self-tapping implants. After bone drilling, self-tapping implants achieved significantly higher stability than non-self-tapping implants during the entire follow-up period. Conclusions: The outcomes of the present study indicate that bone drilling is not an effective technique for improving implant stability and, following this technique, the use of self-tapping implants is highly recommended. Implant stability optimization in the soft bone can be achieved by lateral bone-condensing technique, regardless of implant macro-design