The effectiveness of decompression as initial treatment for jaw cysts : a 10-year retrospective study

Decompression is an approved alternative to cystectomy in the treatment of jaw cysts. This study aimed to evaluate its effectiveness as an initial procedure, as well as factors with potential to influence outcome. The frequency of decompression was analysed, whether completed in one session or followed by enucleation at the Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, from 2005 to 2015. Further analysis focussed on factors potentially influencing outcome: cyst location, histopathology, means of preserving the cyst opening, cyst size, patient age. In all, 53 patients with 55 jaw cysts (mean age of 35.1) were treated by initial decompression in the ten-year period. In the majority of cases, histopathological analysis revealed a follicular cyst (43.6%), followed by odontogenic keratocysts (23.7%), radicular cysts (21.8%), residual cysts (7.3%) and nasopalatine cysts (3.6%) Treatment was completed with a single decompression in 45.5% of the cases. Among those, 72.0% were follicular cysts and 8.0% odontogenic keratocysts. Subsequent enucleation was needed in 54.5% of all cases, with a majority in the keratocystic group (36.7%). Histological findings, means of keeping the cyst open, and patient age were found to influence the effectiveness of decompression. Decompression could be performed as a procedure completed in one session or combined with subsequent enucleation, mainly dependent on histopathological findings. Subsequent enucleation of odontogenic keratocysts is highly recommended

The effect of systemic antibiotics on clinical and patient‐reported outcome measures of oral implant therapy with simultaneous guided bone regeneration

Publisher's version (útgefin grein)Objectives: The aim of the present superiority study was to determine the effect of systemic antibiotics primarily on patient-reported outcome measures (PROMs) and post-surgical complications in patients undergoing oral implant therapy with simultaneous guided bone regeneration (GBR). Materials and Methods: A total of 236 medically and periodontally healthy patients received oral implants with simultaneous GBR at seven centres. Pre-operative antibiotics of 2 g amoxicillin were prescribed to the test group 1 hr prior to surgery and 500 mg thrice daily on days 1–3 after surgery. The control group was given a placebo. Group allocation was performed randomly. Primary outcome variables were PROMs recorded as visual analogue scale scores assessed on days 1–7 and 14 on pain, swelling, haematoma and bleeding. Post-operative complications as secondary outcome variables were examined at 1, 2, 4 and 12 weeks from surgery. Chi-square tests and repeated measures of analysis of variance (ANOVA) were performed for statistical evaluation. Results: No statistically significant differences (p >.05) between the two groups were detected for the evaluated PROMs. The same was noted with respect to post-surgical complications. Four implants were lost—three in the test group and one in the control group. Conclusion: In this trial, systemic antibiotics did not provide additional benefits to PROMs, nor the prevention of post-surgical complications in medically and periodontally healthy patients undergoing oral implant therapy with simultaneous GBR. However, further studies with larger sample sizes are still required to support the clinical outcomes of this study.This study has been supported by a research grant of the ITI Foundation (ITI Grant‐No: No. 962_2013). Further, we want to thank the Geistlich AG, Wolhusen, Switzerland, for providing bone substitutes and collagen membranes (Bio‐Oss® and Bio‐Gide®); Medochemie Limassol, Cyprus, for providing the study medication; and the Straumann AG (Basel, Switzerland) for granting a 50% discount on all the implant materials used in the presented study. The co‐operation of the staff of the centres involved in the study is highly appreciated: (1) Peking University, School of Stomatology, Beijing PR China (2) Medical University Graz, University Clinic of Dental Medicine & Oral Health, Department of Oral Surgery and Orthodontics, Graz Austria (3) Griffith University, Gold Coast, School of Dentistry and Oral Health, Queensland, Australia (4) The University of Hong Kong, Faculty of Dentistry, Hong Kong SAR PR China (5) University of Iceland, Faculty of Odontology, Reykjavik, Iceland (6) Shanghai Jiao Tong University, Shanghai Ninth People's Hospital, Department of Implant Dentistry, Shanghai PR China (7) National Dental Centre Singapore, SingaporePeer Reviewe

Extraoral Root-End Resection May Promote Pulpal Revascularization in Autotransplanted Mature Teeth—A Retrospective Study

Tooth germ autotransplantation of open apices of the teeth exhibits high pulpal healing rates, whereas that of mature permanent teeth normally causes irreversible pulpal necrosis. Extraoral root-end resection (EORER) during transplantation may promote pulpal revascularization (PRV) in transplanted mature teeth and reduce endodontic treatment requirement. This study compared the primary outcomes of survival rates, PRV, and root resorption and determined relevant confounders in autotransplanted mature and immature teeth. The medical charts of consecutive patients who underwent tooth autotransplantation between January 2017 and March 2021 were evaluated. Teeth with a documented follow-up of at least 1 year were included. During the study period, 59 teeth were transplanted in 44 patients. Overall, 2 teeth were excluded owing to missing data; 57 teeth were analyzed, including 25 mature teeth additionally treated with EORER. After a mean follow-up of 21.2 ± 16.1 months, no significant differences in primary outcomes were detected. Fifty-five teeth remained in situ (96.5%), and radiological signs of root resorption were detected in 9/57 teeth (15.8%). PRV was positive in 54/57 teeth (94.7%). Surgical duration and PRV failure were significantly associated with high incidences of root resorption. Mature teeth autotransplantation with EORER yielded similar results to immature teeth autotransplantation and is a feasible treatment option. Long surgery and failed revascularization increased root resorption rates. More factors should be evaluated in larger trials with longer observation periods

Randomized clinical study using xenograft blocks loaded with bone morphogenetic protein‐2 or autogenous bone blocks for ridge augmentation – a three‐dimensional analysis

OBJECTIVES: To test whether or not the use of a xenogeneic block loaded with rhBMP-2 results in superior radiological and profilometric outcomes compared to an autogenous bone block. MATERIALS AND METHODS: Twenty-four patients randomly received a xenogeneic block loaded with rhBMP-2 (test) or an autogenous bone block (control) for primary augmentation. The ridge width (RW) was evaluated by means of a CBCT scan after augmentation surgery and at 4 months, prior to implant placement. Surface scans were taken prior to augmentation and at 4 months for profilometric analyses. Data were analyzed with Wilcoxon-signed rank test, Mann-Whitney test, or nonparametric ANOVA models. RESULTS: The median RW after augmentation amounted to 7.13 mm (Q1 = 6.02; Q3 = 8.47) for test and 6.86 mm (Q1 = 5.99; Q3 = 8.95) for control. During 4 months of healing, the total RW decreased statistically significantly and measured 5.35 mm (Q1 = 4.53; Q3 = 6.7) for test and 5.15 mm (Q1 = 3.57; Q3 = 7.24) for control (p = 0.0005). The differences between the groups were not statistically significant (p > 0.5899). The buccal soft tissue contour slightly increased for test (0.83 mm; Q1 = 0.62; Q3 = 1.87) and control (1.16 mm; Q1 = 0.50; Q3 = 1.44). CONCLUSIONS: Both treatment modalities successfully increased the ridge width to a similar extent. The shrinkage during healing was not greater in the test than in the control group. The impact of hard tissue augmentation on the soft tissue contour was, however, minimal

Pulp Revascularization in an Autotransplanted Mature Tooth: Visualization with Magnetic Resonance Imaging and Histopathologic Correlation

Autotransplantation of a mature tooth usually leads to pulpal necrosis. Root canal treatment is recommended to prevent related inflammatory complications a few weeks after surgery. Extraoral root-end resection may facilitate reperfusion and obviate root canal treatment, but cannot be pictured with conventional dental radiography at this point in time. In the case of a lower mature transplanted molar, contrast-enhanced magnetic resonance imaging proved to be a feasible method for visualizing pulp revascularization just 4 weeks after autotransplantation. Consequently, root canal treatment was obviated. Nevertheless, the tooth had to be extracted 18 months postoperatively due to external cervical root resorption, probably caused by the extraction trauma. This allowed the histological processing and examination of the newly generated intracanal tissue. Uninflamed fibrovascular connective tissue was found, while odontoblasts or cementoblast-like cells were absent. These findings indicated that it was most likely stem cells from the bone marrow and the periodontal ligament that drove the regeneration

Prevalence of Medication-Related Osteonecrosis of the Jaw in Patients with Breast Cancer, Prostate Cancer, and Multiple Myeloma

Medication-related osteonecrosis of the jaw is a known side-effect of antiresorptive therapy in patients with malignant diseases. Nevertheless, the exact pathogenesis is still unknown and published prevalences show a significant range. The aim of the presented paper was to assess the prevalence of osteonecrosis (ONJ) in breast cancer, prostate cancer, and multiple myeloma patients receiving parenteral antiresorptive therapy. For this reason a PubMed search was performed and 69 matching articles comprising 29,437 patients were included in the analysis. Nine-hundred fifty-one cases of jaw necrosis were described. The overall ONJ-prevalence was 2.09% in the breast cancer group, 3.8% in the prostate cancer group, and 5.16% for multiple myeloma patients