Alveolar Preservation with Albumin and Gentamycin-Coated Allograft after Third Molar Tooth Removal: A Randomized Clinical Trial

Alveolar preservation can minimize bone resorption after tooth removal and additional topical antibiotics might also be considered. The goal of this study was to observe alveolar preservation with albumin and gentamycin-coated allograft compared to unfilled control sockets after mandibular third molar removal. Twenty-two patients were involved, 11 in the control group and 11 in the test group. CBCT analysis and micromorphometric analysis were performed. After one year, graft integration was observed with remaining graft particles. Micromorphometric analysis showed increased density and lower trabeculae formation in the grafted group. The buccal height reduction of the alveolar ridge was significantly lower when alveolar preservation was applied (control: 2.54 ± 2.01 mm, graft: 1.37 ± 1.04 mm, p < 0.05). Horizontal bone loss prevention was not significant. At the distal site of the second molar, the marginal bone level (MBL) was significantly lower in the control group. At the control group, five pockets persisted from the eight initial and all healed in the graft group. Alveolar preservation improves bone formation, helps to preserve the buccal bone crest, and minimizes MBL loss and pocket formation on the adjacent teeth. Thus, it needs to be also considered after third molar surgical removal

Endodontic and microsurgical treatments of maxillary lateral incisor dens invaginatus in combination with cone-beam-computed tomography fusion imaging

In this case report, we present the endodontic treatment and microsurgical intervention of dens invaginatus affecting a lateral incisor using cone-beam-computed tomography (CBCT). A 26-year-old woman visited us with a diagnosis of acute apical periodontitis in the upper right lateral incisor (tooth 12). Endodontic treatment of the tooth was carried out. Intraoral radiography provided limited information on the unusual anatomy of the pulp chamber and root canal system; therefore, preoperative CBCT was performed. At the 3-month recall, a radiograph revealed a 5-mm-diameter lateral transparency, and CBCT was, therefore, repeated to facilitate microsurgery treatment planning. A medical image-processing program was used to demonstrate the changes between the CBCT images obtained before and after root canal preparation. In conclusion, endodontic treatment of dens invaginatus is challenging even for endodontic specialists, because the therapy sometimes requires surgical intervention. The currently available novel three-dimensional imaging modalities may have importance in planning and following up the root canal treatment in such cases, especially when unforeseen complications arise