Influence of Resonance Frequency Analysis (RFA) Measurements for Successful Osseointegration of Dental Implants During the Healing Period and Its Impact on Implant Assessed by Osstell Mentor Device

AIM: This study aimed to investigate and assess primary and secondary dental implant stability during the osseointegration period. METHODS: A total of 77 implants were placed in 42 patients with 26 males and 16 females. The study was conducted by comparing the resonance frequency analysis (RFA) values of the implants inserted in the lower jaw. RFA was done immediately after implant insertion and after 12 weeks. Results were statistically evaluated using SPSS Statistics for Windows, Version 7.1. Level of significance was set at P < 0.05. RESULTS: Significant differences were detected between the primary and secondary stability values, respectively. Maximum RFA value of 88 and the minimum value of 52 were observed. Stability values increased during the following three months, and all implants were successfully integrated without complication. CONCLUSION: Our results indicate and suggest that there is a strong linear correlation between implant stability and ISQ values that can be directly estimated by the RFA, especially in the posterior edentulous mandible. Osstell implant device could represent a useful tool which can be used to identify the risk for implant failure

The subcrestal implant placement as factor for crestal bone stability in implant sites with vertically thin gingiva

This prospective comparative study aimed to determine the influence of the implant placement type (subcrestal or equicrestal) on bone level changes in platform-switched implants placed in sites with vertically thin gingiva (<3 mm) and restored with screw-retained or cement-retained restorations. Moreover, the effect of vertical gingival thickness on peri—implant bone loss was analyzed. The clinical significance of the study’s conclusions is in determining a modality of implant placement efficient in preserving stable crestal bone

The clinical outcomes of coronally advanced flap versus bilaminar technique for treatment of multiple gingival recessions: a split-mouth case report with five years follow-up

The aim of this split mouth case presenta9on was to compare the clinical outcomes in terms of complete root coverage (CRC) and buccal so< 9ssue thickness between the coronally advanced flap (CAF) alone and coronally advanced flap plus connec9ve 9ssue gra< (CAF+CTG) in a 5 years follow up. Material and Methods: A periodontally healthy 30 years old female patient presented with mul9ple gingival recessions in the both sides of the upper jaw due to inadequate oral hygiene habits. All recessions fell under Miller 1, Cairo RT-1 class. On the one side, the recessions were treated with coronally advanced envelope flap design (DeSan9s, Zucchelli), whereas on the contralateral side an autogenous connective tissue graft was also used in a bilaminar technique manner. The used connective tissue graft from the palatal donor site resulted from extraoral eepithelization of a gingival graft (DGG). The graft was adapted and stabilized to the root surfaces using resorbable 6.0 PGA suture. The flap on both sides was coronally advance

Odontoma as an etiological factor for impaction of teeth

Odontoma is considered to be the most common odontogenic tumor of the oral cavity. Most odontoma are discovered during routine radiographic investigations and can cause disturbances in the teeth eruption. Here we report two cases, where the odontoma are the main etiological factor for tooth impaction. The aim of this study is to determine the necessity of the removal of the odontoma as a main etiological factor for tooth impaction in order to induce successful tooth eruption. In the first case, a radiography examination using orthopantomogram showed radio-opaque lesions mesial to the impacted right mandibular canine. The lesion was surgically removed under local anesthesia. After mucoperiosteal flap was raised, superficial bone was removed followed by the removal of the calcified structures. The flap was approximated and sutured. In the second case, a radiography examination using CBCT revealed presence of radio-opaque lesions next to the unerupted left maxillary canine. Surgery was performed under local anesthesia. After the primary canine was removed, the odontomas were removed in order to establish eruption path for the canine. The results of this study show that using the appropriate surgical protocols that eliminate odontogenic lesions can establish adequate environment for teeth to erupt. Diagnosis of odontoma at an early age and its surgical excision may prevent eruption disturbances. A careful follow-up of the case, implementing preventive and interceptive orthodontics, if necessary, prevents future malocclusion. Keywords: CBCT, Odontoma, Surgery, Tooth impactio

Clinical outcomes of guided tissue regeneration procedure utilized with two different surgical approaches - a comparative study

The guided tissue regeneration (Nyman et al. 1982) is a well-established surgical technique which main goal is to reconstruct the periodontal ligament with functional collagen fibers inserted into a newly formed cementum and alveolar bone. Teeth with periodontal disease resulting in deep infrabony pockets are successfully treated with this technique. Its main prognostic factors from clinical and biological standpoint include: blood clot stabilization, primary closure of the defect, space provision and exclusion from the gingival tissues. Several surgical techniques have been proposed for utilization of GTR. Lately these techniques have been aiming at minimal invasiveness for optimal wound closure and lesser postoperative morbidity. The aim of this presentation was to compare the clinical outcomes of two different techniques for GTR:modified papilla preservation flap (Cortelinni et al, 1995) vs. single flap approach. Results: The obtained data revealed significantly better results in CAL gain (3.6+/-1.3 mm vs. 2.1+/- 1.2 ), PD reduction (2.7+/- 0.8 vs. 1.4 +/-0.6) and REC ( 1.5 +/- 0.9 vs. 2.6 +/- 0.8) at baseline and one year post surgery in test group. Conclusion: Results from our analysis suggest that single flap approach as less invasive provides better clinical outcomes, although without big clinical relevance considering the small number of patients

Comparative evaluation of implant stability between osseodensification and underdrilling osteotomy technique

Background: Different implant bed drilling techniques have been proposed to increase the implant stability in order to facilitate better implant survival rates. Most of these techniques are indicated in areas with low bone density and aim at its increase. Aim: The aim of this study was to evaluate the effect of two different implant osteotomy methods in terms of implant stability during the period of osseointegration in bone with low density. Material and methods: This prospective randomized clinical study included 22 patients that received a total of 37 implants in the posterior maxillary region. They were divided into two groups: in 11 patients, 18 implants were placed using the underdrilling method (UD), while the other 11 patients received 19 implants using the osseodensification method (OD). Within the OD group, 10 implants were placed with simultaneous crestal sinus floor elevation (max 5 mm) without bone graft use. All implants were placed in a dual-stage manner. The implant stability was measured through their ISQ values at the time of surgery and at the time of their uncovery, four months later. The data were analyzed using paired two-way ANOVA test and the probability value <0.0001 was considered statistically significant. Results: The early implant survival rate was 94,6%, since 35 implants were osseointegrated. There was no statistically significant difference in the primary implant stability values between the two groups. The values of secondary implant stability were significantly higher in the OD group (p<0.05). Within the OD group, there were no statistically significant differences in the secondary stability values between the implants placed with and without sinus floor elevation. Conclusion: The osseodensification method of implant osteotomy results in higher secondary implant stability values that the underdrilling method, which may have clinical relevance regarding the long-term implant survival

Implant Site Guided Bone Regeneration and Pontic Site Ridge Preservation: A Case Report

Guided bone regeneration (GBR) is a therapeutic modality to achieve bone regeneration with the use ofbarrier membranes. The use of deproteinized bovine bone material (DBBM) for ridge preservation allows thepreservation of the edentulous ridge dimensions. Here, we present a case of horizontal GBR using DBBMand a resorbable membrane, with simultaneous implant placement. Simultaneously, ridge preservation ofthe pontic area, using DBBM within a “socket seal” procedure was performed. Two implants were placesat sites 23 and 26 to support a fixed partial denture (FPD). The mesial implant showed exposed buccalthreads, which were then covered with autogenous bone particles and small size granules of DBBM. Thecollagen membrane was stabilized with periosteal mattress suture. Six months postoperatively, CBCT im-ages revealed a stable buccal bone layer at the implant site, indicating a successful GBR procedure. At thispoint in time, tooth 24 was atraumatically extracted. A ridge preservation was done utilizing DBBM, anda soft tissue graft form the tuber. A ceramic-metal FPD with excellent “white aesthetics” and a harmonictransition zone to the soft tissue was fabricated. At 3 years follow up, the peri-implant bone levels werestable, and the clinical outcomes were excellent. It is concluded that a GBR procedure, utilizing DBBMand a collagen barrier membrane with simultaneous implant placement, as well as ridge preservationusing DBBM, are predictable therapeutic methods. However, gentle manipulation of the soft tissues, andwound stability, with tension-free passive closure of the wound margins are prerequisites for a long-termclinical success.Keywords: implants, guided bone regeneration, ridge preservation, deproteinized bovine bone material

HYGIENIC SANITATION IN THE DAIRY INDUSTRY IN THE PRODUCTION OF COW YELLOW CHEESE AS A FACTOR FOR OBTAINING HYGIENICALLY PROPER PRODUCTS IN ACCORDANCE WITH THE EU STANDARDIZATION AND CERTIFICATION STANDARDS

Hygienic sanitation processes in the dairy industry are a major factor in obtaining hygienically healthy dairy products. The subject of the analysis is the production equipment, human resources and the produced finished product – cow yellow cheese, in which different procedures for sanitation are used due to the application of various technologies at work. Studies have shown that hygienic sanitation gives satisfactory results. The responsibility and positive influence of the employees has been confirmed. The results of the examined bacteriological correctness of the equipment showed a greater and better effect when performing the machine compared to the manual cleaning. From the analysis of the key parameters in the CIP (Cleaning-In-Place) system is it was found that the shorter duration of cleaning is correlated with a faster flow and a higher temperature and concentration of the agents. From the recirculating agents, the base and the acid, more clouding occurs in the base material. Finally, from the examined bacteriological correctness of the finished product – yellow cheese, it has been confirmed that the product is completely hygienically straight and healthy for consumption. Hygienic sanitation in the dairy industry is the most critical operation in the milk processing processes and is of great importance for obtaining a quality, healthy and hygienically straightforward finished product. &nbsp; Key words: CIP system, human resources, production equipment, finished produc

Guided implant therapy- tips and tricks

With the introduction of computed tomography (CBCT) into daily dental practice, along with the development of software solutions in dentistry, it revolutionized the planning and protocol of dental implant placement. The development of the surgical guides and their use in the implantation procedure eliminated the possible complications that each implantologist may encounter during his work, such as injury to adjacent teeth, injury to vital anatomical structures, incorrect angulation and incorrect implant position of placed implants. This “guided implant therapy” ensures correct and proper positioning of the implants, shortens the time required for operative intervention, reduces post-operative morbidity, and eliminates the need for flap and bone grafting procedures. This paper will explain the complete procedure of planning and creating of surgical guide, present all the pros and cons of working with the guide and present a few clinical cases from daily practice