1,721,080 research outputs found
Er : YAG laser scaling of diseased root surfaces: A histologic study
No full textBACKGROUND: The aim of the present study was to observe the effects of an
erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser when used to treat
periodontally involved root surfaces.
METHODS: Forty teeth affected by severe periodontal disease and scheduled for
extraction were divided into two groups: in group A (control), 20 teeth were
treated by hand instrumentation, and in group B (test), 20 teeth were treated by
Er:YAG laser.
RESULTS: In group A (teeth treated by curets), the root cementum layer was
completely removed, but many deep scratches on the dentin layer were also
observed. In group B, the laser-treated root surfaces, there was no cracking or
carbonization, and the bacterial flora was completely eliminated, leaving a rough
and uniform surface.
CONCLUSION: Results of the present study showed that clinical use of an Er:YAG
laser in vivo achieves plaque and calculus removal, providing a rough surface
morphology
Sinus floor elevation by osteotome: hand mallet versus electric mallet. A prospective clinical study.
No full textPURPOSE: The aim of this clinical study was to compare a hand mallet with an electric mallet in osteotome-assisted sinus elevation.
MATERIALS AND METHODS: Eighty patients, all of whom were edentulous in the maxillary premolar and molar regions, were included in this prospective study. The patients were divided into two groups. In one group (40 patients, control group) sinus floor elevation was performed with an osteotome pushed by a hand mallet, and in the second group (40 patients, test group) sinus floor elevation was performed with the use of an electric mallet. One-hundred twenty dental implants (60 test, 60 control) were positioned. Intraoral digital radiographic examinations were made at baseline and at 6, 12, and 24 months after implant placement. Alveolar bone height was measured and reported at 6, 12, and 24 months.
RESULTS: After 24 months, a survival rate of 98.33% was reported. Three control group patients developed benign paroxysmal positional vertigo following the use of osteotomes and percussion with the hand mallet. The mean alveolar bone gain at 6 months after implant placement was 2.64 ± 1.21 mm in the control group and 2.45 ± 1.55 mm in the test group. After 12 months, the bone height had increased in both groups, and at 24 months it was stable (4.17 ± 1.70 mm in the control group and 4.07 ± 1.03 mm in the test group). No statistically significant differences were seen between groups.
CONCLUSIONS: A significant increase in bone height was achieved between 6 and 12 months, and bone levels remained stable at 2 years. The use of an electric mallet provided some essential advantages during surgery in comparison with the hand mallet
Fresh-socket implants in periapical infected sites in humans
No full textBACKGROUND:
The aim of the present study is to compare the outcome of the immediate placement of implants when used in the replacement of teeth with and without chronic periapical lesions.
METHODS:
Thirty patients requiring a single-tooth extraction of a monoradicular or premolar tooth were selected. The control group (CG) included 15 patients without periapical lesions but with root caries and root fractures. The test group (TG) included 15 patients with periapical lesions, periapical radiolucencies, and no signs of pain, fistulas, or suppuration. Thirty teeth were extracted, and implants were immediately positioned in fresh sockets and loaded after 3 months in both groups. Clinical parameters (probing depth [PD], modified plaque index, modified bleeding index [mBI], marginal gingiva level [MGL], and keratinized mucosa [KM]) and marginal bone levels were evaluated at baseline and 12 and 24 months after implant placement. Comparisons between CG and TG values over time were performed by the Student two-tailed t test.
RESULTS:
At the 24-month follow-up, a survival rate of 100% was reported for all implants. The mean bone loss was 0.82 +/- 0.52 mm for the CG and 0.86 +/- 0.54 for the TG. Plaque accumulation was 0.74 +/- 0.29 for the CG and 0.69 +/- 0.29 for the TG. The mBI was 0.77 +/- 0.33 for the CG and 0.72 +/- 0.36 for the TG. The soft tissue profile MGL and KM remained stable for up to 24 months for the CG and TG. The mean PD was 2.05 +/- 0.66 mm for the CG and 1.99 +/- 0.57 mm for the TG. Differences that were not statistically significant were reported between the CG and TG over time and between time points.
CONCLUSION:
At the 24-month follow-up, endosseous implants placed immediately in extraction sites affected by periapical infection rendered an equally favorable soft and hard tissue integration of the implants, revealing a predictable outcome
Magnesium-enriched hydroxyapatite compared to calcium sulfate in the healing of human extraction sockets: radiographic and histomorphometric evaluation at 3 months
No full textBACKGROUND:
Reduction of alveolar height and width after tooth extraction may present problems for implant placement, especially in the anterior maxilla where bone volume is important for biologic and esthetic reasons. Different graft materials have been proposed to minimize the reduction in ridge volume. The aim of this study was to compare radiographic and histomorphometric results of magnesium-enriched hydroxyapatite (MHA) and calcium sulfate (CS) grafts in fresh sockets after tooth extractions.
METHODS:
Forty-five fresh extraction sockets with three bone walls were selected in 15 patients. A split-mouth design was used: 15 sockets on the right side of the jaw received MHA, 15 sockets on the left side received CS, and 15 random unfilled sockets were considered the control (C) group. Intraoral digital radiographs were taken at baseline and at 3 months after graft material placement. At 3 months, cylinder bone samples were obtained for histology and histomorphometry analysis.
RESULTS:
The difference in mean radiographic vertical bone level from baseline to 3 months was -2.48 +/- 0.65 mm in the CS group, -0.48 +/- 0.21 mm in the MHA group, and -3.75 +/- 0.63 mm in the unfilled C group. Statistically significant differences (P <0.05) were found between CS and MHA groups and between MHA and C groups. Histologic examination revealed bone formation in all treated sites; trabecular bone assessment did not differ among apical, mesial, and coronal portions of the specimens. Mean vital bone measurements for CS, MHA, and C groups were 45.0% +/- 6.5%, 40.0% +/- 2.7%, and 32.8% +/- 5.8%, respectively. Statistically significant differences (P <0.05) were found among all groups. Connective tissue percentages averaged 41.5% +/- 6.7% for the CS group, 41.3% +/- 1.3% for the MHA group, and 64.6% +/- 6.8% for the C group. Statistically significant differences (P <0.05) were found between CS and C groups and between MHA and C groups. The CS-grafted sockets showed 13.9% +/- 3.4% residual implant material, whereas the MHA-treated sockets showed 20.2% +/- 3.2% residual material. The difference between the groups was statistically significant (P <0.05).
CONCLUSIONS:
Radiographs revealed a greater reduction of alveolar ridge in the CS group than in the MHA group. Histologic examination showed more bone formation and faster resorption in the CS group and more residual implant material in the MHA group
Electrical mallet in implants placed in fresh extraction sockets with simultaneous osteotome sinus floor elevation
No full textTo report the application of an electrical mallet (magnetic mallet) in osteotome-assisted surgery for sinus floor elevation with implants placed in fresh sockets and 2-year follow-up.
MATERIALS AND METHODS:
A total of 32 patients (70 implants, 36 in the molar and 34 in the premolar regions) requiring extractions of maxillary premolars and molars were included in this prospective study. In all cases, implants were positioned immediately after tooth extraction. The implant site was prepared with osteotomes pushed by a magnetic mallet. Intraoral digital radiographic measurements were reported at 70 days and 1 and 2 years. Initial alveolar bone height and mean gained alveolar bone height were calculated for each implant over time. All implants were followed for 2 years.
RESULTS:
One of 70 implants failed 1 month after surgery. This implant was successfully replaced 6 months later. The cumulative survival rate at 2 years was 98.57%. After surgery, no membrane perforation was reported, and no patient experienced vertigo, distress, nausea, and vomiting. Radiographic results were reported at 70 days and 1 and 2 years from implant placement. The alveolar bone gain following 70 days of healing resulted in a mean value of 2.63 ± 1.01 mm and, at 2 years from implant placement, was stable at 4.08 ± 1.25 mm. Statistically significant differences (P .05) between 1 and 2 years.
CONCLUSIONS:
The electrical mallet represents a fast and accurate instrument for placing bone expanders in fresh socket implants and simultaneous sinus floor elevation to avoid patient distress
A 4-year evaluation of the peri-implant parameters of immediately loaded implants placed in fresh extraction sockets.
No full textBACKGROUND: The present study considers the correlation between the meaning of keratinized mucosa (KM) and the long-term maintenance of endosseous root-form dental implants placed in fresh sockets and immediately loaded.METHODS: Twenty-nine patients requiring extractions of ≥2 teeth in the maxilla and mandible were selected. One-hundred thirty-two maxillary and 32 mandibular teeth, in the incisor, canine, and premolar regions, were extracted. Implants were positioned in fresh sockets and immediately loaded. Based on the amounts of KM, implants were categorized as follows: KM ≥2 mm (group A) and KM <2 mm (group B). Clinical parameters (probing depth, modified plaque index, modified bleeding index, and gingival index) and marginal bone levels were followed at 4 years after implant placement. Comparisons between group A and B values were performed by the Student two-tailed t test.RESULTS: At 4-year follow-up, a survival rate of 100% was reported for all implants. The mean values of group B were significantly higher (P <0.05) than group A for the following parameters: gingival index (group A, 0.67 ± 0.09; group B, 1.01 ± 0.11); modified plaque index (group A, 1.18 ± 0.09; group B, 1.71 ± 0.12); and modified bleeding index (group A, 0.35 ± 0.05; group B, 0.78 ± 0.05). Gingival recession was significantly elevated in group B. In both group A and group B, up to 60% of gingival recession occurred within the first 6 months. For mean bone loss values, statistically non-significant differences were reported between groups.CONCLUSIONS: At 4-year follow-up, the results suggested that the presence of mid-buccal KM is not a critical factor in the maintenance of interproximal bone level around fresh socket implants immediately loaded. Conversely, less width of KM is significantly associated with more gingival inflammation, more plaque accumulation, and more gingival recession
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