1,721,022 research outputs found
Removal of a maxillary third molar accidentally displaced into the maxillary sinus: presurgical and surgical management
No full textExtraction of impacted maxillary third molar is a common procedure usually performed either by oral surgeons or general dentists. tuber maxillae fractures and oroantral communications are the most frequently listed intraoperative complications, while the displace- ment of the tooth in the maxillary sinus is rarely de- scribed.1 this event may lead to acute or chronic sinus- itis and, for this reason, a timely surgical removal of the tooth from the sinusal cavity is strongly suggested.2
in this exemplary case, a patient was referred to our department twenty days after the accidental displace- ment of the left third upper molar into the maxillary si- nus, during an attempt of extraction. the orthopanoram- ic exam showed the tooth vertically disposed close to the medial wall with an inverted axial position (Figure 1) and, within the limits of this radiological exam, a sinusal mucosa without signs of inflammation. A cone beam computed tomography (cBct) of the maxillofa- cial complex comprising the paranasal sinuses and the osteomeatal complex, was performed for the pre-sur- gical assessment (Figure 2). cBct volume rendering, obtained by using a postprocessing DicoM software (3Diagnosys, 3DM, cantù, como, italy), allowed the manipulation of a three-dimensional visualization of the tooth displaced in the sinus (Figure 3)
Conjunctival chemosis: an uncommon complication after transcrestal lifting of the sinus floor
No full textConjunctival chemosis is non-specific oedema, which may be caused by many systemic and local factors, including allergies; bacterial, viral, and mycotic infections; autoimmune diseases; thyroid disorders; and neoplasms. The orbit is susceptible to the contiguous spread of infections from the maxillary sinus as they are separated only by a thin plate of bone, which could also have congenital bony dehiscence
Expanded vs. dense polytetrafluoroethylene membranes in vertical ridge augmentation around dental implants: A prospective randomized controlled clinical trial
No full textThis prospective randomized controlled trial was designed to test the performance of titanium-reinforced dence polytetrafluoroethylene membrane vs. titanium-reinforced expanded polytetrafluoroethylene membrane in achieving vertical bone regeneration, both associated with a composite grafting material..
Reuse of Implant Healing Abutments: Comparative Evaluation of the Efficacy of Two Cleaning Procedures
No full textPURPOSE: To compare the efficacy of two systems in cleaning used healing abutments (HAs).
MATERIALS AND METHODS: A total of 60 used HAs were randomized into two groups: one treated with an automatic cleaning system, and the other with conventional decontamination procedures. After sterilization and staining, the HAs were microscopically analyzed and underwent a cellular adhesion in vitro assay.
RESULTS: Contaminated areas were observed with different frequencies in the two groups (3.6% test; 78.2% control; P < .001). In vitro assay showed a uniform cell distribution in test HAs, while areas of debris without adhering cells were a common finding in the control HAs.
CONCLUSION: Further studies investigating the chemical composition and clinical influence of biologic remnants are necessary before considering reusing HAs
Presence of microbrush remnants on the adhesion surface: A microscopical analysis
Full text linkObjectives: the aim of this ex vivo report was to evaluate, on a microscopical analysis, the presence of microbrush remnants on in the adhesive surface in extracted teeth.Methods: Twenty extracted teeth were divided into four groups. Half of the teeth were prepared as Class I cavities, whereas the other half as Class II cavities, according to Black classification. The teeth were conditioned with primer and bonding, both applied with microbrushes. Each of these groups was divided into halves, and the two sub-groups received a polymerization process or not, respectively. The teeth were then analyzed by scanning electron microscopy working in environmental mode.Results: All of the analyzed surfaces (100%) showed the presence of residual bristles on the adhesion surface.Conclusions: Microscopical analysis showed the presence of residual bristles in the 100% of the surfaces treated with Black Classes I and II cavities. Further studies are necessary to evaluate the influence of this factor on the adhesion strength and capacity. Clinical Significance: Clinician should be aware of the realistic possibility of the presence of bristles belonging to disposable applicators in the adhesive interface of Black's class I and II cavities. The impact of these remnants has still to be ascertained
Parotid Gland Edema After Chlorhexidine Mouthrinse: Case Report and Literature Review
Full text linkIntroduction:
Parotid gland swelling, caused by many pathological conditions, has also been reported to be a possible side effect of the use of chlorhexidine mouthwash. This adverse reaction to chlorhexidine mouthwash is, however, extremely rare and very few cases of parotid gland swelling due to chlorhexidine mouthwash have been reported in the literature.
Case Description:
This report describes the clinical management of unilateral parotid swelling caused by chlorhexidine mouthwash.
Methods:
A patient presented with left parotid gland swelling after using chlorhexidine mouthwash for three days following sinus augmentation on the contralateral side of the maxilla. Diagnosis of parotid gland swelling due to rinsing with chlorhexidine was formulated after anamnesis, clinical examination, radiographs and ultrasound of the gland excluded other pathological conditions. The patient was subsequently advised to stop rinsing. However, on the evening of the same day, swelling increased and the patient presented to an emergency department where a single intravenous dose of methylprednisolone was administered.
Results:
After seven days, parotid swelling decreased significantly and after three weeks had completely disappeared.
Conclusion:
Although unilateral or bilateral parotid gland swelling related to the use of chlorhexidine mouthwash is an uncommon adverse event, it must be suspected after other organic or infective conditions have been excluded. The precise pathogenic mechanism has not yet been determined and further studies should be carried out to better understand the pathophysiology of this uncommon phenomenon
Development of an advanced numerical model of heat transfer in a bone-implant system
No full textOBJECTIVES: Implant removal can be required in case of malpositions, biological or mechanical failures. This procedure, performed with trephine burs, piezosurgery or counter-torque ratchets, often results in bone defects requiring corrections with advanced regenerative techniques. Few case reports describe implant removal after weakening the bone-implant interface by applying a localized heating to the fixture: however, this procedure must be standardized to obtain a predictable result, avoiding extensive bone damage. Aim of this preliminary study is to create a high-fidelity numerical model of the bone-implant system, to be validated by in vitro and in vivo tests, for predicting the most appropriate parameters necessary for a minimally invasive implant removal using heating.
MATERIAL AND METHODS: A 3-D virtual advanced numerical model was created using ANSYS CFX, in order to simulate the behavior of a bone-implant system under thermal variations. Various parameters can be adjusted to set the model: heating modalities (temperature and/or heat flux, time and source) and system characteristics (implant geometry and material, type of bone). In vitro tests were performed using titanium implants (Premium, Sweden & Martina, Italy - 3.85 x 8.5, 10 and 13 mm). Implants were inserted in bovine bone (stabilized at 37 ± 0.5 °C), and then heated using an endodontic heat carrier (System B, Sybron Endo, USA). Bone temperatures were recorded using thermocouples at different depths (1 mm, middle and apex of implant) and at different distances from the implant [0.5 mm (T1), 1 mm (T2), 1.5 mm (T3) and 2 mm (T4)]. Non parametric data were analyzed using Friedman and Wilcoxon tests.
RESULTS: The heat carrier, set at 100 °C, was placed in contact with the inner part of the implants for 140 sec. The threshold temperature of 47 °C was reached in T1 after 65.2 ± 11.7 sec, in T2 after 89.3 ± 29.1 sec, in T3 after 110.9 ± 29.6 sec, in T4 the temperature of 47 °C was never reached within 140 sec. Differences between T1, T2, T3 and T4 resulted statistically significant (p<0.05). Implant length and distance from heat source are factors influencing temperature variations.
CONCLUSIONS: From the results of this preliminary study, it seems possible to produce a controlled thermally-induced injury to the bone-implant interface, allowing for a minimally invasive implant removal. Various parameters (implant geometry and material, bone characteristics) must be considered to set temperature and heating duration. In vivo histologic studies are necessary to analyze quality and quantity of bone-implant interface modifications after heat-induced injury, before starting any clinical application
Intraoperative complications and early implant failure after transcrestal sinus floor elevation with residual bone height ≤5 mm: A retrospective multicenter study
Full text linkOBJECTIVE: Clinical indications for maxillary sinus floor elevation with transcrestal techniques have increased in recent years even in sites with minimal residual bone height (RBH). Nevertheless, limited information is currently available on incidence of intraoperative complications and early implant failure in these cases. MATERIAL AND METHODS: This retrospective multicenter study was performed on anonymized clinical and radiographic records of patients who underwent transcrestal sinus floor elevation in seven clinical centers. Influence of different factors related to patient, and sinus anatomy and surgical technique on the incidence of intraoperative complications and early implant failure rate after transcrestal sinus lift were investigated. RESULTS: A total of 430 patients treated with transcrestal sinus floor elevation for single‐implant insertion in sites with RBH ≤5 mm were included in the final analysis. After 1 year of loading, 418 implants of 430 were satisfactorily in function. Early implant failure was recorded in 12 cases (2.8%); results were significantly associated with the presence of large sinus cavities and with the occurrence of membrane perforation. The following adverse events were recorded: membrane perforation (7.2%), acute sinusitis (0.9%), implant displacement into the sinus cavity (0.7%), oro‐antral fistula (0.2%), and benign paroxysmal positional vertigo (0.5% of osteotome cases). A strong direct correlation between sinus membrane perforation and bucco‐palatal sinus width (p = .000) was demonstrated. CONCLUSIONS: Early implant failure after transcrestal sinus elevation showed significant direct correlation with bucco‐palatal maxillary sinus width and the presence of membrane perforation. Sinus membrane perforation was strongly associated with bucco‐palatal sinus width (extremely low perforation rate in narrow and much higher incidence in wide sinuses)
Piezoelectric bone surgery for implant site preparation compared with conventional drilling techniques: A systematic review, meta-analysis and trial sequential analysis
Full text linkTo evaluate whether the use of piezoelectric bone surgery (PBS) for implant site preparation reduces surgical time, improves implant stability, preserves marginal bone level and improves the survival rate of oral implants compared with conventional drilling techniques
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