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ObjectivesTo investigate the effectiveness of hydraulic pressure-assisted sinus augmentation (SA) in a rabbit sinus model in terms of radiographical and histological healing.Materials and methodsBilateral SA was performed in 12 rabbits. Each sinus was randomly assigned to either a hydraulic pressure-assisted SA (test) or a conventional SA (control) group. Healing periods of 2 and 4 weeks were applied (n = 6 for each week). Healing pattern including newly formed bone (NB) and residual bone substitute material (RM) was analyzed with microcomputed tomographically, histologically, and histomorphometrically.ResultsNo sinus membrane perforation was detected in either group. In the microcomputed tomographic analysis, the test group exhibited higher apico-coronal spread of RM compared to the control group (p < 0.05). Particularly, the test group exhibited several masses of NB out of the cluster of RM. Histologically, the test group showed an elongated shape of the augmented space, whereas the control group generally presented a dome shape. Histomorphometrically, the total augmented area and the area of NB (1.32 ± 0.56 vs. 0.84 ± 0.40 mm2 at 2 weeks, 2.24 ± 1.09 vs. 2.22 ± 0.85 mm2 at 4 weeks) were not significantly different between the test and the control groups at both healing periods (p > 0.05).ConclusionHydraulic pressure-assisted SA led to new bone formation in the distant areas from the bony access hole, but similar histological healing pattern to conventional SA.Clinical relevanceHydraulic pressure-assisted SA is a promising option for treating pneumatized posterior maxilla.

The aim of this study was to retrospectively determine the effects of applying different treatment methods to the bony access window on the healing outcomes in lateral sinus floor elevation (SFE). Lateral SFE with implant placement was performed in 131 sinuses of 105 patients. The following three treatment methods were applied to the bony access window: application of a collagen barrier (group CB), repositioning the bone fragment (group RW) and untreated (group UT). Radiographic healing in the window area, augmented bone height changes and marginal bone level changes were examined. Mixed logistic and mixed linear models were analyzed. Over 4.3 ± 1.4 years of follow-up, the implant survival rate was 100% in groups CB and UT, and 96.9% in group RW. The treatment applied to the window did not significantly influence the radiographic healing in the window area, augmented bone height changes or marginal bone level changes ( p  > 0.05). The healed window areas had generally flat morphologies and were fully corticalized. The mean changes in the augmented bone were less than 1.5 mm in all groups. Marginal bone level changes were minimal. In conclusion, Healing outcomes were not different among three different methods to treat the bony access window in lateral SFE.

Abstract Deferoxamine (DFO), an FDA-approved iron chelator used for treatment of iron poisoning, affects bacteria as iron availability is intimately connected with growth and several virulence determinants. However, little is known about the effect on oral pathogens. In this study, the effect of DFO on Porphyromonas gingivalis, a major periodontopathogen which has an essential growth requirement for hemin (Fe3+-protoporphyrin IX), was evaluated. The viability of P. gingivalis W83 was not affected by 0.06–0.24 mM DFO, whereas the doubling time of the bacterium was considerably prolonged by DFO. The inhibitory effect was evident at earlier stages of growth and reduced by supplemental iron. UV-visible spectra using the pigments from P. gingivalis cells grown on blood agar showed that DFO inhibited μ-oxo bisheme formation by the bacterium. DFO decreased accumulation and energy-driven uptake of hemin by P. gingivalis. Antibacterial effect of H2O2 and metronidazole against P. gingivalis increased in the presence of DFO. Collectively, DFO is effective for hemin deprivation in P. gingivalis suppressing the growth and increasing the susceptibility of the bacterium to other antimicrobial agents such as H2O2 and metronidazole. Further experiments are necessary to show that DFO may be used as a therapeutic agent for periodontal disease.

The purpose of this study was to evaluate the surface roughness (R a ) and microscopic change to irradiated dental implant surfaces in vitro and ultimately to determine the proper pulse energy power and application time for the clinical use of Er:YAG lasers. Anodic oxidized surface implants and sand-blasted, large-grit, and acid-etched (SLA) surface implants were used. Each experimental group of implant surfaces included ten implants. Nine implants were used for the laser irradiation test groups and one for the control group. Each test group was equally divided into three subgroups by irradiated pulse energy power. Using an Er:YAG laser, each subgroup of anodic oxidized surface implants was split into 60-, 100-, and 140-mJ/pulse groups, with each subgroup of SLA surface implants irradiated with a 100-, 140-, or 180-mJ/pulse. Three implants in every test subgroup were respectively irradiated for 1, 1.5, and 2 min. The R a values for each specimen were recorded and every specimen was observed by SEM. Irradiation by Er:YAG laser led to a decrease in implant surface roughness that was not statistically significant. In anodic oxidized surfaces, the oxidized layer peeled off of the surface, and cracks appeared on implant surfaces in the 100- and 140-mJ/pulse subgroups. However, with SLA surfaces, no significant change in surface texture could be found on any implant surface in the 100- and 140-mJ/pulse subgroups. The melting and fusion phenomena of implant surfaces were observed with all application times with 180 mJ/pulse irradiation. The SLA implant surfaces are stable with laser intensities of less than 140 mJ/pulse and an irradiation time of less than 2 min. The anodic oxidized surfaces were not stable with laser intensities of 100 mJ/pulse when an Er:YAG laser was used to detoxify implant surfaces.

According to a systematic review, the prevalence of peri-implant mucositis and peri-implantitis was 46.8% and 19.8%, respectively,1 which indicates that dentists encounter peri-implant diseases frequently in clinical settings. Presently, many dentists are well aware of complications posed by bisphosphonate-related osteonecrosis of the jaw (BRONJ) or medication-related osteonecrosis of the jaw (MRONJ) in the context of oral surgery. [...]prior to implant surgery and/or bone augmentation surgery, a history of relevant medication use should be acquired for patient safety. [...]this case report aimed to present cases of BRONJ associated with advanced peri-implantitis and implant removal. [...]the patient was referred to a university hospital and was treated with surgical curettage under general anesthesia, followed by another 4 weeks of antibiotic therapy.

The aim of this case report was to report the course of treatment for advanced paranasal sinus infection triggered by peri-implantitis, managed using functional endoscopic sinus surgery (FESS), with outcomes. A nonsmoking male patient received sinus augmentation with implant placement on his left posterior maxilla 15 years ago. Possibly due to noncompliance to maintenance, peri-implantitis developed and progressed into the augmented bone area in the maxilla. Eventually, maxillary sinusitis occurred concomitantly with a spread of the infection to the other paranasal sinuses. Implant removal and intraoral debridement of inflammatory tissue were performed, but there was no resolution. Subsequently, FESS was performed, with removal of nasal polyp and sequestrum. After FESS, the patient's sinusitis resolved. Histologically, the sequestrum was composed of bone substitute particles, necrotic bone, stromal fibrosis, and a very limited cellular component. Two implants were placed on the present site, and no adverse event occurred for up to 1 year after the insertion of the final prosthesis. Peri-implantitis in the posterior maxilla can trigger maxillary sinusitis with concomitant infection to the neighboring paranasal sinuses. FESS should be considered to treat this condition.

The aim of the present study was to compare bone-collecting capacity of bone harvesting device and minimally irrigated low-speed drilling using three implant systems. One bone harvesting device and three commercially available drill systems were compared using the osteotomies on bovine rib bones. The amount of the collected bone particle and particle size (<500 μm: small, 500–1000 μm: medium, and >1000 μm: large) were measured. Total wet (1.535±0.232 mL) and dry volume (1.147±0.425 mL) of the bone particles from bone harvesting device were significantly greater than three drill systems (wet volume: 1.225±0.187–1.27±0.29 mL and dry volume: 0.688±0.163–0.74±0.311 mL) (P<0.05). In all groups, the amount of large sized particles in wet and dry state was the greatest compared to that of medium and small particles. The dry weight of the bone particles showed the same tendency to volumetric measurement. In conclusion, total bone particles and large sized particles (>1000 μm) were harvested significantly greater by bone harvesting device than minimally irrigated low-speed drilling. The composition of particle size in all harvesting methods was similar to each other.

This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM) application in augmented corticotomy using deproteinized bovine bone mineral (DBBM), during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19 ± 14.60 ° and 28.12 ± 11.48 ° on the control and test sides, respectively. A mean of 79.5 ± 16.0 % of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9 ± 19.5 % was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface.

The purpose of this study was to evaluate the microscopic changes and surface roughness on hydroxyapatite (HA)-coated implants following exposure to different powers and durations of Er:YAG laser irradiation in order to determine the proper pulse energy level and irradiation time. Ten HA-coated implants and ten fluoride-modified TiO sub(2) implants were used. The implants were divided into a control (one implant) and test group (nine implants) for each implant type. Implants in the test groups were sub-divided into three groups (three implants per group) based on the applied laser pulse energy and irradiation time. The measurement of surface roughness was performed on all implants in the test groups using a white light interferometer before and after laser irradiation. R sub(a) values were recorded and compared in order to evaluate changes in surface roughness. For HA-coated implants, the R sub(a) values increased in all test groups after laser irradiation. However, mean R sub(a) values in the fluoride-modified TiO sub(2)-blasted implant test group were decreased after irradiation. There was no statistical difference. Scanning electron microscope analysis revealed surface alterations in both the HA-coated and fluoridated TiO sub(2)-blasted implants irradiated for 1.5 min at 100 mJ/pulse, 10 Hz. When the pulse energy and irradiation time increased, greater surface alterations, including surface flattening and microfractures, were observed. In conclusion, the results of the current study suggest that no changes could be observed in both HA-coated implants and fluoride-modified TiO sub(2)-blasted implants after irradiation at an intensity of 100 mJ/pulse, 10 Hz for 1 min performed to achieve surface detoxification.

The purpose of this study was to evaluate the microscopic changes and surface roughness on hydroxyapatite (HA)-coated implants following exposure to different powers and durations of Er:YAG laser irradiation in order to determine the proper pulse energy level and irradiation time. Ten HA-coated implants and ten fluoride-modified TiO 2 implants were used. The implants were divided into a control (one implant) and test group (nine implants) for each implant type. Implants in the test groups were sub-divided into three groups (three implants per group) based on the applied laser pulse energy and irradiation time. The measurement of surface roughness was performed on all implants in the test groups using a white light interferometer before and after laser irradiation. R a values were recorded and compared in order to evaluate changes in surface roughness. For HA-coated implants, the R a values increased in all test groups after laser irradiation. However, mean R a values in the fluoride-modified TiO 2 -blasted implant test group were decreased after irradiation. There was no statistical difference. Scanning electron microscope analysis revealed surface alterations in both the HA-coated and fluoridated TiO 2 -blasted implants irradiated for 1.5 min at 100 mJ/pulse, 10 Hz. When the pulse energy and irradiation time increased, greater surface alterations, including surface flattening and microfractures, were observed. In conclusion, the results of the current study suggest that no changes could be observed in both HA-coated implants and fluoride-modified TiO 2 -blasted implants after irradiation at an intensity of 100 mJ/pulse, 10 Hz for 1 min performed to achieve surface detoxification.