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Rosas-Díaz J, Guerrero ME, Castillo-Andamayo D, Galindo-Gómez M, García-Luna M, Cervantes-Ganoza L, Cayo-Rojas C. Importance of local and systemic factors in preventing implant displacement in the mandibular body: a scoping review of existing literature. BMC Oral Health 2024; 24:871. [PMID: 39090743 PMCID: PMC11295648 DOI: 10.1186/s12903-024-04671-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The aim of this research was to analyse the current literature on displaced dental implants in the mandibular body, including local and systemic variables related to their cause, and to identify the most frequent location. METHODS The study conducted a search of three databases (Pubmed, Scopus, and Web of Science) using specific index terms such as 'dental implant', 'displacement', 'dislocation', 'displaced', and 'mandible'. The analysis focused on the direction of displacement and the characteristics of the bone tissue (bone quality, density, and quantity) in cases where dental implants were displaced. RESULTS A total of 371 articles were obtained. Thirteen of these articles were selected and read in full. To define bone quality, the Lekholm and Zarb classification, modified by Rosas et al., was used. The type II-B bone, which is characterized by thick cortical bone surrounding cancellous bone with extremely wide medullary spaces, presented the largest number of complications. Twenty-two cases were found in which the displacement direction was horizontal. Of these, four were displaced vestibularly, fourteen lingually, and four remained in the center. Additionally, 24 cases presented vertical displacement, with 12 displaced towards the inferior border of the mandible, 9 towards the middle or adjacent to the inferior dental nerve canal, and 3 above the inferior dental nerve canal. CONCLUSION The accidental displacement of implants within the mandibular body is associated with various risk factors, including the characteristics of the bony trabeculum and the size of the medullary spaces. It is reasonable to suggest that only an adequate pre-surgical diagnostic evaluation, with the help of high-resolution tomographic images that allow a previous evaluation of these structures, will help to have better control over the other factors, thus minimizing the risk of displacement.
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Affiliation(s)
- José Rosas-Díaz
- School of Stomatology, Universidad Privada San Juan Bautista, Jose Antonio Lavalle Avenue 302- 304 (Ex Hacienda Villa), Chorrillos, Lima, Peru.
- Faculty of Stomatology, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Maria Eugenia Guerrero
- Medico Surgical Department, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Maisely Galindo-Gómez
- School of Stomatology, Universidad Privada San Juan Bautista, Jose Antonio Lavalle Avenue 302- 304 (Ex Hacienda Villa), Chorrillos, Lima, Peru
| | - Marco García-Luna
- School of Stomatology, Universidad Privada San Juan Bautista, Jose Antonio Lavalle Avenue 302- 304 (Ex Hacienda Villa), Chorrillos, Lima, Peru
| | | | - César Cayo-Rojas
- School of Stomatology, Universidad Privada San Juan Bautista, Jose Antonio Lavalle Avenue 302- 304 (Ex Hacienda Villa), Chorrillos, Lima, Peru.
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Ozmarasali AI, Kaplan AD, Eser P, Yilmazlar S. Dental implant misplacement into the anterior cranial fossae: a unique case and review of literature. Neurochirurgie 2024; 70:101533. [PMID: 38246017 DOI: 10.1016/j.neuchi.2024.101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024]
Affiliation(s)
| | - Aylin Dogan Kaplan
- Department of Oral Implantology, Oral Implantology PhD Program, Istanbul University, Health Sciences Institute, 34126, Istanbul, Turkey
| | - Pinar Eser
- Department of Neurosurgery, Medical School, Bursa Uludag University, 16059, Bursa, Turkey
| | - Selcuk Yilmazlar
- Department of Neurosurgery, Medical School, Bursa Uludag University, 16059, Bursa, Turkey.
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3
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Thapa D, Shrestha P, Bhochhibhoya A, Sharma R. Retrieval of a displaced implant from the mandibular body: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00443-2. [PMID: 37612196 DOI: 10.1016/j.prosdent.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 08/25/2023]
Abstract
The posterior mandible is often regarded as a reliable area for achieving primary stability during implant placement. However, in rare instances, implant displacement can occur in this region because of a significant decrease in bone density. Typically, surgical procedures such as the lateral or crestal approach have been used to remove displaced implants, requiring extensive bone removal and postponing implant placement for between 3 and 6 months. This clinical report presents an uncommon occurrence of implant displacement in the posterior mandible and introduces a less invasive approach to recovering it. This technique utilized the long screw of an open-tray impression post and an abutment to retrieve the displaced implant while simultaneously performing implant placement at the same site.
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Affiliation(s)
- Dipak Thapa
- Consultant Prosthodontist, Private practice, Kathmandu, Nepal
| | | | - Amar Bhochhibhoya
- Assistant Professor, Department of Prosthodontics, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.
| | - Rinu Sharma
- Assistant Professor, Department of Prosthodontics, Tribhuvan University Teaching Hospital, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
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La Monaca G, Pranno N, Polimeni A, Annibali S, Di Carlo S, Pompa G, Cristalli MP. Hemorrhagic Complications in Implant Surgery: A Scoping Review on Etiology, Prevention, and Management. J ORAL IMPLANTOL 2023; 49:414-427. [PMID: 36796068 DOI: 10.1563/aaid-joi-d-22-00130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/09/2022] [Indexed: 02/18/2023]
Abstract
This article seeks to provide the most relevant aspects of the etiology, prevention, and management of bleeding in routine implant surgery. A comprehensive and systematic electronic search was conducted in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews databases until June 2021. Further references of interest were retrieved from bibliographic lists of the selected articles and the "Related Articles" feature of PubMed. Eligibility criteria were papers about bleeding, hemorrhage, or hematoma associated with routine implant surgery on human subjects. Twenty reviews and 41 case reports fulfilled eligibility criteria and were included in the scoping review. Involved implants were mandibular in 37 and maxillary in 4 cases. The major number of bleeding complications was in the mandibular canine region. The most injured vessels were sublingual and submental arteries, due mainly to perforation of the lingual cortical plate. Time to bleeding occurred intraoperatively, at suturing, or postoperatively. The most reported clinical manifestations were swelling and elevation of the mouth floor and the tongue with partial or complete airway obstructions. First aid to manage airway obstruction was intubation and tracheostomy. For active bleeding control, gauze tamponade, manual or digital compression, hemostatic agents, and cauterization were applied. When conservative procedures failed, hemorrhage was controlled by intra- or extraoral surgical approaches to ligate injured vessels or by angiographic embolization. The present scoping review provides knowledge and evidence on the most relevant aspects of the etiology, prevention, and management of implant surgery bleeding complications.
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Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Giorgio Pompa
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, Sapienza, University of Rome, Rome, Italy
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5
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Juodzbalys G. Dental Implant Placement in Focal Osteoporotic Bone Marrow Defect: a Case Report and Treatment Recommendations. J Oral Maxillofac Res 2022; 13:e5. [PMID: 36382015 PMCID: PMC9617253 DOI: 10.5037/jomr.2022.13305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Focal osteoporotic bone marrow defect is asymptomatic radiolucent area usually discovered incidentally during radiographic examination of the jaws. This bone condition can lead to clinical complications during dental implant placement or during osseointegration process. METHODS A 54-year-old woman was referred to private dental implant centre for a dental implant rehabilitation treatment in May 17, 2016. Oral examination revealed a healthy mucosa with no visible pathology. Adentia of tooth #46 and moderate atrophy of the edentulous alveolar process were found. Panoramic radiography of the jaws showed 2 cm x 2 cm radiolucency with irregular borders located in tooth #46 region. The margins of the bone defect were uneven, single trabeculae were visible, and the cortical layer was not deformed. In the absence of signs of pathology, it was decided to perform a dental implant surgery in the edentulous jaw segment #46. RESULTS The osteoporotic focus was filled with natural bovine bone substitute Cerabone®. The granules were gently condensed to the sides - to the buccal and lingual walls until they filled the entire cavity. A 10 mm long, 4.1 mm diameter Straumann® Tissue Level implant was surgically placed with the shoulder of the implant resting on the margins of the osteotomy. It was proposed six steps protocol for surgical dental implant installation in focal osteoporotic bone marrow defect in mandible. CONCLUSIONS A six-step protocol for surgical placement of dental implants in focal osteoporotic bone marrow defects may be a useful tool for clinicians in implant dentistry.
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Affiliation(s)
- Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Faculty of Odontology, Medical Academy Lithuanian University of Health Sciences, KaunasLithuania.
- Dental implant centre 'Stilus Optimus', KaunasLithuania.
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Alipoor R, Ayan M, Hamblin MR, Ranjbar R, Rashki S. Hyaluronic Acid-Based Nanomaterials as a New Approach to the Treatment and Prevention of Bacterial Infections. Front Bioeng Biotechnol 2022; 10:913912. [PMID: 35757807 PMCID: PMC9213665 DOI: 10.3389/fbioe.2022.913912] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/16/2022] [Indexed: 12/21/2022] Open
Abstract
Bacterial contamination of medical devices is a great concern for public health and an increasing risk for hospital-acquired infections. The ongoing increase in antibiotic-resistant bacterial strains highlights the urgent need to find new effective alternatives to antibiotics. Hyaluronic acid (HA) is a valuable polymer in biomedical applications, partly due to its bactericidal effects on different platforms such as contact lenses, cleaning solutions, wound dressings, cosmetic formulations, etc. Because the pure form of HA is rapidly hydrolyzed, nanotechnology-based approaches have been investigated to improve its clinical utility. Moreover, a combination of HA with other bactericidal molecules could improve the antibacterial effects on drug-resistant bacterial strains, and improve the management of hard-to-heal wound infections. This review summarizes the structure, production, and properties of HA, and its various platforms as a carrier in drug delivery. Herein, we discuss recent works on numerous types of HA-based nanoparticles to overcome the limitations of traditional antibiotics in the treatment of bacterial infections. Advances in the fabrication of controlled release of antimicrobial agents from HA-based nanosystems can allow the complete eradication of pathogenic microorganisms.
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Affiliation(s)
- Reza Alipoor
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Reza Ranjbar
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Somaye Rashki
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran.,Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
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7
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The persistently sensitive or painful osseointegrated implant. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:526-529. [PMID: 35153186 DOI: 10.1016/j.oooo.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/27/2021] [Accepted: 10/02/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine why some implants can appear to be well osseointegrated with no signs of infection and yet can remain sensitive to percussion and painful and unable to tolerate the weight of a restoration. STUDY DESIGN Five patients were identified who between them had 7 implants that met the criteria of being persistently painful and sensitive to percussion while appearing to be well integrated and otherwise disease free. High-definition cone beam computed tomography scans were obtained for all patients. All patients had failed medical treatment. RESULTS The cone beam computed tomography scans showed radiolucent channels running from the nearest nerve trunk to the vicinity of the sensitive implants. These may represent neurovascular channels that originally supplied the teeth that were present at the site of the implants, and they may have terminal neuromas that neuromas may be irritated by the implant. In all cases removal of the offending implant caused either substantial or complete relief of discomfort. CONCLUSION The presence of terminal neuromas within the jaws may be responsible for persistent pain and sensitivity in an otherwise well-integrated and disease-free implant. Removal of the offending implant appears to be the only treatment.
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8
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Yu H, Zhou A, Liu J, Tang Y, Yuan Q, Man Y, Xiang L. Management of systemic risk factors ahead of dental implant therapy: A beard well lathered is half shaved. J Leukoc Biol 2021; 110:591-604. [PMID: 34231923 DOI: 10.1002/jlb.6mr0621-760rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 02/05/2023] Open
Abstract
As the most successful therapy for missing teeth, dental implant has become increasingly prevalent around the world. A lot of papers have reported diverse local risk factors affecting the success and survival rate of dental implants, either for a short or a long period. However, there are also many types of systemic disorders or relatively administrated medicine that may jeopardize the security and success of dental implant treatment. Additionally, the coronavirus disease 2019 pandemic also poses a challenge to dental implant clinicians. Some of these risk factors are clinically common but to some extent unfamiliar to dentists, thus optimal measurements are often lacking when they occur in dental clinics. In this review, we analyze potential systemic risk factors that may affect the success rate of dental implants. Some of them may affect bone mineral density or enhance the likelihood of local infection, thus impeding osseointegration. Others may even systemically increase the risk of the surgery and threaten patients' life. In order to help novices receive high-risk patients who need to get dental implant treatment in a more reasonable way, we accordingly review recent research results and clinical experiments to discuss promising precautions, such as stopping drugs that impact bone mineral density or the operation, and addressing any perturbations on vital signs.
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Affiliation(s)
- Hui Yu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Anqi Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiayi Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yufei Tang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Quan Yuan
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Man
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Xiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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9
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González-Silva NY, Ronceros-Dueñas KA, Tinedo-López PL, Huamaní-Echaccaya JL, Guerrero ME, Malpartida Carrillo V. [Prevention of complications and risk reduction in oral implantology considering human factors and situation awareness]. REVISTA CIENTÍFICA ODONTOLÓGICA 2021; 9:e048. [PMID: 38464405 PMCID: PMC10919832 DOI: 10.21142/2523-2754-0901-2021-048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/08/2021] [Indexed: 03/12/2024] Open
Abstract
In recent years, the percentage of dental implant placement has increased, and the presence of adverse events and complications are not uncommon. The vast majority of recommendations for reducing complications associated with dental implant placement are analyzed from the point of view of their direct causes, evaluating the technique and/or the individual, but not the system as a whole, being this the actual etiology of complications. The inclusion of human factors and situation awareness has recently gained increasing importance in oral implantology complications and has allowed global analysis of both the individual and the environment, providing solutions based on prevention. However, knowledge and use of these aspects in oral implantology are still in the process of popularization, and therefore, the objective of this article was to describe the human factors involved and situation awareness for preventing complications and reducing the risks associated with dental implant placement procedures.
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Affiliation(s)
- Nadia Yudy González-Silva
- Estudiante de pregrado, Escuela de Estomatología de la Universidad Privada San Juan Bautista. Lima, Perú. , Universidad Privada San Juan Bautista Estudiante de pregrado, Escuela de Estomatología Universidad Privada San Juan Bautista Lima Peru
| | - Kevin Adonis Ronceros-Dueñas
- Estudiante de pregrado, Escuela de Estomatología de la Universidad Privada San Juan Bautista. Lima, Perú. , Universidad Privada San Juan Bautista Estudiante de pregrado, Escuela de Estomatología Universidad Privada San Juan Bautista Lima Peru
| | - Pedro Luis Tinedo-López
- División de Periodoncia, Escuela de Estomatología de la Universidad Privada San Juan Bautista. Lima, Perú. , Universidad Privada San Juan Bautista División de Periodoncia, Escuela de Estomatología Universidad Privada San Juan Bautista Lima Peru
| | - José Luis Huamaní-Echaccaya
- División de Estomatología, Escuela de Estomatología de la Universidad Privada San Juan Bautista. Ica, Perú. Universidad Privada San Juan Bautista División de Estomatología Escuela de Estomatología Universidad Privada San Juan Bautista Ica Peru
| | - María Eugenia Guerrero
- Departamento Académico Médico Quirúrgico, Facultad de Odontología de la Universidad Nacional Mayor de San Marcos. Lima, Perú. Universidad Nacional Mayor de San Marcos Departamento Académico Médico Quirúrgico Facultad de Odontología Universidad Nacional Mayor de San Marcos Lima Peru
| | - Violeta Malpartida Carrillo
- División de Periodoncia, Escuela de Estomatología de la Universidad Privada San Juan Bautista. Lima, Perú. , Universidad Privada San Juan Bautista División de Periodoncia, Escuela de Estomatología Universidad Privada San Juan Bautista Lima Peru
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10
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Ribas BR, Nascimento EHL, Freitas DQ, Pontual ADA, Pontual MLDA, Perez DEC, Ramos-Perez FMM. Positioning errors of dental implants and their associations with adjacent structures and anatomical variations: A CBCT-based study. Imaging Sci Dent 2020; 50:281-290. [PMID: 33409136 PMCID: PMC7758259 DOI: 10.5624/isd.2020.50.4.281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/26/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose The objective of the present study was to evaluate the prevalence of dental implants positioning errors and their associations with adjacent structures and anatomical variations by means of cone-beam computed tomography (CBCT). Materials and Methods CBCT images of 207 patients (584 dental implants) were evaluated by 2 oral radiologists. The distance between the implant and the adjacent teeth/implants was measured and classified as adequate (≥1.5 mm and ≥3 mm, respectively) or inadequate. The presence of thread exposure, cortical perforation, implant dehiscence, implant penetration into adjacent structures, and anatomical variations was also recorded. The incisor canal diameter and the depth of the concavity of the submandibular fossa were measured in order to evaluate their correlations with the frequency of implant penetration in these structures. Descriptive analyses, the Fisher exact test, and Spearman correlation analysis were performed (α=0.05). Results The overall prevalence of positioning errors was 82.9%. The most common error was the inadequate distance between the implant and the adjacent teeth/implants. The presence of anatomical variations did not significantly influence the overall prevalence of errors (P>0.05). There was a positive correlation between the diameter of the incisor canal and the frequency of implant penetration in this structure (r=0.232, P<0.05). Conclusion There was a high prevalence of dental implant positioning errors, and positioning errors were not associated with the presence of anatomical variations. Professionals should be aware of the space available for implant placement during the preoperative planning stage.
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Affiliation(s)
- Beatriz Ribeiro Ribas
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Deborah Queiroz Freitas
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Andréa Dos Anjos Pontual
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Danyel Elias Cruz Perez
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Caccianiga G, Perillo L, Portelli M, Baldoni M, Galletti C, Gay-Escoda C. Evaluation of effectiveness of photobiostimulation in alleviating side effects after dental implant surgery. A randomized clinical trial. Med Oral Patol Oral Cir Bucal 2020; 25:e277-e282. [PMID: 31967979 PMCID: PMC7103453 DOI: 10.4317/medoral.23336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/09/2019] [Indexed: 11/30/2022] Open
Abstract
Background To assess if photobiostimulation (PBS) alleviates pain intensity/duration and swelling after implant surgery.
Material and Methods Sixty subjects (27 male and 33 female, with a mean age of 47,13 8.05 years) were included and randomly assigned to experimental group (implant surgery and photobiostimulation), placebo group (implant surgery and simulated photobiostimulation) and control group (implant surgery only). Inclusion criteria: subjects older than 20 years, with a healthy oral mucosa and requiring implant surgery. Exclusion criteria: pregnancy, history of implant failure, light sensitivity, metabolic deseases, consumption of antibiotics or corticosteroids in the last two weeks, smokers and alcohol drinkers. Patients reported the pain experienced by using a numeric rating scale (NRS) at 2 hours, 6 hours, 12 hours, 24 hours and from day 2 to 7. Swelling score was assessed by linear measurements and type and number of analgesic drugs within each time-point were recorded on a spreadsheet. Data of pain and amount of swelling were compared among the three groups by using the Kruskal-Wallis H Test and post-hoc comparisons tests.
Results Pain in the experimental group was less compared to controls and placebo group, at each time intervals (p < 0.001) as well as the maximum pain score (experimental group: median = 2, interquartile range 2-3; control group: median = 8, interquartile range 3,75-9; placebo group: median = 8, interquartile range 6,25-9). Swelling was almost insignificant in the experimental group (maximum value = 1, interquartile range 0-2,75, at 24 hours) compared with control (maximum value = 6, interquartile range 5-8,75, at 24 hours) and placebo (maximum value = 6, interquartile range 5-8, at 24 hours). Subjects in the experimental group assumed less analgesics compared to both controls and placebo groups.
Conclusions Photobiostimulation is an effective method to reduce pain intensity/duration and swelling after implant surgery. Key words:LLLT, photobiostimulation, pain, implant surgery.
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Affiliation(s)
- G Caccianiga
- Oral and Maxillo-facial Surgery Department School of Dentistry, University of Barcelona Campus de Bellvitge UB 08907, L'Hospitalet de Llobregat, Barcelona, Spain
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12
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Barootchi S, Chan HL, Namazi SS, Wang HL, Kripfgans OD. Ultrasonographic characterization of lingual structures pertinent to oral, periodontal, and implant surgery. Clin Oral Implants Res 2020; 31:352-359. [PMID: 31925829 DOI: 10.1111/clr.13573] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/25/2019] [Accepted: 01/07/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Increased applications of ridge augmentation in the lingual posterior mandible call for an urgent need to study its anatomy. Therefore, our first aim was to validate ultrasound in measuring the mandibular lingual structures in human cadavers. Secondarily, to test its feasibility in imaging the lingual nerve in live humans. MATERIALS AND METHODS Nine fresh un-embalmed fully/partially edentulous cadaver heads were utilized for aim 1. Three areas in the lingual mandible were imaged (mandibular premolar, molar, and retromolar). Immediately after, biopsies were harvested from each site. The thickness of the mucosa, mylohyoid muscle, and lingual nerve diameter was measured via ultrasound and statistically compared to histology. Similarly, the lingual nerve in live humans was also imaged. RESULTS None of the differences between the ultrasound and histology measurements reached statistical significance (p > .05). The mean mucosal thickness via ultrasound and histology was 1.45 ± 0.49 and 1.39 ± 0.50 mm, 5 mm lingual to the mylohyoid muscle attachment. At 10 mm beyond the attachment, the ultrasound and histologic values were 1.54 ± 0.48 and 1.37 ± 0.49, respectively. The mean muscle thickness measured via ultrasound and histology was 2.31 ± 0.56 and 2.25 ± 0.47 mm, at the 5 mm distance. At the 10 mm distance, the measurements were 2.46 ± 0.56 and 2.36 ± 0.5 mm, respectively. The mean ultrasonic lingual nerve diameter was 2.38 ± 0.44 mm, versus 2.43 ± 0.42 mm, with histology. The lingual nerve diameter on 19 live humans averaged to 2.01 ± 0.35 mm (1.4-3.1 mm). CONCLUSIONS Within its limitations, ultrasound accurately measured mandibular lingual soft tissue structures on cadavers, and the lingual nerve on live humans.
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Affiliation(s)
- Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Sharon S Namazi
- Division of Anatomy, Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Biomedical Engineering, College of Engineering, Ann Arbor, Michigan.,Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan
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Virtual Bone Augmentation in Atrophic Mandible to Assess Optimal Implant-Prosthetic Rehabilitation—A Finite Element Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10010401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The scope of our study was to analyze the impact of implant prosthetic rehabilitation, in bilateral terminal partial edentulism with mandibular bone atrophy, and potential benefits of mandibular bone augmentation through finite element analysis. A 3D mandible model was made using patient-derived cone-beam computed tomography (CBCT) images, presenting a bilateral terminal edentation and mandibular atrophy. A virtual simulation of bone augmentation was then made. Implant-supported restorations were modeled for each edentulous area. Forces corresponding to the pterygoid and the masseter muscles, as well as mastication conditions for each quadrant, were applied. The resorbed mandible presented high values of strain and stress. A considerable variation between strain values among the two implant sites in each quadrant was found. In the augmented model, values of strain and stress showed a uniformization in both quadrants. Virtually increasing bone mass in the resorbed areas of the mandible showed that enabling larger implants drastically reduces strain and stress values in the implant sites. Also, although ridge height difference between the two quadrants was kept even after bone augmentation, there is a uniformization of the strain values between the two implant sites in each of the augmented mandible quadrants.
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Safdari R, Pouremadi N, Talebzadeh E, Mottaghi A, Amini S, Hossienzadeh A, Movahedian Attar B. The Impacts of Low-Level Laser Therapy - A Complementary Treatment in the Management of Side Effects After Implant Surgery. J Lasers Med Sci 2019; 9:207-211. [PMID: 30809333 DOI: 10.15171/jlms.2018.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: One of the most important medical applications of laser is low-level laser therapy (LLLT). In this method, laser radiation penetrates easily into the target tissue. The aim of this study was to investigate whether LLLT can reduce the side effects of advanced implant surgery. Methods: In this triple-blind clinical trial, 30 patients aged 25 to 65 years were selected for implant insertion and divided into two groups. In the laser group, immediately after the surgery, 72 hours and 1 week after the surgery, the surgical site was irradiated with an 830 nm laser. The dose required for the laser therapy was 5 J/cm2 . The degree of pain, facial swelling and wound healing were analyzed using statistical methods. Results: Our results showed that at 12, 24, 48, and 72 hours after the surgery, the pain level was reduced in the laser group compared with the placebo group (P<0.05). Swelling of the face was also significantly reduced 7 days after surgery in the laser group (P<0.05). The investigation on the recovery conditions of the surgical site showed that on the 3rd, 7th and 14th days after the surgery, higher levels of wound healing have been achieved (P<0.05). Conclusion: Our results suggest that laser, as a complementary therapy; can be used to reduce the severity and duration of pain. Also, laser can reduce facial swelling and accelerate wound healing.
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Affiliation(s)
- Roya Safdari
- Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Narges Pouremadi
- Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Ehsan Talebzadeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Arash Mottaghi
- Department of Oral Diseases, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Shahram Amini
- Department of Periodontics, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Abolfath Hossienzadeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Bijan Movahedian Attar
- Dental Implant Research and Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Science, Isfahan, Iran
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Gul M, Arif A, Ghafoor R. Role of three-dimensional printing in periodontal regeneration and repair: Literature review. J Indian Soc Periodontol 2019; 23:504-510. [PMID: 31849394 PMCID: PMC6906903 DOI: 10.4103/jisp.jisp_46_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Three-dimensional (3D) printing is the process of building 3D objects by additive manufacturing approach. It is being used in endodontics, periodontology, maxillofacial surgery, prosthodontics, orthodontics, and restorative dentistry, but our review article is focused on periodontal application. A detailed literature search was done on PubMed/Medline and Google Scholar using various key terms. A total of 45 articles were included in this study. Most of the studies were in vitro, preclinical, case reports, retrospective, and prospective studies. Few clinical trials have also been done. Periodontal applications included education models, scaffolds, socket preservation, and sinus and bone augmentation and guided implant placement. It showed better alveolar ridge preservation, better regenerative capabilities, greater reduction in pocket depth and bony fill, ease of implant placement in complex cases with greater precision and reduced time with improved outcome and an important tool for education and training using simulated models.
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Affiliation(s)
- Meisha Gul
- Department of Surgery, JHS Building 1st Floor Dental Clinics, Aga Khan University Hospital, Karachi, Pakistan
| | - Aysha Arif
- Department of Surgery, JHS Building 1st Floor Dental Clinics, Aga Khan University Hospital, Karachi, Pakistan
| | - Robia Ghafoor
- Department of Surgery, JHS Building 1st Floor Dental Clinics, Aga Khan University Hospital, Karachi, Pakistan
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Full in-Office Guided Surgery with Open Selective Tooth-Supported Templates: A Prospective Clinical Study on 20 Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112361. [PMID: 30366435 PMCID: PMC6266226 DOI: 10.3390/ijerph15112361] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 10/22/2018] [Accepted: 10/23/2018] [Indexed: 12/29/2022]
Abstract
Background: Guided implant surgery appears to have several benefits, such as the possibility of inserting flapless implants in a prosthetically driven manner, avoiding dangerous anatomical structures. However, to date, only a few surgeons routinely use guided surgery in partially edentulous patients. Aim: To present the results obtained with tooth-supported surgical templates characterized by an innovative open design with selective support, and manufactured via a full in-office procedure with a low-cost desktop 3D printer. Methods: Over a two-year period (2016–2018), all partially edentulous patients with one to three missing teeth (in maxilla and/or mandible), referred to a private dental practice for restoration with dental implants, were considered for inclusion in this prospective clinical study. An intraoral scanner (CS 3600®, Carestream Dental) and cone beam computed tomography (CS 9300®, Carestream Dental) were used to acquire the 3D information on the patients. Guided surgery software (SMOP®, Swissmeda) was used to plan the surgeries and to design open, selective, tooth-supported templates that were fabricated with a stereolithographic (SLA) desktop 3D printer (XFAB2000®, DWS). Guided implant surgeries were performed and patients were followed for a period of one year. The study outcomes were fit and stability of surgical templates, duration (time) of surgery, intra and post-operative complications, and implant stability and survival. Results: Twenty (20) partially edentulous patients (9 males, 11 females; mean age 54.4 ± 9.4 years) were included in the study; 28 open, selective, tooth-supported templates were designed with the aim of inserting 38 implants. Among the surgical templates, 24 had optimal fit and stability, three had optimal fit and sufficient stability, and only one had inadequate fit and unsatisfactory stability and was therefore not suitable for clinical use. The average time of the intervention was 15.7 ± 5.2 min per template. No intra-operative complications were reported, but one implant was not stable at placement and had to be removed. In total, 36 implants were restored with 10 two-unit fixed partial prostheses and 16 single crowns. All implants were successfully functioning at one year, even if, in two single crowns, minor prosthetic complications (abutment screw loosening) occurred. Conclusions: Full in-office guided surgery with open, selective, tooth-supported templates seem to represent a clinically predictable surgical procedure to restore partially edentulous patients. Further studies are needed to confirm these positive outcomes.
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Schlund M, Raoul G, Ferri J, Nicot R. Mandibular Osteomyelitis Following Implant Placement. J Oral Maxillofac Surg 2017; 75:2560.e1-2560.e7. [PMID: 28850817 DOI: 10.1016/j.joms.2017.07.169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE Mandibular osteomyelitis is relatively rare except in cases of osteoradionecrosis or medication-related osteonecrosis. The purpose of this case report is to highlight a rare but devastating complication of dental implant surgery. MATERIALS AND METHODS The case of a patient who developed mandibular osteomyelitis after implant placement, which was resistant to long-term antibiotic therapy and required radical surgical treatment with fibular free flap reconstruction, is reviewed as is the related literature. RESULTS The most frequent etiologies are odontogenic and traumatic; however, hematogenous spread also exists. It usually affects patients with systemic conditions, such as diabetes mellitus, malnutrition, malignancy, or immune deficiency. The infection is usually polymicrobial. Concerning dental implant complications, the literature is comprehensive on the mechanical etiologies of implant failure and the infectious etiologies of peri-implantitis. Mandibular osteomyelitis treatment is a long and challenging process requiring long-term antibiotic therapy and multiple surgeries. CONCLUSION The pathophysiology and treatment of mandibular osteomyelitis are discussed.
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Affiliation(s)
- Matthias Schlund
- Resident, Oral and Maxillofacial Surgery Department, Roger Salengro Hospital, University Lille 2, Lille, France.
| | - Gwenael Raoul
- Professor, Oral and Maxillofacial Surgery Department, Roger Salengro Hospital, University Lille 2, Lille; INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Joel Ferri
- Department Head, Oral and Maxillofacial Surgery Department, Roger Salengro Hospital, University Lille 2, Lille; INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Romain Nicot
- Chief Resident, Oral and Maxillofacial Surgery Department, Roger Salengro Hospital, University Lille 2, Lille, France
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Kim JW, Paeng JY, Choi SY, Kwon TG. Displacement of Dental Implants Into the Mandibular Bone Marrow Space: Cause and Treatment. A Case Study and Literature Review. J ORAL IMPLANTOL 2017; 43:151-157. [PMID: 28085632 DOI: 10.1563/aaid-joi-d-16-00205] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jin-Wook Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Jun-Young Paeng
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - So-Young Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - Tae-Geon Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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What is the best position for palatal implants? A CBCT study on bone volume in the growing maxilla. Clin Oral Investig 2016; 21:541-549. [DOI: 10.1007/s00784-016-1913-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
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Zhong X, Song Y, Yang P, Wang Y, Jiang S, Zhang X, Li C. Titanium Surface Priming with Phase-Transited Lysozyme to Establish a Silver Nanoparticle-Loaded Chitosan/Hyaluronic Acid Antibacterial Multilayer via Layer-by-Layer Self-Assembly. PLoS One 2016; 11:e0146957. [PMID: 26783746 PMCID: PMC4718720 DOI: 10.1371/journal.pone.0146957] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 12/22/2015] [Indexed: 12/11/2022] Open
Abstract
Objectives The formation of biofilm around implants, which is induced by immediate bacterial colonization after installation, is the primary cause of post-operation infection. Initial surface modification is usually required to incorporate antibacterial agents on titanium (Ti) surfaces to inhibit biofilm formation. However, simple and effective priming methods are still lacking for the development of an initial functional layer as a base for subsequent coatings on titanium surfaces. The purpose of our work was to establish a novel initial layer on Ti surfaces using phase-transited lysozyme (PTL), on which multilayer coatings can incorporate silver nanoparticles (AgNP) using chitosan (CS) and hyaluronic acid (HA) via a layer-by-layer (LbL) self-assembly technique. Methods In this study, the surfaces of Ti substrates were primed by dipping into a mixture of lysozyme and tris(2-carboxyethyl)phosphine (TCEP) to obtain PTL-functionalized Ti substrates. The subsequent alternating coatings of HA and chitosan loaded with AgNP onto the precursor layer of PTL were carried out via LbL self-assembly to construct multilayer coatings on Ti substrates. Results The results of SEM and XPS indicated that the necklace-like PTL and self-assembled multilayer were successfully immobilized on the Ti substrates. The multilayer coatings loaded with AgNP can kill planktonic and adherent bacteria to 100% during the first 4 days. The antibacterial efficacy of the samples against planktonic and adherent bacteria achieved 65%-90% after 14 days. The sustained release of Ag over 14 days can prevent bacterial invasion until mucosa healing. Although the AgNP-containing structure showed some cytotoxicity, the toxicity can be reduced by controlling the Ag release rate and concentration. Conclusions The PTL priming method provides a promising strategy for fabricating long-term antibacterial multilayer coatings on titanium surfaces via the LbL self-assembly technique, which is effective in preventing implant-associated infections in the early stage.
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Affiliation(s)
- Xue Zhong
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
| | - Yunjia Song
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
| | - Peng Yang
- Key Laboratory of Applied Surface and Colloid Chemistry, Ministry of Education, College of Chemistry and Chemical Engineering, Shaanxi Normal University, Xi’an, PR China
| | - Yao Wang
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
| | - Shaoyun Jiang
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
| | - Xu Zhang
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
- * E-mail: (X. Zhang); (CL)
| | - Changyi Li
- School of Dentistry, Hospital of Stomatology, Tianjin Medical University, Tianjin, PR China
- * E-mail: (X. Zhang); (CL)
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Favia G, Tempesta A, Limongelli L, Crincoli V, Piattelli A, Maiorano E. Metastatic Breast Cancer in Medication-Related Osteonecrosis Around Mandibular Implants. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:621-6. [PMID: 26371774 PMCID: PMC4574514 DOI: 10.12659/ajcr.894162] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Patient: Female, 66 Final Diagnosis: Breast cancer metastasis in medication-related osteonecrosis of the jaw Symptoms: — Medication: — Clinical Procedure: Clinical and radiological examination • surgical treatment Specialty: Dentistry
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Affiliation(s)
- Gianfranco Favia
- Department of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, "Aldo Moro" University, Barii, Italy
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, "Aldo Moro" University, Barii, Italy
| | - Luisa Limongelli
- Department of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, "Aldo Moro" University, Barii, Italy
| | - Vito Crincoli
- Department of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, "Aldo Moro" University, Barii, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, Operating Unit of Pathological Anatomy, "Aldo Moro" University, Barii, Italy
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