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Serin M, Altinel D, Toplu G, Rakici IT, Toplu SG. Lefort 1 Osteotomy Study of Maxillary Bone in Caprine Skull Model: Comparison of Different Osteotomy Techniques (Piezo Versus Lindemann Bur Versus Manual Chisel). J Craniofac Surg 2024; 35:1581-1584. [PMID: 38767364 DOI: 10.1097/scs.0000000000010309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/03/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE In this study, we aimed to compare the efficiency of different osteotomy techniques for Lefort 1 osteotomy in an experimental caprine skull model. METHODS Twelve caprine skulls were used for the study. Skulls were divided into 3 groups: (1) manual chisel group, (2) Lindemann bur group, and (3) piezo osteotomy group. Bilateral osteotomies were performed on each skull. Results were evaluated with three-dimensional computerized tomography scans and macroscopic observations of the mucosal tears and soft tissue. RESULTS The mean length of the bone gap in the manual, Lindemann, and piezo groups was 4.8 (±0.7), 3.38 (±1.49), and 1.39 (±0.3) mm, respectively ( P < 0.05). The mean number of comminuted fractures in the manual, Lindemann, and piezo groups was 5.5 (±1.4), 1.6 (±0.3), and 0.6 (±0.5), respectively ( P < 0.05). Mucosal tearing and soft tissue damage based on subjective inspection observations were negligible in the piezo technique. Soft tissue and mucosal damage were observed significantly more in the manual chisel osteotomy method compared with the other 2 techniques. CONCLUSION We anticipate that piezo, which has started to be used in new application areas besides rhinoplasty, will continue to be used more widely, especially in reconstructive orthognathic surgery, due to the minimal damage it causes to tissues. With the long-term results, much healthier interpretations can be made.
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Affiliation(s)
- Merdan Serin
- Department of Plastic, Reconstructive and Esthetic Surgery, Goztepe Training and Research Hospital, Medeniyet University
| | - Dinçer Altinel
- Department of Plastic, Reconstructive and Esthetic Surgery, Istanbul Training and Research Hospital, Health Sciences University
| | - Gaye Toplu
- Private practice in Plastic, Reconstructive and Esthetic Surgery, Istanbul, Turkey
| | - Ibrahim Taşkın Rakici
- Department of Radiology, Istanbul Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Selçuk Göksel Toplu
- Department of Biostatistics and Medical IT, Health Sciences Institute, Duzce University, Duzce, Turkey
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Walia S, Verma D, Bansal S, Sutar S, Gupta A, Kardwal K. Comparison of Piezosurgery Devices and the Use of Rotatory Devices for the Extraction of Impacted Mandibular Third Molars. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S2140-S2142. [PMID: 39346438 PMCID: PMC11426619 DOI: 10.4103/jpbs.jpbs_92_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 10/01/2024] Open
Abstract
The present study aimed to examine the extraction of impacted mandibular third molars by using rotatory and piezosurgery equipment. Twenty-five patients of both genders who required surgery to remove their third molars were split into two groups (control group and research group). In the surgical extraction of the impacted mandibular third molar, in the study group, a piezotome was used to remove the bone, while in the control group, a bur was used. Patients' acceptance of bone cutting, the length of the operation, discomfort and bleeding during the procedure, postoperative pain, swelling, trismus, and wound healing were evaluated. A statistically insignificant difference was observed for age and difficulty index. The intraoperative bleeding was similar in both groups. Both the groups tolerated the bone cutting well, with slightly better values for the piezo group. Based on Pederson's difficulty index, the scores of difficulty of extraction of the impacted tooth were measured between the groups. The slight difficulty was observed in 9 (36%) each in the study group and control group. The moderate difficulty in 14 (56%) of control group and 15 (60%) of study group. Severe difficulty was found among 2 (8%) in the control group and 1 (4%) in the study group. The difference was not significant (P > 0.05). Intraoral bleeding was moderately seen in 25 in both groups. Among the study and control groups respectively no intraoperative pain was seen in 14 and 16, mild intraoperative pain in 11 and 7, and moderate intraoperative pain in 0 and 2. Among group I and II acceptance to bone cutting was comfortably seen in 24 and 23, bearable in 1 and 2 respectively. The difference was not significant (P > 0.05). Piezosurgery and bur were comparable in evaluating patient acceptance, intraoperative duration, intraoperative bleeding and pain, postoperative pain, edema, trismus, and wound healing.
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Affiliation(s)
- Sheffali Walia
- Department of Oral and Maxillofacial Surgery, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, Punjab, India
| | - Dinesh Verma
- Department of Dentistry, AIIMS, Bilaspur, Chhattisgarh, India
| | - Shallu Bansal
- Department of Oral and Maxillofacial Surgery, Geetanjali Dental and Research Institute, Udaipur, Rajasthan, India
| | - Smita Sutar
- Department of Oral and Maxillofacial Surgery, Dr. Rajesh Ramdasji Kambe Dental College, Kaneri Sarap, Akola, Maharashtra, India
| | - Asheen Gupta
- Department of Oral and Maxillofacial Surgery, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Kapil Kardwal
- Dr. Kardwals’ Dental and Face Surgery Hospital, Rawatsar, Rajasthan, India
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3
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Blagova B, Krastev D, Malinova L. Conventional drilling versus ultrasound and laser osteotomy in mandibular third molar surgery: A comparative study. Lasers Surg Med 2023; 55:862-870. [PMID: 37811576 DOI: 10.1002/lsm.23730] [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: 05/30/2023] [Revised: 08/13/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND There are few research works with in-depth studies and direct simultaneous comparisons of the effects on tissue reactions and patients' recovery following in vivo conventional drilling, ultrasound- and laser-assisted osteotomy in humans. OBJECTIVE The current study aims to compare bone cutting duration, pain, swelling, and trismus in patients following surgical mandible third molar extraction by bone removal using three different osteotomes-a conventional rotary device, an ultrasonic unit, and an Er:YAG laser. METHODS A prospective, randomized three-group comparative clinical trial was performed. As an experimental setting for the study, аn open mandible third molar surgery was chosen because osteotomy is included in its protocol. Patients were divided into three groups according to the used device for bone removal. Bone cutting time intraoperatively, facial swelling, trismus, and pain on the first, second, and third postoperative days were assessed. The statistical analyses were performed using the SPSS v. 17.0-Kolmogorov-Smirnov test, one-way ANOVA, Student's t-test, Mann-Whitney test, and χ2 test. Statistical results were considered significant at p < 0.05 (confidence interval of difference, 95% CI). RESULTS Eighty patients (34 males and 46 females with an average age of 25.18 years) were included in the study. The average time for bone removal by the conventional low-speed device (4.95 min), by the ultrasonic unit (5.13 min), and by the Er:YAG laser (9.00 min) differed significantly (p = 0.001). The mean postoperative facial swelling showed a marked difference between the groups (p < 0.05), in favor of the laser and piezo groups. The osteotome proved to influence pain intensity not only immediately after surgery (p = 0.002), but also during the followed-up period (p = 0.001), again in favor of the two above-mentioned groups. No association was found between trismus and the osteotome used by the followed-up patients (p > 0.05). CONCLUSION Bone-cutting mechanism and the biological influence of the laser beam and ultrasound on living tissues proved to be favorable factors for patients' pain levels and tissue swelling postoperatively independent of the longer osteotomy duration compared to conventional drilling.
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Affiliation(s)
- Bistra Blagova
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, Sofia, Bulgaria
| | - Dimo Krastev
- Medical College "Jordanka Filaretova", Medical University of Sofia, Sofia, Bulgaria
- Faculty of Public Health, Health Care and Sport, South-West University "Neofit Rilski", Blagoevgrad, Bulgaria
| | - Lina Malinova
- Department of Anatomy, Histology, and Embryology, Medical University of Sofia, Sofia, Bulgaria
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Alam K, Qamar SZ, Iqbal M, Piya S, Al-Kindi M, Qureshi A, Al-Ghaithi A, Al-Sumri B, Silberschmidt VV. Effect of drill quality on biological damage in bone drilling. Sci Rep 2023; 13:6234. [PMID: 37069203 PMCID: PMC10110507 DOI: 10.1038/s41598-023-33381-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/12/2023] [Indexed: 04/19/2023] Open
Abstract
Bone drilling is a universal procedure in orthopaedics for fracture fixation, installing implants, or reconstructive surgery. Surgical drills are subjected to wear caused by their repeated use, thermal fatigue, irrigation with saline solution, and sterilization process. Wear of the cutting edges of a drill bit (worn drill) is detrimental for bone tissues and can seriously affect its performance. The aim of this study is to move closer to minimally invasive surgical procedures in bones by investigating the effect of wear of surgical drill bits on their performance. The surface quality of the drill was found to influence the bone temperature, the axial force, the torque and the extent of biological damage around the drilling region. Worn drill produced heat above the threshold level related to thermal necrosis at a depth equal to the wall thickness of an adult human bone. Statistical analysis showed that a sharp drill bit, in combination with a medium drilling speed and drilling at shallow depth, was favourable for safe drilling in bone. This study also suggests the further research on establishing a relationship between surface integrity of a surgical drill bit and irreversible damage that it can induce in delicate tissues of bone using different drill sizes as well as drilling parameters and conditions.
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Affiliation(s)
- Khurshid Alam
- Department of Mechanical and Industrial Engineering, College of Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud, 123, Sultanate of Oman.
| | - Sayyad Zahid Qamar
- Department of Mechanical and Industrial Engineering, College of Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud, 123, Sultanate of Oman
| | - Muhammad Iqbal
- Creative Engineering & Management Services, Saddar Road, Peshawar, Pakistan
| | - Sujan Piya
- Department of Industrial Engineering and Engineering Management, College of Engineering, University of Sharjah, Sharjah, UAE
| | - Mahmood Al-Kindi
- Department of Mechanical and Industrial Engineering, College of Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud, 123, Sultanate of Oman
| | - Asim Qureshi
- Department of Pathology, Sultan Qaboos University, Al-Khoud, 123, Sultanate of Oman
| | - Ahmed Al-Ghaithi
- Department of Surgery, Sultan Qaboos University Hospital, Al-Khoud, 123, Sultanate of Oman
| | - Badar Al-Sumri
- Histopathology Laboratory, Sultan Qaboos University Hospital, Al-Khoud, 123, Sultanate of Oman
| | - Vadim V Silberschmidt
- School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, UK
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The Local Release of Teriparatide Incorporated in 45S5 Bioglass Promotes a Beneficial Effect on Osteogenic Cells and Bone Repair in Calvarial Defects in Ovariectomized Rats. J Funct Biomater 2023; 14:jfb14020093. [PMID: 36826892 PMCID: PMC9964758 DOI: 10.3390/jfb14020093] [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: 11/06/2022] [Revised: 01/24/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
With the increase in the population's life expectancy, there has also been an increase in the rate of osteoporosis, which has expanded the search for strategies to regenerate bone tissue. The ultrasonic sonochemical technique was chosen for the functionalization of the 45S5 bioglass. The samples after the sonochemical process were divided into (a) functionalized bioglass (BG) and (b) functionalized bioglass with 10% teriparatide (BGT). Isolated mesenchymal cells (hMSC) from femurs of ovariectomized rats were differentiated into osteoblasts and submitted to in vitro tests. Bilateral ovariectomy (OVX) and sham ovariectomy (Sham) surgeries were performed in fifty-five female Wistar rats. After a period of 60 days, critical bone defects of 5.0 mm were created in the calvaria of these animals. For biomechanical evaluation, critical bone defects of 3.0 mm were performed in the tibias of some of these rats. The groups were divided into the clot (control) group, the BG group, and the BGT group. After the sonochemical process, the samples showed modified chemical topographic and morphological characteristics, indicating that the surface was chemically altered by the functionalization of the particles. The cell environment was conducive to cell adhesion and differentiation, and the BG and BGT groups did not show cytotoxicity. In addition, the experimental groups exhibited characteristics of new bone formation with the presence of bone tissue in both periods, with the BGT group and the OVX group statistically differing from the other groups (p < 0.05) in both periods. Local treatment with the drug teriparatide in ovariectomized animals promoted positive effects on bone tissue, and longitudinal studies should be carried out to provide additional information on the biological performance of the mutual action between the bioglass and the release of the drug teriparatide.
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Battista MD, Kernitsky J, Exarchos E, Ohira T, Dibart S. Quantification and comparison of the regional acceleratory phenomenon in bone following piezosurgery or bur osteotomy: A pilot study in rats. Clin Exp Dent Res 2023; 9:66-74. [PMID: 36369743 PMCID: PMC9932235 DOI: 10.1002/cre2.689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/OBJECTIVE The Regional Acceleratory Phenomenon (RAP) can be induced surgically via decortication (selective cortical penetrations) of bone to accelerate orthodontic tooth movement. Few studies have compared the impact and efficiency of different decortication methods to induce the RAP. The aim of this study was to determine if there is a significant difference in the intensity of the RAP induced by a surgical defect created either using a piezoelectric knife or a rotary bur. METHODS Twenty-two Sprague-Dawley rats were divided into two treatment groups (each n = 8) and a control group (n = 6). The treatment groups were subjected to transcortical penetrations (TP) of the right tibia using either a piezoelectric knife (PTP) or a rotary bur (BTP). The right tibias of the control group animals had reflection of tissues (SHAM) and the left legs were kept for comparison (INTACT). The animals were killed at 7 and 14 days after the operation in an equally distributed manner. Microcomputed tomography images were obtained and analyzed utilizing artificial intelligence for bone cortical porosity (Ct.Po) locally and regionally. RESULTS/CONCLUSION Regionally, TP using a PTP induced significantly (p < .05, Kruskal-Wallis test) more Ct.Po than BTP or INTACT for both the 7- and 14-day time points. PTP was not found to induce significantly more Ct.Po than SHAM at any time point. However, PTP induced significantly more Ct.Po than the INTACT group for each time point, while SHAM did not. The local analysis did not reveal any relevant significant differences between groups.
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Affiliation(s)
- Massimo Di Battista
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
| | - Jeremy Kernitsky
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
| | - Elias Exarchos
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
| | - Taisuke Ohira
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
| | - Serge Dibart
- Department of Periodontology and Oral Biology, Henry M. Goldman School of Dental MedicineBoston UniversityBostonMassachusettsUSA
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7
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Rapone B, Inchingolo AD, Trasarti S, Ferrara E, Qorri E, Mancini A, Montemurro N, Scarano A, Inchingolo AM, Dipalma G, Inchingolo F. Long-Term Outcomes of Implants Placed in Maxillary Sinus Floor Augmentation with Porous Fluorohydroxyapatite (Algipore ® FRIOS ®) in Comparison with Anorganic Bovine Bone (Bio-Oss ®) and Platelet Rich Plasma (PRP): A Retrospective Study. J Clin Med 2022; 11:jcm11092491. [PMID: 35566615 PMCID: PMC9105692 DOI: 10.3390/jcm11092491] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/10/2022] Open
Abstract
Purpose: The objective of this retrospective study was to evaluate the long-term clinical outcomes of bone regeneration procedures using algae-derived plant hydroxyapatite (Algipore® FRIOS®) compared with demineralized anorganic bovine bone (Bio-Oss®), in combination with autologous blood-derived PRP. Materials and Methods: Partially edentulous patients with severe atrophy of posterior maxillary treated by means of the split bone technique in a two-stage grafting procedures were observed for up to seven years after implants placement. After surgeries, the natural porous fluorohydroxyapatite (FHA) (Algipore® FRIOS®; Group, n = 29) or anorganic bovine bone (Bio-Oss® Group, n = 28) with autogenous bone in a 50:50 composite ratio with PRP, were administered in a 2.8-mm critical-size defect (CSD). Four months later, implants were placed at second-stage surgery. Results: A sample of fifty-seven consecutive patients who required sinus augmentation was included in the study, and 57 implants were placed. There was no drop out or loss of follow-up of any case. Clinical and radiographic examinations revealed a comparable pattern of newly formed bone in both groups after seven years of functional loading for implants placed after sinus augmentation using porous fluorohydroxyapatite and anorganic bovine bone. No significant difference in marginal bone loss was found around implants in both groups. Conclusions: The favorable implant outcomes suggest both biomaterials are suitable for sinus grafting in severely atrophic maxillae.
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Affiliation(s)
- Biagio Rapone
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.D.I.); (A.M.); (A.M.I.); (G.D.); (F.I.)
- Correspondence: (B.R.); (S.T.); Tel.: +39-3477619817 (B.R.)
| | - Alessio Danilo Inchingolo
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.D.I.); (A.M.); (A.M.I.); (G.D.); (F.I.)
| | - Stefano Trasarti
- Department of European Studies Jean Monnet of Lugano, 6900 Lugano, Switzerland
- Correspondence: (B.R.); (S.T.); Tel.: +39-3477619817 (B.R.)
| | - Elisabetta Ferrara
- Complex Operative Unit of Odontostomatology, Hospital S.S. Annunziata, 66100 Chieti, Italy;
| | - Erda Qorri
- Dean Faculty of Medical Sciences, Albanian University, Bulevardi Zogu I, Tirana 1001, Albania;
| | - Antonio Mancini
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.D.I.); (A.M.); (A.M.I.); (G.D.); (F.I.)
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy;
| | - Antonio Scarano
- Department of Oral Science, Nano and Biotechnology, CaSt-Met University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Angelo Michele Inchingolo
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.D.I.); (A.M.); (A.M.I.); (G.D.); (F.I.)
| | - Gianna Dipalma
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.D.I.); (A.M.); (A.M.I.); (G.D.); (F.I.)
| | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy; (A.D.I.); (A.M.); (A.M.I.); (G.D.); (F.I.)
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Furumori T, Ueda M, Honda Y, Hashimoto Y, Tanioka T, Kusano K, Baba S. The Effect of Different Surgical Instruments for Bone Regeneration under the Surgery of Bone Defect on Rat Calvaria. J HARD TISSUE BIOL 2022. [DOI: 10.2485/jhtb.31.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Mamoru Ueda
- Department of Biomaterials, Osaka Dental University
| | | | | | | | - Kaoru Kusano
- Department of Oral Implantology, Osaka Dental University
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University
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Tomazi MA, da Silveira Gerzson A, Neto AM, da Costa ALP. In-Block Lateralization as a New Technique for Mobilization of the Inferior Alveolar Nerve: A Technique Case Series. J ORAL IMPLANTOL 2021; 47:333-341. [PMID: 32838423 DOI: 10.1563/aaid-joi-d-20-00041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The edentulous atrophic posterior mandible is often a great challenge for implant rehabilitation. Although a number of treatment options have been proposed, including the use of short implants and surgical grafting techniques, in cases of severe bone atrophy, techniques for mobilization of the inferior alveolar nerve (IAN) have been shown to be efficient, with good results. Four female patients underwent IAN lateralization for prosthetic rehabilitation of the posterior mandible from 2013 to 2019, with 3 years to 5 years and 3 months of follow-up. This case series describes a new technique for mobilization of the IAN, named in-block lateralization, to facilitate access to the IAN and to reduce nerve manipulation. The implant is immediately installed (allowing nerve lateralization in unitary spaces), and the original mandibular anatomy is restored with autogenous bone from the original bed during the same surgical procedure. When well indicated and well performed, this new approach provides better and easier visualization of the IAN and safer manipulation aiming to achieve good results for implant stability and minimal risk of neurosensory disturbances, allowing rehabilitation even in unitary spaces.
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Affiliation(s)
- Marcos Augusto Tomazi
- Oral and Maxillofacial Surgery, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alexandre da Silveira Gerzson
- Oral and Maxillofacial Surgery, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Implantology and Periodontology of the Dental Institute of the Americas, Porto Alegre, RS, Brazil
| | - Angelo Menuci Neto
- Postgraduate Program in Periodontology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Gabrić D, Aumiler D, Vuletić M, Gjorgievska E, Blašković M, Mladenov M, Pavlić V. Thermal Evaluation by Infrared Thermography Measurement of Osteotomies Performed with Er:YAG Laser, Piezosurgery and Surgical Drill-An Animal Study. MATERIALS 2021; 14:ma14113051. [PMID: 34205094 PMCID: PMC8199930 DOI: 10.3390/ma14113051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
The bone healing process following osteotomy may vary according to the type of surgical instrumentation. The aim of the present in vivo study was to determine thermal changes of the bone tissue following osteotomies performed by Er:YAG laser ablation in contact and non-contact modes, piezoelectric surgery, and surgical drill using an infrared thermographic camera. For each measurement, the temperature before the osteotomy-baseline (Tbase) and the maximal temperature measured during osteotomy (Tmax) were determined. Mean temperature (ΔT) values were calculated for each osteotomy technique. The significance of the difference of the registered temperature between groups was assessed by the ANOVA test for repeated measures. Mean baseline temperature (Tbase) was 27.9 ± 0.3 °C for contact Er:YAG laser, 29.9 ± 0.3 °C for non-contact Er:YAG laser, 29.4 ± 0.3 °C for piezosurgery, and 28.3 ± 0.3 °C for surgical drill. Mean maximum temperature (Tmax) was 29.9 ± 0.5 °C (ΔT = 1.9 ± 0.3 °C) for contact Er:YAG laser, 79.1 ± 4.6 °C (ΔT = 49.1 ± 4.4 °C) for non-contact Er:YAG laser, 29.1 ± 0.2 °C (ΔT = −0.2 ± 0.3 °C) for piezosurgery, and 27.3 ± 0.4 °C (ΔT = −0.9 ± 0.4 °C) for surgical drill. Statistically significant temperature changes were observed for the non-contact laser. The results of the study showed beneficial effects of the osteotomy performed by the Er:YAG laser used in the contact mode of working as well as for piezosurgery, reducing the potential overheating of the bone tissue as determined by means of infrared thermography.
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Affiliation(s)
- Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University Hospital Center, University of Zagreb, 10000 Zagreb, Croatia;
| | | | - Marko Vuletić
- Department of Oral Surgery, School of Dental Medicine, University Hospital Center, University of Zagreb, 10000 Zagreb, Croatia;
- Correspondence:
| | - Elizabeta Gjorgievska
- Department of Pediatric and Preventive Dentistry, Faculty of Dental Medicine, Ss. Cyril and Methodius University, 1000 Skopje, North Macedonia;
| | - Marko Blašković
- Department of Oral Surgery, Faculty of Dental Medicine, University Hospital Center, University of Rijeka, 51000 Rijeka, Croatia;
| | - Mitko Mladenov
- Faculty of Natural Sciences and Mathematics, Institute of Biology, Ss. Cyril and Methodius University, 1000 Skopje, North Macedonia;
| | - Verica Pavlić
- Department of Periodontology and Oral Medicine, Medical Faculty, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
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11
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Odashima K, Shimizu Y, Sano Y, Yamamoto A, Mukai T, Takada Y, Yanagisawa Y, Imai Y, Takahashi T, Kumamoto H. Osteogenic response under the periosteum by magnesium implantation in rat tibia. Dent Mater J 2021; 40:498-507. [PMID: 33642444 DOI: 10.4012/dmj.2020-011] [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] [Indexed: 11/23/2022]
Abstract
This study was designed to examine osteoconductive effects of Mg in rats tibia. The animals were sacrificed after 1, 2, and 8 weeks. The elemental analysis was performed using SEM/EDX at week 1. Following X-ray micrography at weeks 2 and 8, samples were embedded in paraffin. The expression of osteocalcin was observed by immunohistochemical staining. The element concentrations of fibrous capsules around the specimens were also measured by ICP-MS. The concentrations of Ca and P on the surface of the Mg specimen increased in SEM/EDX. The tissue specimen showed new bone formation on the bone surface near the implanted area. The concentrations of Mg, Ca, and P were high in the fibrous capsules surrounding Mg. Implantation induced differentiation of osteoblasts, and this process was considered to be associated with new bone formation. Induction of cell differentiation may be influenced by corrosion products in addition to corroding magnesium.
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Affiliation(s)
- Kenji Odashima
- Division of Oral and Maxillofacial Surgery, Department of Oral and Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Yoshinaka Shimizu
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Yuya Sano
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Akiko Yamamoto
- Biometals Group, Biomaterials Unit, Nano-life Field, International Center for Materials Nanoarchitectonics, National Institute for Materials Science
| | - Toshiji Mukai
- Department of Mechanical Engineering, Kobe University
| | - Yukyo Takada
- Division of Dental Biomaterials, Tohoku University Graduate School of Dentistry, Tohoku University
| | - Yuta Yanagisawa
- Division of Oral and Maxillofacial Surgery, Department of Oral and Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Yoshimichi Imai
- Department of Plastic and Reconstructive Surgery, Tohoku University Graduate School of Medicine
| | - Tetsu Takahashi
- Division of Oral and Maxillofacial Surgery, Department of Oral and Medicine and Surgery, Graduate School of Dentistry, Tohoku University
| | - Hiroyuki Kumamoto
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Graduate School of Dentistry, Tohoku University
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Bone Healing Evaluation Following Different Osteotomic Techniques in Animal Models: A Suitable Method for Clinical Insights. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10207165] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Osteotomy is a common step in oncological, reconstructive, and trauma surgery. Drilling and elevated temperature during osteotomy produce thermal osteonecrosis. Heat and associated mechanical damage during osteotomy can impair bone healing, with consequent failure of fracture fixation or dental implants. Several ex vivo studies on animal bone were recently focused on heating production during osteotomy with conventional drill and piezoelectric devices, particularly in endosseous dental implant sites. The current literature on bone drilling and osteotomic surface analysis is here reviewed and the dynamics of bone healing after osteotomy with traditional and piezoelectric devices are discussed. Moreover, the methodologies involved in the experimental osteotomy and clinical studies are compared, focusing on ex vivo and in vivo findings.
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Alam K, Iqbal M, Umer J, Amjad M, Al-Ghaithi A. Experimental study on biological damage in bone in vibrational drilling. Biomed Mater Eng 2020; 31:269-277. [PMID: 32986649 DOI: 10.3233/bme-201122] [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] [Indexed: 01/19/2023]
Abstract
BACKGROUND Drilling is a well-known mechanical operation performed for fixing fracture at required locations in bone. The process may produce mechanical and thermal alterations in the structure of the bone and surrounding tissues leading to irreversible damage known as osteonecrosis. OBJECTIVE The main purpose of this study was to measure the level of biological damage in bone when a drill assisted by low and high levels of vibrations is penetrated into bone tissue. METHODS Histopathology examination of sections of bones has been performed after drilling the bone using a range of vibrational frequency and rotational speed imposed on the drill with and without supply of saline for cooling. RESULTS Cell damage in bone was caused by the combined effect of drill speed and frequency of vibrations. Histopathology examination revealed more damage to bone cells when a frequency higher than 20 kHz was used in the absence of cooling. Cooling the drilling region helped minimize cell damage more at a shallow depth of drilling compared to deep drilling in the cortex of cortical bone. The contribution of cooling in minimizing cell damage was higher with a lower drill speed and frequency compared to a higher drill speed and frequency. CONCLUSION Vibrational drilling using a lower drill speed and frequency below 25 kHz in the presence of cooling was found to be favorable for safe and efficient drilling in bone.
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Affiliation(s)
- Khurshid Alam
- Mechanical and Industrial Engineering Department, Sultan Qaboos University, Al-Khoud, Sultanate of Oman
| | - Muhammad Iqbal
- Creative Engineering and Management Services, Deans Centre, Peshawar, Pakistan
| | - Jamal Umer
- Department of Mechanical Engineering, University of Engineering and Technology, Lahore, Pakistan
| | - Muhammad Amjad
- Department of Mechanical Engineering, International Islamic University, Sector H-11, Islamabad, Pakistan
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Fujiwara S, Kato S, Bengazi F, Urbizo Velez J, Tumedei M, Kotsu M, Botticelli D. Healing at implants installed in osteotomies prepared either with a piezoelectric device or drills: an experimental study in dogs. Oral Maxillofac Surg 2020; 25:65-73. [PMID: 32803459 DOI: 10.1007/s10006-020-00895-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/11/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare osseointegration and marginal bone level at implants placed in osteotomies prepared with either conventional drills or a piezoelectric device. MATERIAL AND METHODS Three months after the extraction of all mandibular premolars and first molars, two recipient sites were selected. The osteotomies were randomly prepared with either conventional drills (drill sites) or a piezoelectric device (piezoelectric sites). Implants were installed and a submerged healing was allowed. The animals were euthanized in groups of six after 4 and 8 weeks of healing. Biopsies were obtained for histological preparation. Coronal level of osseointegration (bone level) and bone-to-implant contact percentage (BIC%) were evaluated. RESULTS After 4 weeks of healing, the bone level was 0.6 ± 0.9 mm for the piezoelectric sites and 1.6 ± 0.7 mm for the drill sites (p = 0.173). After 8 weeks, the respective measures were 0.9 ± 0.3 mm and 1.0 ± 1.1 mm (p = 0.917). After 4 weeks of healing, a new bone apposed onto the implant surface was found at fractions of 54.9 ± 6.7% and 55.1 ± 16.6% for the piezoelectric and the drill sites, respectively (p = 0.674). The respective total bone fractions, including new and old bone, was 64.0 ± 4.8% and 63.4 ± 20.4% (p = 0.917). After 8 weeks, a new bone increased to 67.4 ± 6.7% and 62.9 ± 12.5% for the piezoelectric and the drill sites, respectively (p = 0.463). The respective total bone fractions were 70.4 ± 5.5% and 67.8 ± 12.1% (p = 0.753). CONCLUSIONS The use of a piezoelectric device for implant site preparation is a safe procedure that allows a proper integration since the early periods of healing similar to that observed using conventional drills.
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Affiliation(s)
| | - Shingo Kato
- ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, Italy
- , Nishinomiya City, Hyogo, Japan
| | - Franco Bengazi
- Faculty of Dentistry, University of Medical Science, La Habana, Cuba
| | | | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Mitsuo Kotsu
- ARDEC Academy, Viale Giovanni Pascoli 67, Rimini, Italy
- , Suita City, Osaka, Japan
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15
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Marques AC, Lopes GR, Samico RP, Matos JD, Souza FA, Corat EJ, Nishioka RS. Evaluation of temperature and osteotomy speed with piezoelectric system. Minerva Dent Oral Sci 2020; 70:65-70. [PMID: 32698562 DOI: 10.23736/s2724-6329.20.04328-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Piezosurgery is an option to realize several clinical and surgical procedures, due to its advantages as precision in osteotomy. This study aims to evaluate the heating and osteotomy speed in bone blocks of ox's shins, to report the best way of its use in the clinical practice. METHODS A bone blocks had the dimensions as follow: 20 mm length, 10 mm width, and 5 mm wide. It was evaluated 5 different groups: group LM (low speed and medium pressure); group HM (high speed and medium pressure); group HH (high speed and high pressure); group LH (low speed and high pressure); group LL (low speed and low pressure). The heating increasement was measured with a thermal viewer and the osteotomy was timed when the cut depth reached 5 mm and the whole block detached itself. One-way ANOVA and Tukey tests were adopted to analyze the data and the level of significance was set at a P value of 0.05. RESULTS The pressure and speed of the tip, works directly in the generated temperature during osteotomy. The medium pressure level is the most favorable, because high pressure level caused a high increase in heating over the bone and low pressure presented a very long osteotomy time. CONCLUSIONS The high speed and medium pressure can be suggested as the most efficient in both standards of time/temperature to realize the osteotomy.
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Affiliation(s)
- Ana C Marques
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Guilherme R Lopes
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil -
| | - Renata P Samico
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
| | - Jefferson D Matos
- Department of Surgery, São Paulo State University (FOA-Unesp), Araçatuba, Brazil
| | | | - Evaldo J Corat
- National Institute for Space Research, São José dos Campos, Brazil
| | - Renato S Nishioka
- Department of Prosthodontics and Dental Materials, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil
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Senos R, Hankenson K. Calvaria critical-size defects in rats using piezoelectric equipment: a comparison with the classic trephine. Injury 2020; 51:1509-1514. [PMID: 32448465 PMCID: PMC8245198 DOI: 10.1016/j.injury.2020.04.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 04/17/2020] [Accepted: 04/25/2020] [Indexed: 02/02/2023]
Abstract
Calvarial critical-size defects in rats are used to study regeneration of both craniofacial bone and long-bones. For decades, the trephine technique has been used with no notable refinements in the procedure. The use of piezoelectric surgical equipment has increased in human clinical oral and maxillofacial surgery, neurosurgery, traumatology, and orthopedics, because the devices are easy to handle, and can cut bone without damaging sensitive soft tissues such as blood vessels, nerves, and membranes. This study evaluated and compared the surgical technique and bone regeneration process between a traditional hand-drill trephine and piezoelectric equipment in a critical-size calvaria defect in a rat model. Thirty SD male rats were randomly divided into two groups and had either a 7.9mm diameter circular defect created with trephine or a 7.0mm square defect using the piezoelectric device, both creating 49 mm2 defect areas. MicroCT and histology were performed at 45 and 75d after surgery. While trephine surgeries were performed faster than piezoelectric (25.5 minutes vs 38.5 minutes), the rate of complications was much higher, with 36% of trephine rats taking 20 minutes to achieve hemostasis. Although the extent of new bone formation was similar between the two surgical groups, the piezoelectric technique resulted in 50% less variability. No additional new bone formation was observed from 45 to 75d in both techniques. Piezoelectric technique represents a refined and more reproducible technique for calvarial defect generation in comparison to classic trephine methods.
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Affiliation(s)
- R. Senos
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA,Department of Biomedical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, USA
| | - K.D. Hankenson
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA
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de Molon RS, Fiori LC, Verzola MHA, Belluci MM, de Souza Faloni AP, Pereira RMR, Tetradis S, Orrico SRP. Long-term evaluation of alendronate treatment on the healing of calvaria bone defects in rats. Biochemical, histological and immunohistochemical analyses. Arch Oral Biol 2020; 117:104779. [PMID: 32559508 DOI: 10.1016/j.archoralbio.2020.104779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of the long-term alendronate administration on bone healing in defects created in rat calvarias. MATERIALS AND METHODS Female Wistar rats were randomly distributed into 2 groups: Control (CTL): animals received saline solution once a week; and Alendronate (ALD): rats underwent alendronate treatment (1 mg/kg/weekly). After 120 days from the commencement of treatment, a critical size defect was created in all animals, and 10 animals from each group were sacrificed at 5, 10, 15, 20, 25, 30, 45 and 60-days after the defect creation. On the day of sacrifice, urine and blood samples were collected for determination of the serum levels of bone resorption and formation markers by enzyme linked immunosorbent assay, and the urinary concentration of deoxypyridinoline. Bone mineral density (BMD) in the femurs, descriptive histology, tartrate-resistant acid-phosphatase staining and immunohistochemical analyzes were assessed in the calvaria. RESULTS Alendronate group showed increased BMD compared to the test group. The concentration of C-terminal telopeptide of type I collagen and deoxypyridinoline decreased significantly, and the concentration of aminoterminal propeptide of procollagen type 1 and osteocalcin were significant lower in the alendronate group. Immunohistochemical analysis showed significant downregulation in the inducible nitric oxide synthase, runt-related transcription factor-2, cathepsin-K and receptor activator of nuclear factor kappa-B ligand expression in the alendronate group. Vascular endothelial growth factor and osteopontin were upregulated in the later periods of alendronate group. CONCLUSIONS Our results suggest that long-term treatment with alendronate did not compromise the repair processing of critical size defects in rat.
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Affiliation(s)
- Rafael Scaf de Molon
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara Sao Paulo, Brazil.
| | - Leslie Cristine Fiori
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara Sao Paulo, Brazil
| | - Mario Henrique Arruda Verzola
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara Sao Paulo, Brazil
| | - Marina Montosa Belluci
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara Sao Paulo, Brazil
| | - Ana Paula de Souza Faloni
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, Sao Paulo, Brazil
| | | | - Sotirios Tetradis
- Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, 10833, CA, USA; Molecular Biology Institute, UCLA, Los Angeles, 10833, CA, USA
| | - Silvana Regina Perez Orrico
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araraquara Sao Paulo, Brazil; Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto, S.P., Brazil
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Minimally Invasive Surgery for Clinical Crown Lengthening Using Piezoelectric Ultrasound. Case Rep Dent 2020; 2020:7234310. [PMID: 32181022 PMCID: PMC7066419 DOI: 10.1155/2020/7234310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/18/2020] [Indexed: 11/17/2022] Open
Abstract
This case report is aimed at describing a flapless, minimally invasive clinical crown lengthening with an osteotomy performed using a piezoelectric ultrasound. A female patient complained about the amount of gum that was exposed when she smiled, which caused aesthetic discomfort. After a clinical examination, it was confirmed that the patient had excessive gum exposure in the upper arch of the dental region for teeth 14 to 24 when she smiled. The tomographic exam showed that bone tissue was at the level of the enamel-cementum junction, and gingival tissue covered a part of the anatomic crown. Virtual analysis using digital smile design (DSD) demonstrated that enlarging the clinical crowns would provide better aesthetics. The excess gingival tissue was removed from the gingival margin region with the aid of a mockup without interference to the interdental papillae. Then, osteotomy was performed using piezoelectric ultrasound until there was a 2.5 mm distance from the top of the bone crest to the new gingival margin. In the postoperative period, good repositioning of the gingival margin, absence of postoperative complications, and rapid healing of the gingival tissue were verified. After 6 months, a good aesthetic outcome was observed with stability in the level of the periodontal tissues obtained via the crown-lengthening technique. It can be concluded that the minimally invasive clinical crown-lengthening technique was effective in repositioning the gingival margin with no postoperative complications.
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Abstract
AIM The aim of this study was to investigate the effect of piezoelectric surgery (piezosurgery) on soft tissue in open septorhinoplasty. METHODS A total of 30 patients (21 females, 9 males; mean age 29.16 ± 8.17 years; range, 18-43 years) who underwent open septorhinoplasty between January 2019 and February 2019 were randomly divided into 2 groups. After the nasal dorsum was opened in all groups, 1 mm tissue under the skin in radix region was taken as punch biopsy. In the first group (classical group, n = 15), the cartilage hump was resected with number 15 scalpel and the bone hump with the help of a chisel. Lateral and median osteotomies were conducted using 4 mm sharp osteotomes. Rasping was performed to dorsum to correct bone deformities. Then, 1 mm punch biopsy was taken from under the skin tissue of the nose back near the radix. In the second group (piezo group, n = 15) hump excision, osteotomies and rasping were performed by piezoelectric surgery. Then, 1 mm punch biopsy was taken from the subcutaneous tissue of the nose back near the radix. Biopsies were examined histopathologically in the light microscope for edema, necrosis, and inflammation. RESULTS Of the 30 patients presented in this series, 21 were female and 9 were male. In the classical group, edema in the soft tissue was seen in 86.7% of the cases after osteotomy, while this rate was 26.7% in the piezosurgery group. The difference was statistically significant (P < 0.05). Although necrosis was not seen prior to the osteotomy in both groups, the rate of necrosis in the classical group was 13.3% and in the piezo group it was 66.7%. Necrosis was significantly different in the piezosurgery group compared with the classical osteotomy group (P < 0.05). CONCLUSION Piezosurgery is not completely harmless to soft tissue. A statistically significant increase in subcutaneous necrosis compared with the classical group can be explained by long-term soft tissue trauma caused by piezoelectric vibrations. We think that developing necrosis may cause problems in late period, especially in patients with thin skin.
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20
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Kim CH, Chung CK, Choi Y, Kuo CC, Lee U, Yang SH, Lee CH, Jung JM, Hwang SH, Kim DH, Yoon JH, Paik S, Lee HJ, Jung S, Park SB, Kim KT, Park HP. The Efficacy of Ultrasonic Bone Scalpel for Unilateral Cervical Open-Door Laminoplasty: A Randomized Controlled Trial. Neurosurgery 2019; 86:825-834. [DOI: 10.1093/neuros/nyz301] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/18/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
In cervical open-door laminoplasty for cervical myelopathy, a high-speed rotatory drill and rongeurs are used to make unicortical troughs and bicortical openings in the laminae. The lamina is reflected at the trough to enlarge the spinal canal, followed by bone healing on the hinge side to stabilize laminoplasty. The ultrasonic bone scalpel (UBS) has been used due to theoretical advantages including a better hinge union rate, less soft tissue trauma, less neurological injury, and shorter operative time.
OBJECTIVE
To assess the superiority of UBS for hinge union compared to the drill through randomized controlled trial.
METHODS
In 190 randomly allocated cervical myelopathy patients, the trough and opening at the lamina were made using either the drill (n = 95) or UBS (n = 95) during 2015 to 2018. The primary outcome was the hinge union rate on 6-mo postoperative computed tomography. Secondary outcomes included the hinge union rate at 12 mo, the operative time, intraoperative/postoperative bleeding, neurological injury, complications, and clinical outcomes over a 24-mo follow-up.
RESULTS
Hinge union in all laminae was achieved in 60.0% (drill) and 43.9% (UBS) of patients at 6 mo (intention-to-treat analysis; P = .02; odds ratio, 2.1) and in 91.9% (drill) and 86.5% (UBS) at 12 mo. Dural injury only occurred in the drill group (2.1%), and the UBS group showed significantly less intraoperative bleeding (P < .01). The other secondary outcomes did not differ between groups.
CONCLUSION
The hinge union rate was inferior in the UBS group at 6 mo postoperatively, but UBS was efficacious in reducing dural injuries and bleeding.
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Affiliation(s)
- Chi Heon Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Chun Kee Chung
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Seoul National University Hospital, Seoul, South Korea
- Human Brain Function Laboratory, Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Yunhee Choi
- Division of Medical Statistics, Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South Korea
| | - Calvin C Kuo
- Regional Spine Surgery Department, Kaiser Permanente, Oakland, California
| | - Urim Lee
- Human Brain Function Laboratory, Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
| | - Seung Heon Yang
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Chang-Hyun Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Jong-Myung Jung
- Department of Neurosurgery, Seoul National University Bundang Hospital, Kyung-gi, South Korea
| | - Sung Hwan Hwang
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Hwan Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Joon Ho Yoon
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Seoi Paik
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Nursing, Seoul National University Hospital, Seoul, South Korea
| | - Hwa Jin Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Nursing, Seoul National University Hospital, Seoul, South Korea
| | - Sunhyang Jung
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Nursing, Seoul National University Hospital, Seoul, South Korea
| | - Sung Bae Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neurosurgery, Seoul National University Boramae Hospital, Boramae Medical Center, Seoul, South Korea
| | - Kyoung-Tae Kim
- Department of Neurosurgery, Kyungpook National University Hospital, Daegu, South Korea
- Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Hee-Pyoung Park
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, South Korea
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Guided Bone Regeneration Using BioGlue As a Barrier Material With and Without Biphasic Calcium Phosphate. J Craniofac Surg 2019; 30:1308-1313. [PMID: 31163569 DOI: 10.1097/scs.0000000000005428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to investigate the effects of Bioglue as a mechanical barrier with or without biphasic calcium phosphate (BCP) in a rat tibia model. Sixty Sprague Dawley male rats weighing 250 ± 20 g and 10 to 12 weeks of age were studied. Unicortical defects were created on the right tibia of all rats. Subjects were randomly divided into 3 groups. BioGlue group (24 rats); BioGlue alone, Graft group (24 rats); BioGlue + BCP and Control group; unfilled and uncovered (12 rats). Animals were euthanized at 7th, 21st, and 45th days postoperatively for histological and histomorphometric analyses. BioGlue material exhibited no adverse effects until the end of observation period. Bone-healing scores did not differ statistically between Control and BioGlue group, but found to be lower in Graft group on 21st and 45th days, (P < 0.001 and P < 0.01 on the 21st day and P < 0.01 and P < 0.05 on the 45th day, respectively). New bone formation in Graft group was found to be statistically different from Control group on the 7th and 21st days (P < 0.01 and P < 0.05 respectively), whereas no statistical difference was observed between BioGlue and Control group at all times. The present analysis indicates that BioGlue functioned well as a mechanical barrier allowing new bone formation. No additional benefit of combination treatment was detected in this study design and BCP did not offer any advantage for bone regeneration, thus it can serve as only a space maintainer.
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Systemic and local effects of radiotherapy: an experimental study on implants placed in rats. Clin Oral Investig 2019; 24:785-797. [PMID: 31154539 DOI: 10.1007/s00784-019-02946-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 05/03/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Evaluate the modulating effect of ionizing radiation, blood cytokine levels, and bone remodeling of the interface around the implant to understand the radiation mechanisms which can impair the implants receptor site. MATERIAL AND METHODS Sixty rats were submitted to grade V titanium implants in the femurs and were divided into the following groups: no-irradiation (N-Ir): control group with implant only; early-irradiation (E-Ir): implant + irradiation after 24 h; late-irradiation (L-Ir): implant + irradiation after 4 weeks; and previous-irradiation (P-Ir): irradiation + implant after 4 weeks. The animals in the E-Ir, L-Ir, and P-Ir groups were irradiated in two fractional stages of 15 Gy. At 3 days, 2 weeks, and 7 weeks after the final procedure, five animals were randomly euthanized per group. Serum levels of TNF-ɑ, IL-1β, TGF-β, IL-6, M-CSF, and IL-10 were measured from blood collected prior to euthanasia using the ELISA test. The pieces containing the implants were subjected to immunohistochemical labeling using the tartrate acid resistant to phosphatase, osteocalcin, and caspase-3 markers and mCT. The ANOVA test was used for statistical analysis, and the Tukey multiple comparison test (p < 0.05) was applied. RESULTS The results indicated that ionizing radiation modifies the production of pro- and anti-inflammatory serum cytokines, the expression of proteins involved in bone remodeling and cellular apoptosis, as well as changes in bone formation. CONCLUSIONS The results suggests that a longer period between radiotherapy and implant placement surgery when irradiation occurs prior to implant installation would allow the recovery and renewal of bone cells and avoid future failures in osseointegration. CLINICAL RELEVANCE The search for modifications caused by ionizing irradiation in bone tissue can indicate the ideal period for implant placement without affecting the osseointegration process.
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Massimi L, Rapisarda A, Bianchi F, Frassanito P, Tamburrini G, Pelo S, Caldarelli M. Piezosurgery in Pediatric Neurosurgery. World Neurosurg 2019; 126:e625-e633. [DOI: 10.1016/j.wneu.2019.02.103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/09/2019] [Accepted: 02/10/2019] [Indexed: 02/04/2023]
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Alam K, Al-Ghaithi A, Piya S, Saleem A. In-vitro experimental study of histopathology of bone in vibrational drilling. Med Eng Phys 2019; 67:78-87. [PMID: 30981608 DOI: 10.1016/j.medengphy.2019.03.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 03/09/2019] [Accepted: 03/30/2019] [Indexed: 02/06/2023]
Abstract
Drilling is a common surgical procedure for fracture treatment and reconstruction in multiple surgical fields, including orthopaedics, neurology, and dentistry. Drilling delicate tissue (such as bone) with a hard metallic tool is considered notorious for inducing mechanical and thermal damage, which can adversely affect osseointegration and may weaken the bond between the bone and implant, or other fixative devices anchoring the bone. The aim of this study is to explore the benefits of vibrational drilling (VD) in overcoming the complications associated with conventional drilling (CD). Drilling tests were performed on fresh cortical bone with the intention of investigating the effect of a range of frequencies, in combination with drilling speed and feed rate, on biological damage around the drilling region using histological sections of skeletally mature bone. The study examined the most influential factors and optimal combination of parameters for safe and efficient drilling in bone. Results from Taguchi grey relational analysis showed that a lower drilling speed and feed rate combined with a frequency of 20 kHz were favourable parameters for safe drilling in bone. Accordingly, VD using controlled parameters may be an alternative to CD in bone surgical procedures.
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Affiliation(s)
- Khurshid Alam
- Department of Mechanical and Industrial Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud 123, Sultanate of Oman.
| | | | - Sujan Piya
- Department of Mechanical and Industrial Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud 123, Sultanate of Oman
| | - Ashraf Saleem
- Department of Electrical and Computer Engineering, Sultan Qaboos University, P.O. Box 33, Al-Khoud 123, Sultanate of Oman
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Gonzaga MG, Santos Kotake BG, Figueiredo FAT, Feldman S, Ervolino E, Santos MCG, Issa JPM. Effectiveness of rhBMP‐2 association to autogenous, allogeneic, and heterologous bone grafts. Microsc Res Tech 2019; 82:689-695. [DOI: 10.1002/jemt.23215] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/03/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Miliane Gonçalves Gonzaga
- Ribeirão Preto Medical School, Department of Biomechanics, Medicine and Rehabilitation of LocomotorUniversity of São Paulo São Paulo Brazil
| | - Bruna Gabriela Santos Kotake
- Ribeirão Preto Medical School, Department of Biomechanics, Medicine and Rehabilitation of LocomotorUniversity of São Paulo São Paulo Brazil
| | | | - Sara Feldman
- School of Medicine, LABOATEM ‐ Osteoarticular Biology, Tissue Engineering and Emerging Therapies LaboratoryNational Rosario University Santa Fe Argentina
| | - Edilson Ervolino
- Faculty of Dentistry, Department of Basic SciencesSão Paulo State University São Paulo Brazil
| | - Maria Cecília Gorita Santos
- School of Dentistry of Ribeirão Preto, Department of Pediatric DentistryUniversity of São Paulo São Paulo Brazil
| | - João Paulo Mardegan Issa
- School of Dentistry of Ribeirão Preto, Department of Pediatric DentistryUniversity of São Paulo São Paulo Brazil
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Piezoelectric Surgery in the Inferior Alveolar Nerve Lateralization With Simultaneous Implant Placement: A Case Report. IMPLANT DENT 2019; 28:86-90. [PMID: 30624393 DOI: 10.1097/id.0000000000000855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this case report was to describe the inferior alveolar nerve (IAN) lateralization technique using the piezoelectric device for the posterior rehabilitation of an atrophic mandible with implants. The patient presented the absence of elements 35 and 36 associated with a vertical defect impairing the adequate dental implant placement without IAN damage. A full-thickness mucoperiosteal flap was raised, and a bone window was made with a piezoelectric device centralized on the IAN canal position. After dissection, the IAN was moved buccally with a sterile elastic strip. Morse cone 4.0 × 1.5-mm implants were inserted while the IAN remained retracted. At the 4-month follow-up, the screw-retained prosthesis was installed guaranteeing the recovering masticatory function. In conclusion, the case report showed that the IAN lateralization performed with an adequate surgical technique can be successfully indicated for longer implant placement in edentulous atrophic posterior mandible with no permanent neural damage.
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Abe F, Takahashi H, Tanaka A. Investigation on the Action and Effect of Culture Supernatant of Human Dental Pulp Stem Cells Using Rats with Medication-Related Osteonecrosis of the Jaw. J HARD TISSUE BIOL 2019. [DOI: 10.2485/jhtb.28.349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Fumihiko Abe
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata
| | - Haruka Takahashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata
- Division of Cell Regeneration and Transplantation, Advanced Research Center School of Life Dentistry at Niigata, The Nippon Dental University
| | - Akira Tanaka
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata
- Division of Cell Regeneration and Transplantation, Advanced Research Center School of Life Dentistry at Niigata, The Nippon Dental University
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Gürkan A, Tekdal GP, Bostancı N, Belibasakis GN. Cytokine, chemokine, and growth factor levels in peri‐implant sulcus during wound healing and osseointegration after piezosurgical versus conventional implant site preparation: Randomized, controlled, split‐mouth trial. J Periodontol 2018; 90:616-626. [DOI: 10.1002/jper.18-0216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Ali Gürkan
- Department of PeriodontologySchool of Dentistry, Ege University Izmir Turkey
| | - Gözde Peker Tekdal
- Department of PeriodontologySchool of Dentistry, Ege University Izmir Turkey
- Department of PeriodontologyKarşıyaka Oral and Dental Health Center Izmir Turkey
| | - Nagihan Bostancı
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Stockholm Sweden
- Center of Dental MedicineUniversity of Zürich Zürich Switzerland
| | - Georgios N. Belibasakis
- Division of Oral DiseasesDepartment of Dental MedicineKarolinska Institutet Stockholm Sweden
- Center of Dental MedicineUniversity of Zürich Zürich Switzerland
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Experimental Comparison of the Performance of Cutting Bone and Soft Tissue between Piezosurgery and Conventional Rotary Instruments. Sci Rep 2018; 8:17154. [PMID: 30464184 PMCID: PMC6249262 DOI: 10.1038/s41598-018-35295-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 11/01/2018] [Indexed: 11/13/2022] Open
Abstract
Piezosurgery is an innovative technique widely used for osteotomies in the field of oral and maxillofacial surgery. The surgical technique has been clinically supposed to cut mineralized bone selectively with reducing the risk of damage to adjacent soft tissues. However, none of the previous literature has reported any evidence of scientific experiments to examine performance of the piezoelectric device, i.e. the time required for cutting bone and the effect on soft tissues under the standardized conditions. This study was designed to test the hypothesis that cutting time of the piezoelectric device is longer than that of rotary instruments while the cut surface of bone is smoother and soft tissues are less damaged with piezosurgery under the standardized experimental system. We measured the time for cutting bone and soft tissues of rats with the piezoelectric device and rotary instruments. Damage to soft tissues was examined histologically, and the cut surface of bone was investigated using scanning electron microscopy. Our study demonstrated experimentally that piezosurgery provides a smooth cut bony surface with no damage to soft tissues and takes longer time to cut bone than conventional drillings. We propose that piezosurgery is beneficial for medical safety and usability.
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de Molon RS, Magalhaes-Tunes FS, Semedo CV, Furlan RG, de Souza LGL, de Souza Faloni AP, Marcantonio E, Faeda RS. A randomized clinical trial evaluating maxillary sinus augmentation with different particle sizes of demineralized bovine bone mineral: histological and immunohistochemical analysis. Int J Oral Maxillofac Surg 2018; 48:810-823. [PMID: 30442550 DOI: 10.1016/j.ijom.2018.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/19/2018] [Accepted: 09/10/2018] [Indexed: 02/02/2023]
Abstract
This study was performed to investigate sinus floor augmentation with two different particle sizes of demineralized bovine bone mineral (DBBM) by means of histological and immunohistochemical (IHC) analysis. A randomized clinical trial was conducted involving 10 individuals requiring two-stage bilateral maxillary sinus augmentation for implant installation. The patients were randomly divided into two groups following a split-mouth design: the maxillary sinus on one side was filled with small-sized particles (0.25-1mm) and on the contralateral side with large-sized particles (1-2mm). After a healing period of 8 months, 25 implants were placed. During implant site preparation, bone biopsies were obtained from each sinus, perpendicular to the long axis of the implant (buccal-palatal direction), for descriptive and histomorphometric analyses. IHC staining for protein expression of osteocalcin (OCN), vascular endothelial growth factor (VEGF), and tartrate-resistant acid phosphatase (TRAP) was also performed. Histomorphometric analysis revealed no statistically significant difference in the percentage of biomaterial (32.4±8.56% and 38.0±6.92%), newly formed bone (36.1±9.60% and 36.7±5.79%), or connective tissue (30.4±8.63% and 23.8±6.16%) between the small- and large-sized particle groups, respectively. IHC analysis did not reveal differences in the expression of OCN, VEGF, or TRAP. These findings suggest that both particle sizes of DBBM are effective for bone augmentation in the maxillary sinus.
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Affiliation(s)
- R S de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil.
| | - F S Magalhaes-Tunes
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - C V Semedo
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - R G Furlan
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - L G L de Souza
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - A P de Souza Faloni
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
| | - E Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University - UNESP, Araraquara, São Paulo, Brazil
| | - R S Faeda
- Department of Health Sciences, Implantology Post Graduation Course, University Centre of Araraquara - UNIARA, São Paulo, Brazil
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Minimally Invasive Approach Based on Pterygoid and Short Implants for Rehabilitation of an Extremely Atrophic Maxilla: Case Report. IMPLANT DENT 2018; 26:639-644. [PMID: 28486354 DOI: 10.1097/id.0000000000000603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Extremely atrophic maxillae can be considered the most important indication for three-dimensional maxillary reconstruction. Different bone-augmentation techniques have been suggested to accomplish this. This article illustrates a minimally invasive approach to rehabilitation of the extremely atrophic maxilla. MATERIAL AND METHODS A 63-year-old male patient was referred for restoration of his totally edentulous maxilla with a fixed full-arch implant-prosthetic rehabilitation. Four short implants in the premaxillary region and 2 longer implants in the pterygomaxillary regions were inserted with piezoelectric implant site preparation. DISCUSSION At the 1-year follow-up appointment, no clinical or radiographic changes in the soft-tissue contours or crestal bone levels were observed. CONCLUSION This surgical approach, based on the combination of short implants in the premaxillary regions and pterygoid implants in the pterygomaxillary regions, represents a way to shorten treatment timing, minimize the risk of surgical complications, and reduce patient discomfort and costs.
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Comparative Evaluation of Cell Viability Immediately After Osteotomy for Implants With Drills and Piezosurgery: Immunohistochemistry Analysis. J Craniofac Surg 2018; 29:1578-1582. [PMID: 29742566 DOI: 10.1097/scs.0000000000004542] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate the effect of reusing drills and piezosurgery tips during implant osteotomy on immediate bone cell viability through immunohistochemical analysis. MATERIALS AND METHODS Six male rabbits were divided into 2 groups and then divided into 5 subgroups-correspond to drills and tips used 10, 20, 30, 40, and 50 times, respectively. All animals received 10 osteotomies in each tibia, by use of the classic drilling procedure in one group (G1) and the piezosurgery device in the other group (G2). For immunohistochemical technique were utilized the osteoprotegerin, RANKL, osteocalcin, and caspase 3. Control procedures were performed by omitting the primary antibodies (negative control). RESULTS Bone formation and resorption responses presented in more intense way during the piezosurgery. The expression of osteocalcin had become quite intense in piezosurgery groups, but with reduced immunostaining from the 30th osteotomy. The caspase 3 showed the viability of the osteoblast from the 20th osteotomy with piezosurgery and remained constant until the 50th. CONCLUSION Piezosurgery provides greater osteoblastic cell viability than the system of conventional drilling. CLINICAL RELEVANCE This study will provide data so that the authors can recycle the drills and tips for implant placement, thus enabling a better cell viability for osseointegration.
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Anesi A, Ferretti M, Cavani F, Salvatori R, Bianchi M, Russo A, Chiarini L, Palumbo C. Structural and ultrastructural analyses of bone regeneration in rabbit cranial osteotomy: Piezosurgery versus traditional osteotomes. J Craniomaxillofac Surg 2018; 46:107-118. [DOI: 10.1016/j.jcms.2017.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 09/07/2017] [Accepted: 10/05/2017] [Indexed: 12/17/2022] Open
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Troedhan A, Mahmoud ZT, Wainwright M, Khamis MM. Cutting bone with drills, burs, lasers and piezotomes: A comprehensive systematic review and recommendations for the clinician. ACTA ACUST UNITED AC 2017. [DOI: 10.17352/2455-4634.000028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Öğreden Ş, Rüzgar S, Tansuker HD, Taşkın Ü, Alimoğlu Y, Aydın S, Oktay MF, İzol U. Histopathological comparison of bone healing effects of endonasal and percutaneous lateral osteotomy methods in rabbit rhinoplasty model. Braz J Otorhinolaryngol 2017; 84:540-544. [PMID: 28760713 PMCID: PMC9452219 DOI: 10.1016/j.bjorl.2017.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 06/08/2017] [Accepted: 06/22/2017] [Indexed: 11/15/2022] Open
Abstract
Introduction Lateral osteotomy is mainly performed either endonasally or percutaneously in rhinoplasty which is a frequently performed operation for the correction of nasal deformities. Both techniques have both advantages and disadvantages relative to each other. Objective The aim of this study was to compare the histopathological effects of endonasal and percutaneous osteotomy techniques performed in rhinoplasty on bone healing and nasal stability in an experimental animal model. Methods Eight one year-old New Zealand white rabbits were included. Xylazine hydrocloride and intramuscular ketamine anesthesia were administered to the rabbits. Endonasal osteotomy (8 bones) was performed in Group 1 (n = 4), and percutaneous osteotomy (8 bones) in Group 2 (n = 4). One month later the rabbits were sacrificed. Bone healing of the rabbits was staged according to the bone healing score of Huddleston et al. In both groups, nasal bone integrity was assessed subjectively. Results In the percutaneous osteotomy group, Grade 1 bone healing was observed in two samples (25%), Grade 2 bone healing in two samples (25%), Grade 3 bone healing in four samples (50%). In the endonasal osteotomy group, Grade 1 bone healing was observed in 6 samples (75%) and Grade 2 bone healing was observed in 2 samples (25%). In the percutaneous group, fibrous tissue was observed in 2, predominantly fibrous tissue and a lesser amount of cartilage was observed in 2 and an equal amount of fibrous tissue and cartilage was observed in 4 samples. In the endonasal group, fibrous tissue was observed in 6 samples, and predominantly fibrous tissue with a lesser amount of cartilage was observed in 2 samples. In both groups, when manual force was applied to the nasal bones, subjectively the same resistance was observed. Conclusion Percutaneous lateral osteotomy technique was found to result in less bone and periost trauma and better bone healing compared to the endonasal osteotomy technique.
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Affiliation(s)
- Şahin Öğreden
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Otolaryngology, Istanbul, Turkey
| | - Sedat Rüzgar
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Otolaryngology, Istanbul, Turkey
| | - Hasan Deniz Tansuker
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Otolaryngology, Istanbul, Turkey.
| | - Ümit Taşkın
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Otolaryngology, Istanbul, Turkey
| | - Yalçın Alimoğlu
- Haseki Training and Research Hospital, Department of Otolaryngology, Istanbul, Turkey
| | - Salih Aydın
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Otolaryngology, Istanbul, Turkey
| | - Mehmet Faruk Oktay
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Otolaryngology, Istanbul, Turkey
| | - Uğur İzol
- University of Health Sciences, Bagcilar Training and Research Hospital, Department of Pathology, Istanbul, Turkey
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Moradi Haghgoo J, Arabi SR, Hosseinipanah SM, Solgi G, Rastegarfard N, Farhadian M. Comparison of the effect of three autogenous bone harvesting methods on cell viability in rabbits. J Dent Res Dent Clin Dent Prospects 2017; 11:73-77. [PMID: 28748046 PMCID: PMC5519996 DOI: 10.15171/joddd.2017.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 06/18/2017] [Indexed: 11/09/2022] Open
Abstract
Background. This study was designed to compare the viability of autogenous bone grafts, harvested using different methods, in order to determine the best harvesting technique with respect to more viable cells.
Methods. In this animal experimental study, three harvesting methods, including manual instrument (chisel), rotary device and piezosurgery, were used for harvesting bone grafts from the lateral body of the mandible on the left and right sides of 10 rabbits. In each group, 20 bone samples were collected and their viability was assessed using MTS kit. Statistical analyses, including ANOVA and post hoc Tukey tests, were used for evaluating significant differences between the groups.
Results. One-way ANOVA showed significant differences between all the groups (P=0.000). Data analysis using post hoc Tukey tests indicated that manual instrument and piezosurgery had no significant differences with regard to cell viability (P=0.749) and the cell viability in both groups was higher than that with the use of a rotary instrument (P=0.000).
Conclusion. Autogenous bone grafts harvested with a manual instrument and piezosurgery had more viable cells in comparison to the bone chips harvested with a rotary device.
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Affiliation(s)
- Janet Moradi Haghgoo
- Department of Periodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Reza Arabi
- Department of Periodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Ghasem Solgi
- Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Neda Rastegarfard
- Department of Periodontics, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics, Faculty of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Wang L, Aghvami M, Brunski J, Helms J. Biophysical regulation of osteotomy healing: An animal study. Clin Implant Dent Relat Res 2017; 19:590-599. [PMID: 28608504 DOI: 10.1111/cid.12499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/01/2017] [Accepted: 05/02/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Osteotomies have been performed for centuries yet there remains a remarkable lack of consensus on optimal methods for cutting bone. There is universal agreement, however, that preserving cell viability is critical. PURPOSE To identify mechanobiological parameters influencing bone formation after osteotomy site preparation. MATERIALS AND METHODS A murine maxillary osteotomy model was used to evaluate healing. Computational modeling characterized stress and strain distributions in the osteotomy, as well as the magnitude and distribution of heat generated by drilling. The impact of osteocyte death and bone composition were assessed using molecular and cellular assays. RESULTS The phases of osteotomy healing in mice align closely with results in large animals; in addition, molecular analyses extended our understanding of osteoprogenitor cell proliferation, differentiation, and mineralization. Computational analyses provided insights into temperature changes caused by drilling and the mechanobiological state in the healing osteotomies, while concomitant cellular assays correlate drill speed with osteocyte apoptosis and bone resorption. Even when drilling was controlled, trabeculated, spongy (Type III) bone healed faster than densely lamellar (Type I) bone because of the abundance of Wnt responsive osteoprogenitor cells in the former. CONCLUSIONS These data provide a mechanobiological framework for evaluating tools and technologies designed to improve osteotomy site preparation.
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Affiliation(s)
- Liao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, 94305
| | - Maziar Aghvami
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, 94305
| | - John Brunski
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, 94305
| | - Jill Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, California, 94305
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Sirolli M, Mafra CES, Santos RABD, Saraiva L, Holzhausen M, César JB. Influence of Piezosurgery on Bone Healing around Titanium Implants: A Histological Study in Rats. Braz Dent J 2017; 27:278-83. [PMID: 27224560 DOI: 10.1590/0103-6440201600161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 03/28/2016] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to evaluate histomorphometrically the influence of two techniques of dental implant site preparation on bone healing around titanium implants. Fifteen male Wistar rats (±300 g) were used in the study. Each tibia was randomly assigned to receive the implant site preparation either with a conventional drilling technique (control - DRILL group) or with a piezoelectric device (PIEZO group). The animals were sacrificed after 30 days and then the following histomorphometric parameters were evaluated (percentage) separately for cortical and cancellous regions: proportion of mineralized tissue (PMT) adjacent to implant threads (500 μm adjacent); bone area within the threads (BA) and bone-implant contact (BIC). The results demonstrated that there were no statistically significant differences between both groups for cancellous BIC (p>0.05) and cortical PMT (p>0.05). On the other hand, a higher percentage of BA was observed in the PIEZO group in the cortical (71.50±6.91 and 78.28±4.38 for DRILL and PIEZO groups, respectively; p<0.05) and cancellous regions (9.62±4.06 and 19.94±14.18 for DRILL and PIEZO groups, respectively; p<0.05). The piezosurgery also showed higher PMT values in the cancellous zone (9.35±5.54 and 18.72±13.21 for DRILL and PIEZO groups, respectively; p<0.05). However, the DRILL group presented better results for BIC in cortical region (80.42±10.88 and 70.25±16.93 for DRILL and PIEZO groups, respectively; p<0.05). In conclusion, for the implant site preparation, the piezosurgery was beneficial to bone healing rates in the cancellous bone region, while the drill technique produced better results in the cortical bone.
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Thomas M, Akula U, Ealla KKR, Gajjada N. Piezosurgery: A Boon for Modern Periodontics. J Int Soc Prev Community Dent 2017; 7:1-7. [PMID: 28316942 PMCID: PMC5343677 DOI: 10.4103/2231-0762.200709] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/12/2017] [Indexed: 12/18/2022] Open
Abstract
Dentistry has undergone significant advancement and has seen several changing concepts over a decade. One such novel innovation is piezosurgery. Piezoelectric bone surgery or otherwise known as piezosurgery is a novel technique invented by Professor Vercellotti in 1988 to overcome the limitations of traditional instrumentation in oral bone surgery by modifying and improving conventional ultrasound technology. It is a promising, meticulous, and soft tissue sparing system for bone cutting based on low frequency ultrasonic microvibrations. The absence of macrovibration makes the instrument more manageable and allows greater intraoperative control with a significant increase in cutting safety in the more difficult anatomical cutting zone. The present review compares piezosurgery with the traditional tools and emphasizes on its mechanism of action, instruments, biologic effects, advantages, and limitations, as well as its various applications in the field of dentistry.
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Affiliation(s)
- Mathai Thomas
- Department of Periodontology, PSM College of Dental Sciences and Research, Akikavu, Thrissur, Kerala, India
| | - Uttam Akula
- Department of Periodontology, MNR Dental College and Hospital, Sangareddy, Medak, Telangana, India
| | - Kranti K R Ealla
- Department of Oral and Maxillofacial Pathology, MNR Dental College and Hospital, Sangareddy, Medak, Telangana, India
| | - Nirosha Gajjada
- Department of Oral and Maxillofacial Pathology, MNR Dental College and Hospital, Sangareddy, Medak, Telangana, India
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Blaskovic M, Gabrić D, Coleman NJ, Slipper IJ, Mladenov M, Gjorgievska E. Bone Healing Following Different Types of Osteotomy: Scanning Electron Microscopy (SEM) and Three-Dimensional SEM Analyses. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2016; 22:1170-1178. [PMID: 27998364 DOI: 10.1017/s1431927616011971] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The aim of the present study was to compare dynamics of the bone healing process after different types of osteotomies. In total, 24 Wistar rats were subjected to different types of osteotomy performed with standard steel bur, piezosurgery, contact, and non-contact Erbium:yttrium-aluminum-garnet (Er:YAG) laser ablation. The animals were randomly divided into four groups, to be euthanized immediately after the procedure, or at 1, 2, or 3 weeks after surgery. The obtained bone samples were analyzed by scanning electron microscopy (SEM). Immediately after surgery, there were significant differences in the appearance of the bone defects, with presence of bone fragments and debris after standard steel bur preparation, compared with the clean smooth walls and relatively sharp edges in all other groups. The initial bone formation in defects prepared by piezosurgery was observed to be the most rapid. After 3 weeks, all bone defects were completely restored; although, differences in the healing pattern were noted, with a modest initial delay in healing after laser preparation. The first stage of the bone healing process was delayed when contact and non-contact Er:YAG laser modes were used and accelerated by piezosurgery; however, the results after 3 weeks demonstrated similar restitution of defects in all tested groups.
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Affiliation(s)
- Marko Blaskovic
- 1Department of Oral Surgery,School of Dental Medicine, Faculty of Dentistry,University of Zagreb,Republic of Croatia, Ivana Gundulića 5, 10000, Zagreb,Croatia
| | - Dragana Gabrić
- 1Department of Oral Surgery,School of Dental Medicine, Faculty of Dentistry,University of Zagreb,Republic of Croatia, Ivana Gundulića 5, 10000, Zagreb,Croatia
| | - Nichola J Coleman
- 2Faculty of Engineering and Science,University of Greenwich,Maritime, Gillingham, Chatham ME4 4TB, Central Ave, Gillingham, Chatham ME4,UK
| | - Ian J Slipper
- 2Faculty of Engineering and Science,University of Greenwich,Maritime, Gillingham, Chatham ME4 4TB, Central Ave, Gillingham, Chatham ME4,UK
| | - Mitko Mladenov
- 3Faculty of Natural Sciences and Mathematics,University "Ss Cyril and Methodius" Skopje,Arhimedova, 1000 Skopje,Republic of Macedonia
| | - Elizabeta Gjorgievska
- 4Faculty of Dentistry,University "Ss Cyril and Methodius" Skopje,Vodnjanska 17, 1000 Skopje,Republic of Macedonia
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Assessment of Temperature Rise and Time of Alveolar Ridge Splitting by Means of Er:YAG Laser, Piezosurgery, and Surgical Saw: An Ex Vivo Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:9654975. [PMID: 27957502 PMCID: PMC5121450 DOI: 10.1155/2016/9654975] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 06/06/2016] [Accepted: 10/13/2016] [Indexed: 11/18/2022]
Abstract
The most common adverse effect after bone cutting is a thermal damage. The aim of our study was to evaluate the bone temperature rise during an alveolar ridge splitting, rating the time needed to perform this procedure and the time to raise the temperature of a bone by 10°C, as well as to evaluate the bone carbonization occurrence. The research included 60 mandibles (n = 60) of adult pigs, divided into 4 groups (n = 15). Two vertical and one horizontal cut have been done in an alveolar ridge using Er:YAG laser with set power of 200 mJ (G1), 400 mJ (G2), piezosurgery unit (G3), and a saw (G4). The temperature was measured by K-type thermocouple. The highest temperature gradient was noted for piezosurgery on the buccal and lingual side of mandible. The temperature rises on the bone surface along with the increase of laser power. The lower time needed to perform ridge splitting was measured for a saw, piezosurgery, and Er:YAG laser with power of 400 mJ and 200 mJ, respectively. The temperature rise measured on the bone over 10°C and bone carbonization occurrence was not reported in all study groups. Piezosurgery, Er:YAG laser (200 mJ and 400 mJ), and surgical saw are useful and safe tools in ridge splitting surgery.
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Lambert LJ, Challa AK, Niu A, Zhou L, Tucholski J, Johnson MS, Nagy TR, Eberhardt AW, Estep PN, Kesterson RA, Grams JM. Increased trabecular bone and improved biomechanics in an osteocalcin-null rat model created by CRISPR/Cas9 technology. Dis Model Mech 2016; 9:1169-1179. [PMID: 27483347 PMCID: PMC5087831 DOI: 10.1242/dmm.025247] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 07/19/2016] [Indexed: 11/20/2022] Open
Abstract
Osteocalcin, also known as bone γ-carboxyglutamate protein (Bglap), is expressed by osteoblasts and is commonly used as a clinical marker of bone turnover. A mouse model of osteocalcin deficiency has implicated osteocalcin as a mediator of changes to the skeleton, endocrine system, reproductive organs and central nervous system. However, differences between mouse and human osteocalcin at both the genome and protein levels have challenged the validity of extrapolating findings from the osteocalcin-deficient mouse model to human disease. The rat osteocalcin (Bglap) gene locus shares greater synteny with that of humans. To further examine the role of osteocalcin in disease, we created a rat model with complete loss of osteocalcin using the CRISPR/Cas9 system. Rat osteocalcin was modified by injection of CRISPR/Cas9 mRNA into the pronuclei of fertilized single cell Sprague-Dawley embryos, and animals were bred to homozygosity and compound heterozygosity for the mutant alleles. Dual-energy X-ray absorptiometry (DXA), glucose tolerance testing (GTT), insulin tolerance testing (ITT), microcomputed tomography (µCT), and a three-point break biomechanical assay were performed on the excised femurs at 5 months of age. Complete loss of osteocalcin resulted in bones with significantly increased trabecular thickness, density and volume. Cortical bone volume and density were not increased in null animals. The bones had improved functional quality as evidenced by an increase in failure load during the biomechanical stress assay. Differences in glucose homeostasis were observed between groups, but there were no differences in body weight or composition. This rat model of complete loss of osteocalcin provides a platform for further understanding the role of osteocalcin in disease, and it is a novel model of increased bone formation with potential utility in osteoporosis and osteoarthritis research. Summary: A complete null of osteocalcin, generated by the CRISPR/Cas9 system, results in an increase in trabecular bone, increased bone strength and altered glucose homeostasis in Sprague-Dawley rats.
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Affiliation(s)
- Laura J Lambert
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Anil K Challa
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Aidi Niu
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Lihua Zhou
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Janusz Tucholski
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Maria S Johnson
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Tim R Nagy
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Alan W Eberhardt
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Patrick N Estep
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Robert A Kesterson
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jayleen M Grams
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA Department of Surgery, Birmingham VA Medical Center, Birmingham, AL 35233, USA
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de Vicente J, Peña I, Braña P, Hernández-Vallejo G. The use of piezoelectric surgery to lateralize the inferior alveolar nerve with simultaneous implant placement and immediate buccal cortical bone repositioning: a prospective clinical study. Int J Oral Maxillofac Surg 2016; 45:851-7. [DOI: 10.1016/j.ijom.2016.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/20/2015] [Accepted: 01/28/2016] [Indexed: 10/22/2022]
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Dos Santos PL, de Molon RS, Queiroz TP, Okamoto R, de Souza Faloni AP, Gulinelli JL, Luvizuto ER, Garcia IR. Evaluation of bone substitutes for treatment of peri-implant bone defects: biomechanical, histological, and immunohistochemical analyses in the rabbit tibia. J Periodontal Implant Sci 2016; 46:176-96. [PMID: 27382506 PMCID: PMC4928206 DOI: 10.5051/jpis.2016.46.3.176] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/28/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose We sought to evaluate the effectiveness of bone substitutes in circumferential peri-implant defects created in the rabbit tibia. Methods Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant (4.1 mm × 8.5 mm) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss® (BI), and Bio-Oss® Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated. Results For biomechanics, BC showed a better biological response (61.00±15.28 Ncm) than CO (31.60±14.38 Ncm) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group. Conclusions Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.
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Affiliation(s)
- Pâmela Letícia Dos Santos
- Department of Oral and Maxillofacial Surgery and Implantology, Sagrado Coracao University - USC, Bauru, SP, Brazil
| | - Rafael Scaf de Molon
- Department of Diagnosis and Surgery, Sao Paulo State University - UNESP School of Dentistry at Araraquara, Araraquara, SP, Brazil
| | - Thallita Pereira Queiroz
- Department of Health Sciences, Implantology Post Graduation Course, University Center of Araraquara - UNIARA Dental School, SP, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| | - Ana Paula de Souza Faloni
- Department of Health Sciences, Implantology Post Graduation Course, University Center of Araraquara - UNIARA Dental School, SP, Brazil
| | - Jéssica Lemos Gulinelli
- Department of Oral and Maxillofacial Surgery and Implantology, Sagrado Coracao University - USC, Bauru, SP, Brazil
| | - Eloá Rodrigues Luvizuto
- Department of Surgery and Integrated Clinic, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
| | - Idelmo Rangel Garcia
- Department of Surgery and Integrated Clinic, Sao Paulo State University - UNESP School of Dentistry at Araçatuba, Araçatuba, SP, Brazil
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Tezuka R, Tanaka A. Jawbone Changes in Sodium Zoledronic Acid- and Dexamethasone-Treated Rats. J HARD TISSUE BIOL 2016. [DOI: 10.2485/jhtb.25.383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rina Tezuka
- Course of Clinical Science, Field of Oral and Maxillofacial Surgery and Systemic Medicine, Oral and Maxillofacial Surgery, Graduate School of Life Dentistry at Niigata, The Nippon Dental University
| | - Akira Tanaka
- Course of Clinical Science, Field of Oral and Maxillofacial Surgery and Systemic Medicine, Oral and Maxillofacial Surgery, Graduate School of Life Dentistry at Niigata, The Nippon Dental University
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Niigata, The Nippon Dental University
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Esteves JC, de Souza Faloni AP, Macedo PD, Nakata PB, Chierici Marcantonio RA, Intini G, Marcantonio E. Effects on Bone Repair of Osteotomy With Drills or With Erbium, Chromium: Yttrium-Scandium-Gallium-Garnet Laser: Histomorphometric and Immunohistochemical Study. J Periodontol 2015; 87:452-60. [PMID: 26693695 DOI: 10.1902/jop.2015.150406] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser has been widely used in the dental clinic; however, few studies have demonstrated the advantages of the use of this laser for bone osteotomies. The purpose of this study is to evaluate and compare the bone repair process of defects generated by the Er,Cr:YSGG laser or conventional drills. METHODS Ninety-six rats were divided into two groups of 48 animals (drill group and laser group). After surgical exposure of the right tibia, the animals were subjected to a 2-mm-diameter osteotomy created by conventional drills (drill group) or by the Er,Cr:YSGG laser (laser group). The animals were sacrificed 0, 3, 7, 14, 30, and 60 days after the creation of the defect, and histologic sections were obtained and used for histomorphometric and immunohistochemical analyses for the detection of osteocalcin, osteoprotegerin, receptor activator of nuclear factor κ-B ligand, vascular endothelial growth factor, and caspase-3. RESULTS The osteotomy with the drill produced well-delimited and smooth walls, whereas the osteotomies in the laser group were irregular and presented an amorphous basophilic line and bone necrosis that was slowly resorbed during the repair process. Despite these characteristics, bone repair was similar between groups at various time points, and, at 60 days, the defects in both groups were completely repaired by newly formed bone. CONCLUSION The repair process of osteotomies created by the Er,Cr:YSGG laser, despite producing thermal damage to bone tissue, is comparable to that with conventional drills.
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Affiliation(s)
- Jônatas Caldeira Esteves
- Department of Dental Clinic, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Paula de Souza Faloni
- Department of Health Sciences, Implantology Postgraduation Course, University Center of Araraquara (UNIARA), Araraquara, São Paulo, Brazil
| | - Paula Delello Macedo
- Department of Diagnosis and Surgery, Division of Periodontology, Araraquara Dental School, Univ Estadual Paulista (UNESP), Araraquara, São Paulo, Brazil
| | - Patrícia Borges Nakata
- Department of Diagnosis and Surgery, Division of Periodontology, Araraquara Dental School, Univ Estadual Paulista (UNESP), Araraquara, São Paulo, Brazil
| | - Rosemary Adriana Chierici Marcantonio
- Department of Diagnosis and Surgery, Division of Periodontology, Araraquara Dental School, Univ Estadual Paulista (UNESP), Araraquara, São Paulo, Brazil
| | - Giuseppe Intini
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, MA.,Harvard Stem Cell Institute, Cambridge, MA
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, Division of Periodontology, Araraquara Dental School, Univ Estadual Paulista (UNESP), Araraquara, São Paulo, Brazil
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Abstract
Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies.
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Affiliation(s)
- Stefan Stübinger
- Hightech Research Center of Cranio-maxillofacial Surgery, University of Basel, Allschwil, Switzerland
| | | | - Britt-Isabelle Berg
- Department of Cranio-maxillofacial Surgery, University Hospital Basel, Basel, Switzerland ; Division of Oral and Maxillofacial Radiology, Columbia University Medical Center, New York, NY, USA
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Morphological characteristics of osteotomies using different piezosurgical devices. A scanning electron microscopic evaluation. IMPLANT DENT 2015; 23:334-42. [PMID: 24819806 DOI: 10.1097/id.0000000000000077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of this study was to compare morphological characteristics of osteotomies performed by 6 Piezosurgical devices. MATERIALS AND METHODS The 6 Piezosurgical units were: (a) Piezotom, (b) SurgySonic, (c) Piezon Master Surgery, (d) VarioSurg, (e) Surgybone, and (f) Piezosurgery 3. Osteotomies on 9 freshly slaughtered cattle ribs (2 cuts by each unit, per rib) from the cortical (first cut at 5 mm) to the cancellous (second cut at 3 mm) bone layer were performed. The osteotomy margins were compared using scanning electron microscopy analysis. The cutting areas, osteotomy bottoms, and osteotomy margins were analyzed morphologically. Statistical evaluation of the 2 cuts regarding the design of the tips (a-d: tapered tool shanks, f: parallel tool shank) was performed by an unpaired t test. RESULTS Morphological characteristics were different for each Piezosurgical unit and each examined area. A significant difference (P = 0.0209) of the upper width of the first cut between tapered and parallel tips was shown. CONCLUSIONS The morphological characteristics of the produced Piezosurgical osteotomies vary and depend on the Piezosurgical unit and tip.
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Peker Tekdal G, Bostanci N, Belibasakis GN, Gürkan A. The effect of piezoelectric surgery implant osteotomy on radiological and molecular parameters of peri-implant crestal bone loss: a randomized, controlled, split-mouth trial. Clin Oral Implants Res 2015; 27:535-44. [PMID: 26077862 DOI: 10.1111/clr.12620] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2015] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the effect of piezoelectric surgery (PS) implant osteotomy on biochemical and radiological parameters of crestal bone (CB) loss. MATERIAL AND METHODS In this randomized, controlled, clinical study, 38 osteotomies were prepared with PS and drilling in the posterior maxilla in a split-mouth design. Implants were placed and left for non-submerged healing. Osteotomy time, insertion torque, pain perception, probing depth, and modified gingival and plaque indices were recorded. Peri-implant sulcular fluid (PISF) was collected from four sites of each implant at 2, 4, 8, 12, and 24 weeks. PISF samples were analyzed by ELISA for receptor activator of nuclear factor kappa-B-ligand (RANKL) and osteoprotegerin. CB loss was assessed on periapical radiographs at the 12th and on cone beam computed tomography (CBCT) at the 24th weeks. The influence of time and osteotomy method on biochemical and radiological parameters of CB loss employed statistical method of Brunner-Langer. RESULTS Osteotomy time for PS group was significantly longer than the drill group (P < 0.05). Pain perception that was lower in the PS than in the drill group depended on osteotomy method (P < 0.05). PS group had lower RANKL total amount than the drill group (P < 0.05). Mean CB loss on periapical radiographs at the 12th week for PS and drill groups were 0.11 and 0.18 mm, respectively (P > 0.05). At the 24th week, PS and drill groups showed 0.11 and 0.12 mm CB losses on CBCT, respectively (P > 0.05). However, CB loss values did not depend on osteotomy modality (P > 0.05). CONCLUSION PS may modify and reduce bone-destructive inflammatory response during implant osseointegration. Therefore, on the molecular level, it might be a less traumatic osteotomy modality than drilling although this was not reflected by CB loss values in the present study.
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Affiliation(s)
- Gözde Peker Tekdal
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Nagihan Bostanci
- Section of Oral Microbiology and Immunology, Institute of Oral Biology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Georgios N Belibasakis
- Section of Oral Microbiology and Immunology, Institute of Oral Biology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ali Gürkan
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
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