Review of the Long-Term Outcomes of Guided Bone Regeneration and Autologous Bone Block Augmentation for Vertical Dental Restoration of Dental Implants

Vertical bone resorption is a frequent consequence of tooth loss. Hence, implant-supported restorations imply, first of all, bone reconstruction. We aimed to review the current status of guided bone regeneration and autologous bone block augmentation for vertical dental restoration of dental implants. This review identified that between 2009 and 2022 there were few clinical studies that included more than 10 patients and a follow-up period of more than 5 years after bone restoration. The highest vertical bone gain was reported in the autologous bone grafting technique (4–7.6 mm), whereas the minimum augmentation was reported for one of the guided bone regeneration techniques. When comparing intraoral to extraoral bone blocks, the highest values for the mean vertical bone gains were obtained in the cases in which intraoral bone blocks were used as graft material. The highest rate of bone resorption was observed in the extraoral bone block group. Implant survival rate was not significantly influenced by surgical technique. Complications had a higher incidence in autologous bone block augmentation studies. Soft tissue recession showed similar results for guided bone regeneration as for autologous bone block augmentation. Vertical ridge augmentation is a predictable option for the reconstruction of alveolar ridges with severe atrophy, but complications can appear.

Clinical-pathological correlations in Warthin tumors of parotid gland: a series of 10 cases

Warthin tumor is described using various terms, such as papillary cystadenoma lymphomatosum, adenolymphoma or monomorphic adenoma. It is a medical condition related to the salivary glands, namely a benign cystic tumor which contains an epithelial component and an abundant lymphoid stroma. It is also named Warthin tumor after Aldred Scott Warthin, the pathologist who described this entity in 1929 by observing it in two patients. Warthin tumor is a benign one and ranks secondly in terms of the most common not malignant salivary gland tumor located in the parotid gland. Because of its cystic nature, from the clinical point of view, it appears to be a slow-growing tumor often fluctuant on palpation. In terms of the treatment of choice, complete excision with wide tumor-free margins is preferred. The aim of the present article is to evaluate possible correlations between clinical-pathological features and postoperative complications in a target group made up of 10 patients diagnosed with Warthin tumor of the parotid gland admitted for surgery in a period of 21 years and to compare the results with literature.

Clinical, imaging and histopathological correlations of gingival overgrowth: a retrospective analysis in northeastern Romanian population

BACKGROUND

Gingival overgrowth refers to an increase in the size of the gingival tissue. The etiology varies, and is often a multi-factor issue; what may contribute to gingival enlargement are aspects, such as disease, local and systemic conditions and idiopathic factors. The aim of the present study is to analyze and to correlate the clinical, epidemiological, imaging and histopathological (HP) features of gingival overgrowth in northeastern Romanian population.

PATIENTS, MATERIALS AND METHODS

We conducted a clinical, imaging, and pathological study on 98 patients with gingival overgrowth, who underwent a surgical intervention for a gingival biopsy in the Office of Oral and Maxillofacial Surgery, "Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital, Iaşi, Romania, during a 14-month period (January 1, 2018 to February 28, 2019). All patients with localized gingival overgrowth had clinical and imaging investigations done and then were referred to an oral and maxillofacial facility. A surgeon performed the excision of the gingival overgrowth and then sent the surgical specimens to the Laboratory of Pathology for HP examination.

RESULTS

Local inflammation was found responsible for the gingival overgrowth in most of the cases, with the number of females outnumbering that of the males. A very good correlation was found between clinical and HP diagnosis when epithelial hyperplasia, peripheral giant cell granuloma and pyogenic granuloma were involved and a moderate one when fibrous hyperplasia was involved.

CONCLUSIONS

These findings suggest that the occurrence of gingival overgrowth can have many causes, which highlights the importance of clinical pathology in assisting practitioners with making a better diagnosis.

Maxillary sinus anatomic and pathologic CT findings in edentulous patients scheduled for sinus augmentation

OBJECTIVES

An aberrant sinus anatomy or pathology can influence the sinus lift technique if it is encountered during surgical exposure. The purpose of the present study was to determine the prevalence of sinus disease and variations of normal anatomy among edentulous patients prior to sinus augmentation.

MATERIAL AND METHODS

120 patients attending a private surgical practice (53 women and 67 men, with a mean age of 62.02 years, ranging between 34 and 81 years old) for whom treatment was planned for sinus augmentation were evaluated--medical history, radiographic and clinical examinations. Computerized tomograms (CT) and 3D reconstructions from 240 sinuses were analyzed using Dental CT.

RESULTS

Abnormalities were diagnosed in 74.2% of cases. Mucosal thickening was the most prevalent abnormality (68.3%), followed by retention cysts (15.8%) and opacification (9.2%). The diagnosed conditions included mucosal thickening, chronic sinusitis, sinus cysts and polyps. The prevalence of one or more septa per sinus was found to be 30%. Males present pathology more often than females (p=.028). No statistical correlation could be found between age and pathology (p>0.05) No significant differences in age or gender between patients with and without sinus septum were found (p>0.05).

CONCLUSIONS

The results reinforce the importance of thorough history taking and clinical and radiographic assessment prior to performing sinus augmentation, to prevent the probability of complications.

A software tool used in 3D evaluation of the alveolar bone defect in bilateral cleft lip and palate patients

Evaluation of the cleft size and the assessment of an estimative volume required for bone grafting provide useful information to the surgeon performing secondary alveolar bone grafting.

AIM

To use a software tool to evaluate the estimative volume of the bone defect in the alveolar cleft area, based on cone beam computed tomography (CBCT) data.

MATERIAL AND METHODS

Three patients with bilateral cleft lip and palate (BCLP) were randomly selected in the order of referral to treatment at "Saint Mary" Emergency Hospital for Children. CBCT examinations were performed prior to secondary alveolar bone grafting procedure. The preoperative estimative volume (PEV) of the alveolar bone defect was evaluated by three observers with different areas of expertise (a dentomaxillofacial radiologist, a maxillofacial surgeon, and a Ph.D. radiology student), using Romexis 3.0.1 software program. The inter-observer fidelity was assessed using the Interclass Correlation Coefficient (ICC), with an optimal value of 0.837 for all observers.

RESULTS

The mean PEV for all BCLP patients was 1.84 +/- 0.16 cm3.

CONCLUSIONS

The results suggest that measuring the preoperative estimative volume of the alveolar bone defect in CLP patients using Romexis 3.0.1 software program, with CBCT scan data is beneficial. A proper protocol should be established, in order to provide useful information for the surgeon performing the secondary alveolar bone grafting.

Clinical--imaging aspects of young permanent teeth traumas and the ethiopatogenic mechanisms involved

Dental trauma occurring to children and teenagers all over the world represents a serious issue in Public Health.

AIM

This present study wants to investigate the etiology and the environment in which the dental trauma occurs and also wants to establish a connection between dental trauma and social-economic status.

MATERIAL AND METHODS

The study was made to collect information about dental trauma on human subjects involving 372 children and teenagers, both female and male, between 8 and 20 years of age. The data obtained from the clinical and radiological exams for each patient have been registered in a special conceived register, which represented a stage of the study.

RESULTS

The frequency of dental trauma varied from 62.1% for males to 37.9% for women. Most of them have suffered from dental trauma between the age of 14 and 16 (30.1%), and a few between 18 and 20 years (2.2%). Dental trauma has occurred most frequently in school, during sports lessons, followed by those in public places like the street (23.1%), from which 17.1% have been associated with bicycle accidents, 3.5% with scooter accidents and 2.5% with car accidents. Children and teenagers who live in areas with a low social economic level have been the fewest to seek medical attention due to difficult access to medical services.

CONCLUSIONS

Overall, this study wanted to present the importance of knowing the frequency of dental trauma in children and teenagers and to point out the need of promoting medical education to parents regarding the means they can use to reduce the risk factors associated with dental trauma.

Evaluation of serum and gingival crevicular fluid C-reactive protein and IL-6 levels in patients with periodontitis and transient ischemic attacks

BACKGROUND

Recent advances have suggested that periodontitis (PD), the paradigm of chronic infection in dental pathology, shares several pathogenic pathways with cardio- and cerebro-vascular disorders (CVD), based on inflammatory mediators including IL-1, IL-6, TNF-α.

AIM

To assess pro-inflammatory biomarkers (C-reactive protein - CRP, IL-6) in serum and gingival crevicular fluid (GCF) in patients with PD and with transient ischemic attacks (TIAs).

MATERIALS AND METHODS

Prospective observational study on 143 patients classified as follows: 40 healthy subjects (group A), 50 PD patients (group B) and 53 PD-TIAs patients (group C). The predefined assessment protocol has included: current medical data, risk factors for CRP changes, periodontal status (clinical, orthopantomography, Schei Ruler technique), inflammatory biomarkers (CRP, IL-6).

RESULTS

High serum CRP and IL-6 have been reported in both TIAs and PD, while statistically significant increase in GCF CRP only in PD-TIAs (p<0.05). Moreover, both generalized and localized chronic PD may be at higher risk for CVD, since CRP level was higher in these subgroups. However, no significant differences were reported in serum IL-6 between generalized and localized PD. A score function was demonstrated, including bone loss degree, bleeding index, collection site depth, serum and GCF IL-6 and CRP, tooth loss, allowing the classification of PD based on risk for developing TIAs.

CONCLUSIONS

CRP and IL-6 are commonly involved in the pathways of PD and TIAs. Interdisciplinary assessment should be promoted in order to implement the stratification of PD patients according to the risk for TIAs as suggested by the proposed algorithm.