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A comparative study of platelet-rich plasma, hydroxyapatite, demineralized bone matrix and autologous bone to promote bone regeneration after mandibular impacted third molar extraction AbstractObjectives: 1) to compare mandibular bone regeneration by applying autologous bone, platelet-rich plasma and two biomaterials (synthetic calcium hydroxyapatite, and demineralized bone matrix), and thus establish the potential benefits of these biomaterials in the regeneration of postextraction alveolar bone, 2) to identify wich of them accelerates more bone regeneration and 3) to determine whether there are differences in the postoperative period (pain, swelling, trismus, infection) depending on the material used. Study Design: It consists in a prospective, controlled (with a split-mouth design) and double blinded study. We use as a model an easily reproducible non-critical bone defect: the defect that remains after extraction of mandibular impacted third molar. The study design is based on the extraction of two mandibular impacted third molars in a patient during the same surgical procedure by the same surgeon. We assessed postoperative clinical data, and short, medium and long term neoformation of alveolar bone after extraction. We compared the two sockets (right and left), which had been grafted in a different way with the various elements mentioned above. In addition, we compared the postoperative inflammatory symptoms between groups. Results: The highest acceleration in bone formation was observed in groups in which we used autologous bone and demineralized bone matrix. There were no statistically significant differences between groups regarding pain, swelling, trismus and infection throughout the postoperative period. Conclusions: According to the results of our study, autologous bone persists as the gold standard material for bone regeneration. Among the assessed biomaterials, demineralized bone matrix has yielded the best results obtained. No significant differences in the postoperative (pain, swelling, trismus and infectious events) were observed, depending on the type of material used as a graft.

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The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of all facial fractures treated by the Department of Oral and Maxillofacial Surgery in A Coruña University Hospital (Spain) from 2001 to 2008. A descriptive and analytic retrospective study evaluated 643 patients treated for facial fracture (excluding nasal and dento-alveolar) by the Department of Oral and Maxillofacial Surgery in A Coruña University Hospital from January 2001 to December 2008. Five parameters were studied: year of the injury, gender, age, fracture type, and etiology. Six hundred and fortythree patients with 793 fractures were included. Of these, 83.2% were males and 16.8% were females. The patients' age ranged between 18 months and 89 years, with a mean of 37.6 and a median of 33. The major cause of injury was traffic accidents (27%), followed by assaults (20.5%), accidental traumas (20.1%), sports (11%), syncopes (7.8%), rural accidents (6.1%), industrial accidents (5.1%), and suicide attempts (0.3%). In 1.1% of the patients, it was impossible to verify the etiology. The etiology of facial fractures varies from one country to another, depending on the cultural, environmental, and socioeconomic factors. In our study, the most common cause was traffic accidents, closely followed by assaults. The number of fractures due to traffic accidents has decreased in the last 3 years. Rural accidents accounted for a significantly higher percentage of fractures than that observed in other series. The number of fractures receiving a surgical treatment from 2005 to 2008 has progressively decreased.KEYWORDS: Fracture, facial, trauma, maxillofacialThe etiology of facial fractures has been the subject of numerous studies. The etiology of this group of fractures has changed over the years and it is related to several factors such as gender, age, geographic region, and socioeconomic status. This makes both the incidence and the etiology different between countries, and even within the same country. The aim of this study is to assess the incidence, epidemiology, type, and cause of all

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This investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative contribution to the total time, and to assess the impact of the presenting symptom on diagnostic timelines and patient referral routes. A cross-sectional, ambispective study was designed to investigate symptomatic incident cases. The Aarhus statement was used as a conceptual framework. Strategies for minimizing potential recall biases were implemented. A sample of 181 patients was recruited (power: 99.5%; α = 0.05). The patient interval reached 58.2 days (95% CI, 40.3–76.2), which accounted for 74% of the whole prereferral interval and for more than one third of the total time interval. The presenting symptom (trigger for consultation) influenced both the number of primary care consultations and the length of time to diagnosis. General dental practitioners generated longer intervals to diagnosis (p < 0.005) and needed more consultations before referring a patient (RR = 0.76; 95% CI, 0.61–0.93), than general medical practitioners. The current study identifies the patient as the main target for interventions to improve awareness and reinforces the need for increased alertness amongst healthcare professionals about presenting symptoms of oral cancer and to diminish the number of prereferral consultations in order to optimize the primary care interval.

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