Implant stability is a principal precondition for the success of implant therapy. Extraoral implants (EO) are mainly used for anchoring of maxillofacial epithesis. However, assessment of implant stability is mostly based on principles derived from oral implants. The aim of this study was to investigate clinical stability of EO craniofacial disk implants (single, double, and triple) by resonance frequency analysis at different stages of the bone's healing. Twenty patients with orbital (11), nasal (5), and auricular (4) defects with 50 EO implants placed for epithesis anchorage were included. Implant stability was measured 3 times; after implant placement, at 3 months and at least after 6 months. A significant increase in implant stability values was noted between all of the measurements, except for triple-disk implants between third and sixth months, and screw implants between 0 and third months. Disk implants showed lower implant stability quotient (ISQ) values compared with screw implants. Triple-disk implants showed better stability compared with single and double-disk implants. Based on resonance frequency analysis values, disk implants could be safely loaded when their ISQ values are 38 (single disks), 47 (double disks), and 48 (triple disks). According to resonance frequency analysis, disk implant stability increased over time, which showed good osseointegration and increasing mineralization. Although EO screw implants showed higher ISQ values than disk implants, disk-type implants can be safely loaded even if lower values of stability are measured.
Introduction. Implantation in irradiated bone is very challenging due to many factors: implant therapy parameters, irradiated tissue, and the patient's general health. Implantologists have to consider all of these aspects when planning implant therapy and during the postsurgical recovery period. Case outline. A case presented in this paper is a 54-year old male, who was admitted to the Clinic for maxillofacial surgery, School of dental medicine in Belgrade, for implant anchored orbital prosthesis. One year previously, the patient had orbital exenteration and postoperatively received radiotherapy with an overall dose of 60 Gy. After planning, three disk implants - two double and one triple disk were placed (Ihde Dental, Switzerland). Implant stability was clinically satisfactory with immediate ISQ of 37, 46, and 51, respectively. After osseointegration implant retained prosthesis was manufactured. After six years due to osteoradionecrosis (ORN) implant stability was compromised. The patient received conservative and hyperbaric chamber treatment. The implants regained stability, and the patient was in remission for four years. Afterwards due to ORN two implants were explanted, and the third implant was stable enough to anchor the prosthesis. The prosthetic plan had to be modified for one implant anchorage, afterwards successful prosthetic rehabilitation was achieved. Conclusion. Implantation in irradiated bone is very delicate, and careful planning of implant insertion and prosthetic rehabilitation is essential. The possible occurrence of osteoradionecrosis should also be taken into account, as a result of which the implant may be lost, which compromises the retention of the prosthesis.
Introduction. It is generally known that dermal fillers are widely used in anti-aging medicine, to provide volume in healthy skin and mucous tissue. Fillers can also be successfully used with concave scars in order to lift the tissue and to give third dimension to the retracted skin surface. The aim of this case report was to show successful non-surgical treatment with hyaluron filler of the post traumatically deformed upper lip. Case outline. We report a case of a woman, with asymmetric partly incompetent upper lip, after trauma and primary surgical reconstruction. After almost 12 years, reconstruction with hyaluron filler was performed, using linear retrograde and bolus technique. Conclusion. Presented case correction of the posttraumatic scar of the upper lip illustrates that good aesthetic results could be achieved with hyaluron fillers.
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