The aim of this study was to compare the bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation.Forty patients requiring tooth extraction in anterior maxilla were randomly allocated to the four following treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM) and Plasma Rich in Growth Factors alone (PRGF). Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, the newly formed non-mineralized tissue, and the residual bone grafting material (if applicable). Statistical analysis was performed for descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4±15.2% vs 75.5±16.3%), control/(BBM/CM) (46.4±15.2% vs 20.3±21.9%), control/(FDBA/CM) (46.4±15.2% vs 7.2±8.6), PRGF/(BBM/CM) (75.5±16.3 vs 20.3±21.9%), and PRGF/(FDBA/CM) (75.5±16.3 vs 7.2±8.6) groups. The new mineralized tissue formation was in the following order: PRGF > control > BBM>FDBA. Alveolar ridge preservation in aesthetic zone with PRGF has been the most effective in bone regeneration of the alveolar ridge.
Objectives To evaluate alveolar ridge dimensional changes of different alveolar ridge preservation techniques after 3 months of tooth extraction and to compare the efficacy of autologous plasma rich in growth factor (PRGF) to the bone substitutes in alveolar ridge preservation and sites left to heal spontaneously. Materials and Methods Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the four following treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze‐dried bone allograft covered with resorbable native collagen membrane (FDBA/CM) and PRGF alone. Cone beam computed tomography (CBCT) scans were taken after surgery and 3 months later. The measurements of height and width (at 1, 3, and 5 mm below the crest) were performed after superimposing the 2 consecutive CBCT scans. Results The greatest horizontal alveolar bone resorption at 1 mm below bone crest was observed in the control group (−1.61 ± 1.76 mm, P = .037), whereas the least reduction in width was found in the BBM/CM group (−0.68 ± 0.67 mm, P = .037). The most pronounced alveolar height reduction was observed in the control group (−0.86 ± 0.43 mm), whereas alveolar ridge preservation with BBMC/CM (−0.26 ± 0.91 mm) and PRGF (−0.54 ± 0.86 mm) successfully reduced the alveolar height reduction as compared to the control group. Conclusions Alveolar ridge preservation technique in the esthetic zone using BBM/CM or using PRGF is beneficial to reduce horizontal and vertical bone changes.
Objectives To review and assess the efficiency of different post extraction socket preservation techniques. Material and Methods An electronic literature search was performed on the MEDLINE and Embase databases. The review included human studies published between from January 1 st , 2007 to January 1 st , 2018, in English. Outcome measures included dimensional changes and/or histological evaluation of alveolar bone. Results Twenty-six full text articles were reviewed, 16 of which met the inclusion criteria and were selected for the study. Autogenous tooth graft prevented vertical resorption the most: -0.28 (SD 0.13) mm, observation period (OP): 4 months, while the least effective approach was beta tri-calcium phosphate (β-TCP): -1.72 (SD 0.56) mm, OP: 4 months. Estimating horizontal resorption, the most effective technique was biphasic calcium sulphate (BCS) with β-TCP and hydroxyapatite (HA) - BCS + TCP + HA: 0.03 (SD 2.32) mm, OP: 4 months, while β-TCP was the least efficient: -1.45 (SD 0.4) mm, OP: 4 months. Evaluating residual graft particles (RG) and newly formed bone (NFB) ratio the best results were achieved with demineralized freeze-dried bone allograft: RG: 8.88%, NFB: 38.42%, OP: 5 months, whereas magnesium-enriched hydroxyapatite was least effective: RG: 40.82%, NFB: 31.85%, OP: 4 months. Conclusions This review revealed that even though there are numerous types of biomaterials for socket preservation none of them can completely stop alveolar bone loss after tooth extraction. Furthermore, lack of information about qualitative evaluation of bone was noticed indicating that further studies regarding this topic are needed.
Trigeminal neuralgia (TN) is a rare neuropathic disorder with an excruciating facial pain. The unpredictable pain attacks may result in anxiety and depression. The aim of this study was to determine and to evaluate the level of chronic facial pain and its association with the appearance of anxiety and depression. Materials and Methods. A total of 30 patients with TN and chronic facial pain (group A, 25 women and 5 men; mean age, 64.2±3.2 years) and 30 with atypical facial pain (group B, 26 women and 4 men; mean age, 64.8±1.9 years) were examined. A standardized diagnostic protocol was applied to all of them, which consisted of the following: 1) demographic data and estimation of overall pain on a visual analog scale; and 2) evaluation of emotional status using the Sheehan Disability Scale, Covi’s Anxiety Scale, and Beck Depression Inventory. Results. The intensity of facial pain was much higher in the group A than the group B (89.7±2.5 versus 44.0±2.9, P<0.0001). Besides, the group A reported increased scores on the disability and anxiety symptom scales (17.4±1.3 and 9.7±0.3 vs. 6.4±0.7 and 3.6±0.1, respectively, P<0.0001). Severe (46.7%) or moderate (30%) levels of depression were documented in the majority of patients in the group A, while the group B did not show depressive symptoms (P<0.0001). Conclusions. Patients with TN and chronic facial pain had a significantly higher level of pain perception, and they presented the higher level for anxiety and depression than those with atypical facial pain. A multidisciplinary approach is needed for the additional assessment of emotional status of patients in order to improve the efficacy of treatment and patients’ quality of life.
Periodontal pathologies are highly widespread throughout the world. Epidemiological studies have shown that as much as 1% of the population is suffering from periodontal disease. In recent years, there has been a growing number of studies linking these diseases with autoimmune diseases, especially with rheumatoid arthritis. This literature review evaluates changes in the relationship between periodontal pathologies caused by the bacterium Porphyromonas gingivalis and rheumatoid arthritis. The systematic review of the literature was performed according to the PRISMA analysis protocol. The review was performed with articles from the PubMed database. Searched articles were not older than 5 years. Only full texts and research performed with people were selected. A total of 56 results were received. A review and analysis of their full texts have been carried out and 10 articles were selected according to the established criteria. They were analyzed and results were presented. The results obtained from the literature were based on the influence of Porphyromonas gingivalis on the pathogenesis of rheumatoid arthritis. In the literature, the activity of this bacterium is explained by the analysis of its enzyme peptidylarginine deiminase and its principle of action. Studies have also been found to prove the presence of Porphyromonas gingivalis not only in the oral cavity but its DNA is also found in synovial fluid and plasma. In the researched articles, direct links between Porphyromonas gingivalis and rheumatoid arthritis have led doctors to draw attention to patients' oral hygiene and the condition of parodentium, as this may be the cause of autoimmune lesions. Treatment of periodontal disease will not only help maintain a healthy oral cavity but prevent the spread of bacteria to the surrounding tissues.
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