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The purpose of this systematic review was to perform a comparative analysis of the use or not of graft material in maxillary sinus lift surgery. Relevant studies published in the last 10 years were identified through a search of the PubMed/MEDLINE, ScienceDirect, and Cochrane Library databases and were assessed against the study inclusion and exclusion criteria. The initial search resulted in 1037 articles. After applying the inclusion and exclusion criteria, 16 articles remained. Four hundred and thirty-six patients were followed up over a postoperative period ranging from 6 months to 11 years. In total, 868 implants were installed in 397 maxillary sinuses. The implant survival rate was 96.00% for surgeries performed without graft material and 99.60% for those in which biomaterial was used, within a follow-up period of 48 to 60 months. In conclusion, maxillary sinus lift surgery, with or without graft material, is a safe procedure with a low complication rate and predictable results.

IntroductionOsteonecrosis of the jaws associated with the use of bisphosphonates is one of the most serious complications of long-term therapy with bisphosphonates associated to oral surgical procedures, such as dental implants placement.1 Osteonecrosis is defined as bone exposure in the maxillofacial region that does not heal within 8 weeks after its identification. It is associated with the use of an antiresorptive agent (bisphosphonate or denosumab), without history of radiation therapy for the craniofacial region.2 The treatment of this condition is extremely difficult. Currently, antibiotic therapy, minimally invasive surgery, and lower-level laser therapy (LLLT) during the early stages have been considered the gold standard for medication-related osteonecrosis of the jaw (MRONJ). Case PresentationA 65-year-old female patient was referred to the oral and maxillofacial surgery team from Araçatuba Dental School 2 months after a dental implant installation, complaining about its mobility. During anamnesis, hypertension and diabetes were reported, both controlled by daily medication, and use of alendronate (70 mg/d for 5 years) for prevention of osteoporosis. The clinical examination showed an accentuated mobility of the dental implant in the region of tooth 16, bone exposure in the periimplant region with vestibular and palatal extensions, purulent secretion and bad odor, and absence of remission of signs and symptoms ( Figure 1A). After careful evaluation of the medical history and clinical examination, stage 2 MRONJ was diagnosed, characterized by the presence of exposure and necrotic bone associated with symptomatic infection and purulent discharge. The treatment proposed for this case was the implant removal ( Figure 1B), followed by the initiation of 3 sessions per week of LLLT in the area of necrosis over 8 weeks, associated with administration of clindamycin (300 mg every 8 houes) and regular mouthwash with chlorhexidine 0.12% for the same period. An InGaAlP laser was used (Photon lase, DMC; wavelength 810 nm, power 100 mW, frequency 50/60 Hz, and power density 0.3-0.5 W/cm²). The "alveolitis" program was used, corresponding to 50 J/cm² and applied at 3 points of the lesion (distobuccal, mesiobuccal, and palatal), 1-2 mm from the tissue, 3 times in each spot for Case Report This study aimed to report a case of medication related osteonecrosis of the jaw (MRONJ) of a 65-year-old female patient referred to the Oral and Maxillofacial Surgery team from Araçatuba Dental School, complaining about mobility of a previously dental implant placed on the posterior maxillary region. Clinical examination revealed an extensive necrosis area around the implant region. The patient reported bisphosphonate therapy with sodium alendronate for prevention of osteoporosis 5 years ago. A diagnosis of MRONJ was reached and the treatment decided was to remove the dental implant damaged and use the lower-level laser therapy (LLLT) associated with antibiotic therapy with clindamycin 300 mg and mouth rinses with chlorhexidine 0.1...

ResumoA remoção dos terceiros molares inferiores é um procedimento frequente nas clínicas e consultórios odontológicos. Para remoção destes elementos o profissional deve conhecer os possíveis acidentes ou complicações. A fratura mandibular durante ou após este procedimento é uma complicação que pode ser evitada com o auxílio de exames de imagens adequados e técnica cirúrgica bem executada. Os procedimentos cirúrgicos realizados para remoção destes dentes muitas vezes requerem osteotomias e odontosecção com brocas cirúrgicas e o uso de alavancas, sendo que o mal uso de ambas, associado ao padrão de inclusão geram fragilidade do osso mandibular aumentando a possibilidade de fratura no trans ou pós-operatório. O objetivo deste trabalho foi revisar a literatura sobre os aspectos clínicos e tratamentos realizados para restauração das fraturas mandibulares durante ou após a remoção dos terceiros molares inferiores. Concluímos que a fratura mandibular durante ou após a extração dos terceiros molares inferiores, embora rara, é uma complicação complexa que pode ocorrer durante a aplicação de forças excessivas para remoção do elemento dental ou no pós-operatório durante a mastigação, principalmente nas três primeiras semanas. Descritores: Cirurgia Bucal; Fraturas Mandibulares; Terapêutica. AbstractThe removal of third molars is a common procedure in clinics and dental offices. For removal of these elements the surgeon must know the possible accidents or complications. The mandibular fracture during or after this procedure is a complication which should be avoided with the aid of appropriate imaging and surgical technique performed well. The surgical procedures performed to remove these teeth often require osteotomies and odontosection with surgical drills and the use of levers. However, the misuse of both, associated with the inclusion pattern, generate fragility of the mandibular bone increasing the possibility of fracture in the trans or post -operation. The aim of this study was to review the literature on the clinical aspects and treatment provided for restoration of mandibular fractures during or after removal of third molars. We conclude that the mandibular fracture during or after extraction of lower third molars, although rare, is a complex complication that can occur during the application of excessive force to remove the dental element or postoperatively during mastication, especially the first three weeks. Descriptors: Surgery, Oral; Mandibular Fractures; Therapeutics. ResumenLa extracción de los terceros molares es un procedimiento común en las clínicas y consultorios dentales. Para la eliminación de estos elementos técnicos deben conocer los posibles accidentes o complicaciones. La fractura mandibular durante o después de este procedimiento es una complicación que debe evitarse con la ayuda de formación de imágenes adecuadas y técnica quirúrgica realizada también. Los procedimientos quirúrgicos para la eliminación de estos dientes a menudo requieren osteotomías y odontosección con fresas quirúrgicas y el uso ...

It was concluded that the treatment with rhBMP-2 foi satisfactory in most cases and the placement of dental implants in the bone regenerated with rhBMP-2 is feasible.

Objective. To evaluate the effect of chemically modified tetracycline-3 (CMT-3) and simvastatin on tooth relapse after orthodontic movement in rats using a novel analysis method employing high-resolution micro-CT (Micro-CT) images. In addition, the correlation between bone density and orthodontic relapse was also evaluated for each experimental group. Methods. Forty adult male Wistar rats had stainless steel springs installed on their left upper first molars in order to generate tooth movement for 18 days. After this initial period, the animals were divided into three groups: (1) 30 mg/kg of CMT-3; (2) 5 mg/kg of simvastatin; and (3) 0.5% carboxymethylcellulose, and each group was treated for 20 days. Micro-CT images were analyzed (conventional method and 3D reconstruction) on the 7th and 18th days following spring fixation and finally, 20 days after treatment either with CMT-3 or simvastatin (38th day). Bone mineral density (BMD) of the mesial and distal roots of the upper first molar was also analyzed. Results. The difference was statistically significant between the groups as to recurrence (p=0.048), and the post hoc test identified the value of p=0.007 between the control group and the CMT-3 group. Simvastatin was not able to inhibit tooth relapse. The bone mineral densities of both the mesial and distal roots were different between the three groups, after the 20th day of drug use (p=0001 and p<0001). Conclusion. Our findings support the initial evidence that CMT-3 is able to prevent relapse after tooth movement. Future trials in humans should evaluate such treatment as a promising approach to preventing this common phenomenon. Clinical Relevance. Considering the results obtained, CMT-3 can be used to avoid relapse after tooth movement.

Administering CSs in orthognathic surgery improved the regression of facial edema independent of the dosage used but did not influence neurosensory disorders.

Our aim was to compare the wound healing of autogenous bone grafts with that of fresh-frozen allogeneic block bone in rabbits. We used 25 animals. One was killed before the experiment to provide the allogeneic bone, and the remainder were killed at four time points (n=6 in each group). On histometrical analysis there was a significant difference between the two groups only at 45days and between 15 and 45days in the intergroup analysis. However, there was significantly more revascularisation (p<0.05), resorption (p<0.05), and bony replacement (p<0.05) in the autogenous group in the immunohistochemical analysis. In later periods, the autogenous bone was replaced by newly-formed bone in all samples, whereas it was always possible to find regions of devitalised bone in the fresh-frozen allogeneic bone grafts. Autogenous grafts were completely replaced whereas, in the fresh- frozen allogeneic grafts, we found acellular tissue that had been incorporated into the receptor bed interface during the later evaluation times.