Andrei Mihai Gavrilovici, Anca Jivănescu and Meda Lavinia Negruțiu
Introduction. Chronic periodontal diseases and dental caries are the primary reasons for tooth loss in adults, which is further increased in people with diabetes. In most cases of bone loss, the treatment of partial edentulous patients with implant supported restorations impose additional surgical procedures, like sinus lift elevation and bone augmentation, which can complicate the healing process.
Case report. This case report presents a type 2 diabetes female patient with several oral health problems, like periodontal disease, poor decay control, bad oral hygiene, a severe maxillary atrophy and the presence of a large maxillary periapical cyst. After a careful examination, based on clinical and radiographic findings, a comprehensive treatment plan was established. The sequential treatment plan consists in extraction, surgical removal of periapical cyst, bilateral external sinus lift procedures and bone augmentation. The surgical protocol was adapted to the particular health conditions of this type 2 diabetes patient.
Conclusion. Sinus elevation and bone augmentation are predictable procedures often required when restoring the posterior maxilla with dental implants. In case of diabetes patients with bone resorption and defects due to periapical cyst, if the correct protocol is followed, no post-surgical complications and good result in bone augmentation can be attaint.
Cristian Zaharia, Alin-Gabriel Gabor, Andrei Gavrilovici, Adrian Tudor Stan, Laura Idorasi, Cosmin Sinescu and Meda-Lavinia Negruțiu
Three-dimensional (3D) printing is an additive manufacturing method in which a 3D item is formed by laying down successive layers of material. 3D printers are machines that produce representations of objects either planned with a CAD program or scanned with a 3D scanner. Printing is a method for replicating text and pictures, typically with ink on paper. We can print different dental pieces using different methods such as selective laser sintering (SLS), stereolithography, fused deposition modeling, and laminated object manufacturing. The materials are certified for printing individual impression trays, orthodontic models, gingiva mask, and different prosthetic objects. The material can reach a flexural strength of more than 80 MPa. 3D printing takes the effectiveness of digital projects to the production phase. Dental laboratories are able to produce crowns, bridges, stone models, and various orthodontic appliances by methods that combine oral scanning, 3D printing, and CAD/CAM design. Modern 3D printing has been used for the development of prototypes for several years, and it has begun to find its use in the world of manufacturing. Digital technology and 3D printing have significantly elevated the rate of success in dental implantology using custom surgical guides and improving the quality and accuracy of dental work.
Ivan L. Chenchev, Vasilena V. Ivanova, Deyan Z. Neychev and Radka B. Cholakova
Background: Different barrier membranes and augmentation techniques are used in oral surgery to recover lost bone structures with varied success. Recently, a combination between bone graft materials and Platelet-Rich-Fibrin (PRF) is implemented in the periodontology and implantology.
Aim: The aim of this case report was to assess the possibility for augmentation of the alveolar ridge in the frontal region of the upper jaw, utilizing a combination of bone graft material, injectable platelet-rich-fibrin (i-PRF) and advanced platelet-rich fibrin (A-PRF).
Materials and methods: An 18 year-old male with expulsion of tooth 11 and partial fracture of the alveolar ridge was treated with augmentation of the alveolar ridge using bone graft material, injectable platelet–rich-fibrin(i-PRF) and advanced platelet-rich-fibrin (A-PRF). Clinical results were reviewed 4 months after the augmentation and a dental implant was placed.
Results: The postoperative period was uneventful. The control CBCT scan showed good organization of new bone allowing placement of a dental implant.
Conclusion: The successful clinical and radiographic results of the case suggest that using A-PRF and i-PRF can be beneficial for bone augmentation of the alveolar ridge before implant placement.
The marginal bone loss around dental implants is an important indicator that helps to evaluate the course and the final outcome of implant-prosthetic treatment. It is, therefore, important to understand the factors that may affect this. The aim of the study was to assess the impact of the specific characteristics of implant-prosthetic treatment on the marginal bone loss around implants. The study included 28 patients, aged 37-66 years, treated with dental implants. Every patient received at least one of the two types of implants: with Morse taper connection and with internal hexagonal connection. The average marginal bone loss around the implants was evaluated on the basis of the panoramic radiographs. The maximum follow-up period after implantation was 46 months. The peri-implant marginal bone loss was evaluated taking into consideration the implant localisation, the procedure of sinus lift with bone augmentation, implant type, implant diameter, vertical implant position relative to the compact bone level and the type of prosthetic restoration, the time between implantation and loading with prosthetic restoration, as well as the time between loading and the measurement of marginal bone loss. The correlation between bone loss and the selected characteristics of the treatment was assessed using generalised estimating equations (GEE). An objective analysis was enabled via the applied research model: evaluation of an impact of the specific implant-prosthetic treatment characteristics on peri-implant marginal bone loss in patients treated with implants with different implant-abutment interface systems. The results of the study showed that peri-implant marginal bone loss increased significantly with implant localisation in canine sites (compared to the localization in premolar sites), as well as with prosthetic restorations in the form of dentures (compared to bridges), and decreased when implants were placed below the compact bone level (compared to those placed at the bone level). At the same time, marginal bone loss was not significantly related to implant diameter or to the sinus lift procedure. The results obtained seem extremely useful in everyday clinical practice
Aleksandar Đorđević, Mirko Mikić, Jelena Stanišić and Filip Đorđević
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