2021 Jul-Sep; Vol 12, No 3
Lateral Alveolar Ridge Augmentation with an Autogenous Bone Block Graft Alone with or without Barrier Membrane Coverage: a Systematic Review and Meta-Analysis
J Oral Maxillofac Res 2021;12(3):e1
Objectives: To test the hypothesis of no difference in implant treatment outcome following lateral alveolar ridge augmentation with autogenous bone block graft with or without barrier membrane coverage.
Material and Methods: PubMed (MEDLINE), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 8th of February 2021 were included. Randomised controlled trials with an observation period longer than three months were included. Survival of implants and suprastructures were considered as primary outcomes measures, whereas peri-implant marginal bone loss, dimensional changes of the alveolar ridge, bone regeneration, patient-reported outcome measures, biological and mechanical complications were secondary outcome measures, as evaluated by descriptive statistics and meta-analysis including 95% confidence interval (CI).
Results: Electronic search and hand-searching resulted in 411 entries. Five randomised controlled trials characterised by low or high risk of bias fulfilled inclusion criteria. No statistically significant difference between the two treatment modalities was observed in any of the outcome measures. However, barrier membrane coverage was associated with a non-significant gain in alveolar ridge width of 0.5 mm (95% CI = -0.1 to 1.1) and diminished resorption of -0.9 mm (95% CI = -2.4 to 0.7) compared with no barrier membrane coverage.
Conclusions: Comparable implant treatment outcomes were revealed following lateral alveolar ridge augmentation with autogenous bone block graft alone with or without barrier membrane coverage. However, postoperative dimensional changes of the augmented seems to be diminished with the use of barrier membrane coverage as evaluated by two-dimensional linear measurements.
Keywords: alveolar ridge augmentation; dental implants; membranes; oral surgical procedures; review.
Effects of Systemic Propranolol Application on the New Bone Formation in Periimplant Guided Bone Regeneration
J Oral Maxillofac Res 2021;12(3):e2
Objectives: The aim of this experimental animal study was to evaluate the effects of systemic propranolol on new bone formation in peri-implant bone defects.
Material and Methods: Implant slots were created 4mm long and 2.5 mm wide. After the titanium implants were placed in the sockets, 2 mm defects were created in the neck of the implants. Bone grafts were placed in these defects. Then the rats were randomly divided into three equal groups: control (n = 8), propranolol dose-1 (PRP-1) (n = 8), and propranolol dose-2 (PRP-2) (n = 8) groups. In the control group, the rats received no further treatment during the eight-week experimental period after the surgery. The rats in the PRP-1 and PRP-2 groups were given 5 mg/kg and 10 mg/kg propranolol, respectively, every three days for the eight-week experimental period after the surgery. At the end of the experimental period, the rats were euthanized. Blood serum was collected for biochemical analysis, and the implants and surrounding bone tissues were used for the histological analysis.
Results: There were no significant differences in the histological analysis results and the biochemical parameters (alkaline phosphatase, calcium, creatinine and phosphorus) of the groups (P > 0.05). Also, in the test groups, there was numerically but not statistically more new bone formation detected compared with the controls.
Conclusions: Within the limitations of this study, propranolol did not affect the new bone formation in peri-implant defects.
Keywords: bone; peri-implantitis; propranolol; regeneration.
Radiological Evaluation of Olfactory Fossa with Cone-Beam Computed Tomography
J Oral Maxillofac Res 2021;12(3):e3
Objectives: The aim of this retrospective study was to evaluate the morphology of the olfactory fossa in the Turkish population using cone-beam computed tomography according to Keros classification and to investigate the effect of age, gender and nasal septum deviation on the olfactory fossa.
Material and Methods: Olfactory fossa (OF) were analysed in coronal sections on cone-beam computed tomography images of 385 individuals. Nasal floor (NF), medial ethmoid roof point (MERP), cribriform plate (CP) heights, CP depth and width, OF width, lateral lamella-cribriform plate angle (LLCPA), and nasal septum deviation angle (NSDA) were measured. Keros and Gera classifications were made according to the measurements.
Results: According to the Keros classification, 137 of 770 OFs were type I (17.8%), 554 (71.9%) were type II, and 79 (10.3%) were type III. The most common combination was Keros type II and Gera type II (45.6%). There was a positive correlation between CP depth and LLCP angle, NF, MERP and CP heights (P ≤ 0.05). NF, MERP, and CP heights, CP depth and LLCP angle were statistically significant differences according to Keros classification (P ≤ 0.05). Only the right LLCP angle showed a statistically significant difference according to the NSD sides (P = 0.014).
Conclusions: The study shows that the lateral lamella-cribriform plate angle increases as the cribriform plate depth increases. This result suggests that it may moderate the risk during endoscopic sinus surgery. Also, according to the nasal septum deviation sides, the dimensions of the olfactory fossa did not change significantly, except for the lateral lamella-cribriform plate angle.
Keywords: anatomy; cone-beam computed tomography; cribriform plate; ethmoid bone.
Osseointegration Aspects of Implants at the Bone Reconstruction Site by a Novel Porous Titanium Scaffold
J Oral Maxillofac Res 2021;12(3):e4
Objectives: Porous titanium is used for the reconstruction of large bone defects due to its excellent mechanical strength. The quality of osseointegration of implants placed in bone reconstructed with porous titanium is unknown. The purpose of this in vivo study was to evaluate the osseointegration of implants at sites reconstructed using porous titanium.
Material and Methods: Hollow porous titanium (Ti) (outer-diameter 6 mm, inner-diameter 2 mm, length 4 mm, 85% porosity) and similar-sized porous hydroxyapatite (porous HA: 75% porosity) samples were prepared and implanted in 6 New Zealand white rabbit femurs. Four weeks later, an implant bed was created to receive a Ti implant (diameter 2 mm, length 4 mm). An implant placed at a pristine bone site served as the control. Four weeks later, histological and histomorphometric evaluations of the test and control sites were conducted.
Results: Osseointegration was observed in all groups. There was no significant difference in the bone formation ratio and bone-implant contact (BIC) ratio across all groups for the whole area. At the cancellous bone area of the bone defect, superior bone formation ratio and BIC ratio were observed with porous Ti and porous HA compared to the control (bone formation ratio: control 1.8 [SD 3]%, HA 23 [SD 3]%, Ti 23.6 [SD 5]%; BIC ratio: control 5.4 [SD 5.3]%, HA 28.9 [SD 10.7]%, Ti 41.6 [SD 14]%). Porous Ti demonstrated good osteoconduction and osseointegration abilities, similar to porous HA.
Conclusions: To our knowledge, this is the first report of implant treatment after preliminary bone reconstruction using a titanium biomaterial. Porous titanium is a suitable material for bone reconstruction before implant treatment in load-bearing areas that allow subsequent prosthetic treatment.
Keywords: biocompatible material; dental implants; dental implantation; oseointegration; titanium.