Defects of the oral and maxillofacial region may arise from several reasons such as trauma, infection, cyst, tumor, medication related osteonecrosis of the jaw, and misuse of some irritant agents. For reconstruction, autogenous grafts remain the gold standard among the alternatives. In our case, a 42-year-old woman referred to our clinic for implant-supported fixed bridge rehabilitation of her edentulous and defected left 2nd premolar and 1st molar region. In examinations, devitalizing agent-dependent large defect was observed. Anterior iliac crest (AIC) grafting technique was preferred for reconstruction. Consecutively, 16-week bone healing and 3-month implant osseointegration periods were uneventful. After fabrication of the implant-supported fixed bridge, the patient was followed up for 2.5 years with no signs of bone resorption, gingival inflammation, and pain. AIC grafting and implant-borne fixed bridges seem stable and satisfactory methods for large maxillofacial defects.
Purpose: The objective of this systematic review was to investigate the possible association between the drilling technique and proper implant integration and survival in areas with low bone density.
Materials and methods: An electronic search using the MEDLINE/PubMed database was performed including studies published up to April 2018. Animal and clinical studies that evaluated the association between the drilling technique and proper implant integration and survival in low-density bone were included.
Results: Fifteen studies met the inclusion criteria, including 7 experimental and 8 clinical. Undersized, osteotome, Piezosurgery, and osseodensification drilling were the 4 techniques found in the literature to enhance osseointegration of implants in low-density bone. Owing to the methodological variation, meta-analysis was not performed. The 4 drilling protocols were effective in increasing primary stability, but the long-term outcome is comparable with that of the conventional surgical drilling protocol.
Conclusion: There is weak evidence suggesting that any of the previously mentioned surgical techniques could enhance successful osseointegration and survival of the implants placed in low-density bone.
Introduction: The depressive impact of immunosuppressive medications used by patients after organ transplantations is commonly known and well proven. The aim of research is the assessment of functional and esthetic results of implantoprosthetic treatment in patients subject to immunosuppressive treatment after organ transplants.
Materials and methods: The study encompassed a group of 21 patients in the course of maintenance immunosuppression after transplantation procedures, in whom altogether 24 implants were inserted. The control group comprised 15 people with 15 implants in place. The research protocol assumed replacing a single missing tooth with a titanium implant. After 4 months, a prosthetic reconstruction in the form of a single crown was performed. After 24 months, the preliminary assessment of treatment results was attempted. The measured parameter was crestal bone level (CBL). The mechanical assessment was performed by measuring the torque indispensable to locate the implant and by an objective measurement of implant stability.
Results: The basic measured parameter of CBL median in the experimental group and in the control group amounted to 0.325 mm (min 0-max 0.95) and 0.5 mm (min 0.15-max 1.8), respectively. The comparison of CBL medians revealed lack of significant differences between the experimental group and the control group (P = 0.089).
Conclusion: Patients with organ transplants can safely and effectively undergo dental implant treatment.
The purpose of this study was to assess clinically and radiographically efficacy of maxillary sinus augmentation using hydraulic pressure in a lateral approach with immediate implant placement. In a total of 10 patients having less than 4 to 6 mm of subantral bone height, lateral approach sinus membrane elevation procedure was performed using hydraulic pressure with the help of a specialized water lift kit followed by grafting and simultaneous implant placement. Cone beam computed tomography analysis was used to assess the change in subantral bone height from baseline to the 6 months postoperatively. Radiographically, subantral bone height increased from 3.86 ± 1.423 mm at baseline to 15.49 ± 2.73 mm at 6 months postoperatively with a gain of 11.63 + 2.63 mm (P < 0.001). Thus, it is concluded that hydraulic pressure may be efficiently used in lateral sinus augmentation procedures along with simultaneous implant placement.
Purpose: To investigate clinical factors and cellular responses of in situ human alveolar bone-derived mesenchymal stromal cells involved in early periimplant marginal bone loss.
Materials and methods: Thirty-seven completely or partially edentulous patients were enrolled in this study. Periapical radiographs were taken at the time of implant surgery, at 3-month follow-up, and at 1-year follow-up. Univariate analysis and multiple logistic regression were performed to investigate the associations between marginal bone loss and study variables. The mRNA expression levels of 21 bone-remodeling- and tissue-healing-associated genes were analyzed by subgroup.
Results: Thirty-one patients with 98 implants were followed. The incidence and mean amount of bone loss were higher for overdentures than for other prosthesis and higher for the maxilla than for the mandible. The bone loss group showed lower mRNA expression levels of runt-related transcription factor-2, bone morphogenetic protein-2, and peroxisome proliferator-activated receptor gamma-2 and higher receptor activator of NKκB ligand/osteoprotegerin (RANKL/OPG) ratio.
Conclusion: Within the limitations of the study, certain genes involved in bone remodeling (runt-related transcription factor-2 [Runx-2], bone morphogenetic protein-2 [BMP-2], and peroxisome proliferator-activated receptor gamma-2 [PPARγ-2]) and RANKL/OPG are correlated with early periimplant bone loss, with the type of suprastructure and the involved jaw being significant clinical factors.

