eJournal of Oral Maxillofacial Research最新文献

Objectives: The increasing resistance of microorganisms that cause odontogenic cellulitis to empirically administered antibiotics increases the duration of hospitalization. The aim of this retrospective cohort study is to evaluate the latest data on maxillofacial odontogenic cellulitis in order to provide valuable information for optimizing the treatment of this pathology.

Material and methods: The medical records of patients treated for maxillofacial odontogenic cellulitis at the Hospital of Lithuanian University of Health Sciences (Kauno klinikos), between 2018 and 2023 were analysed. Data on age, gender, general health status, duration of intensive care unit treatment, total duration of treatment, and complications were analysed. The results of the microbiological culture of the pus were used to analyse the primary pathogen, its resistance, and sensitivity to antibiotics and antibacterial treatment.

Results: The streptococcus group (41.4%) was the most common pathogen. The duration of treatment did not differ significantly between the different localizations of cellulitis. The most commonly used antibiotics were a combination of penicillin and metronidazole. The highest success rate (76.9%) was observed with empirically administered combinations of cephalosporins and metronidazole. Antibiotic therapy was changed in 33.3% of cases.

Conclusions: The most frequently detected pathogens - the streptococcus group - are characterized by a high sensitivity to penicillin and clindamycin as well as third-generation cephalosporins. The most effective empirical antibiotic therapy is a combination of cefazolin and metronidazole and cefuroxime and metronidazole. Diabetes mellitus, lung disease, alternating antibiotic therapy and complications prolong the duration of treatment.

Objectives: This cross-sectional study explored the psychosocial impact on patients undergoing wisdom tooth surgery of the current evidence-based recommendation to only undertake additional cone-beam computed tomography after panoramic X-ray shows a high risk of nerve injury.

Material and methods: Questionnaires evaluated anxiety levels, awareness of cone-beam computed tomography (CBCT) necessity, satisfaction with the clinical pathway and the patient's treatment decision-making. Quantitative data analysed using descriptive statistics, chi-square tests, linear regression, and independent t-tests were used to assess the outcomes. Qualitative data were thematically analysed using manual coding.

Results: The study included a total of 119 participants, where having a CBCT resulted in a self-reported 31% reduction in anxiety about the upcoming wisdom tooth surgery. Interestingly, 45% of all patients reported a substantial reduction in anxiety levels, and only 5 participants (4%) suffered increased anxiety. A significant association was found between anxiety levels and treatment decisions (P < 0.001), with more anxious participants being more likely to alter their treatment choices. Additionally, 54 out of 57 (95%) participants considered the CBCT worthwhile and increasing age was weakly negatively associated with anxiety, with no significant gender effect.

Conclusions: We show for the first time that cone-beam computed tomography can reduce presurgical anxiety as well as enhance patient understanding of risks associated with wisdom tooth surgery. Further investigation of this anxiolytic phenomenon is required to determine if any clinical benefits outweigh the radiation risks.

Objectives: The primary objective of this systematic review is to evaluate the effectiveness of photobiomodulation in promoting neurosensory regeneration in patients with inferior alveolar nerve injury resulting from the extraction of mandibular third molars or dental implant placement.

Material and methods: An electronic search was conducted across major scientific databases including MEDLINE (PubMed), Scopus, Web of Science, and the Cochrane Library. Predefined inclusion and exclusion criteria were applied, and a total of 10 studies were included for qualitative analysis.

Results: A total of 10 studies were analysed, including 4 randomized clinical trials, 5 case series, and 1 retrospective study. All utilized GaAlAs lasers for photobiomodulation (PBM) therapy with wavelengths ranging from 808 to 830 nm. The number of treatment sessions ranged from 7 to 20, delivered at frequencies of 1, 2, or 3 times per week. Nearly all studies reported statistically significant improvements in both objective and subjective neurosensory assessments in favour of PBM therapy. Additionally, no significant differences were found between groups regarding sex, age, injury aetiology, or time to treatment initiation.

Conclusions: Photobiomodulation shows promising potential in the neurosensory recovery of inferior alveolar nerve injuries. However, further randomized controlled trials with larger sample sizes and long-term follow-up are needed to establish standardized clinical protocols and confirm its efficacy in dental practice.

Objectives: This systematic review aimed to determine the prevalence of peri-implant diseases in patients affected by osteoporosis rehabilitated with dental implants.

Material and methods: An electronic search was conducted in the MEDLINE (PubMed), EMBASE, Scopus, and Web of Science databases up to April 2025, complemented by a manual search of the reference lists from the full-text studies. The search included observational studies that identified peri-implantitis and/or peri-implant mucositis in patients affected by osteoporosis rehabilitated with dental implants. The risk of bias was assessed using the Newcastle-Ottawa tool.

Results: A total of 10, from 321, articles were included, and the reported evaluation periods after implant placement ranged from 3 to 11 years. Regardless of age, sex, number of implants, implant location, or duration of oral bisphosphonate use, all studies investigating the presence of mucositis and/or peri-implantitis reported no higher prevalence compared to systemically healthy patients. The prevalence of peri-implantitis was found to be 22%, and peri-implant mucositis 20%, in patients affected by osteoporosis.

Conclusions: Within the limits of this systematic review, it is concluded that osteoporosis does not increase the prevalence of peri-implant diseases or dental implant failure.

Objectives: This case series pilot study aimed to test the masticatory efficiency of mandibulectomy patients reconstructed with the free fibula flap using a modified mixing ability test and a digital colorimetric assessment.

Material and methods: Ten healthy dentate volunteers chewed a two-colour chewing gum for 30, 40, and 50 cycles to determine the minimum number of chewing cycles required to achieve consistently at least 90% colour blending (50 cycles). Mandibulectomy patients (n = 6) were given the same chewing gum and separate specimens were collected from the operated and non-operated side after (50 chewing cycles). The masticatory efficiency was assessed by: 1) photometric analysis to calculate the percentage of blended surface; and 2) measuring the colour blending deviation (ΔE) compared to healthy volunteers' master specimen (P < 0.05).

Results: The test group of cancer patients registered a mean 76.75% surface with blended colour after 50 chewing cycles at the non-operated site, and at the operated site (fibula free flap and implant-supported fixed prosthesis) a mean 60.08% blended colour surface was found. The colorimetric analysis revealed significant differences in ΔE values between all the investigated groups (cancer patients operated site < cancer patients non-operated site < healthy patients, P < 0.001).

Conclusions: The qualitative comparison of masticatory efficiency between test and control group of healthy patients showed different values of efficiency, attesting lower masticatory performance for mandibulectomy patients, especially in the operated site of small extent rehabilitation.

Objectives: The purpose of this systematic literature review was to evaluate the effects of local simvastatin on alveolar bone regeneration, pain and swelling after tooth extraction, with a minimum follow-up of two months.

Material and methods: A literature search was conducted using PubMed (MEDLINE) database to identify studies published between January 2015 and January 2025 containing a minimum of 20 sockets per study to evaluate the effect of local simvastatin in promoting bone regeneration after tooth extraction. Data synthesis in test and control groups included following parameters: Extraction socket filling material and method, regenerated bone morphology, pain, and swelling. Quality and risk-of-bias assessment were evaluated by the Joanna Briggs Institute Critical Appraisal Tools. Descriptive statistics were used.

Results: A total of 628 articles were screened, with 6 articles meeting the inclusion criteria and being utilized for this review. A total of 326 sockets with different types were evaluated, the effect of local simvastatin on the morphology of regenerated bone showed statistically significant (P < 0.05) progressive improvement in most cases. Furthermore, pain and swelling assessments revealed a decrease in the test groups compared to the control groups suggesting that local simvastatin may promote bone regeneration while reducing post-treatment discomfort. However, different tools were used to measure regenerated bone morphology pain and swelling, making it hard to draw consistent conclusions about patient comfort.

Conclusions: Local simvastatin application promotes bone regeneration without increasing pain or swelling, supporting its use as a safe and effective supplement in regenerative bone treatment after tooth extraction.

Objectives: The aim of this systematic review is to assess how different types of surgical sutures impact the microbiological composition of bacterial plaque in patients undergoing impacted third molar teeth removal surgery.

Material and methods: This systematic review followed PRISMA guidelines. Electronic literature searches were conducted across PubMed, Google Scholar, ResearchGate, and Web of Science databases, employing electronic databases and hand searches. Keywords such as "suture", "third molar", "wisdom teeth", "impacted teeth", "surgical extraction" were used in various combinations with Boolean operators. A 10-year filter, English language, and full-text access filter were applied. The research spanned the period from January 1, 2016, to January 1, 2025, and incorporated studies on humans published in English.

Results: The systematic literature review included 11 studies with 649 suture samples from 360 patients undergoing impacted third molar removal surgery. Twenty-five suture types were used, with silk being the most common but often accumulating the highest bacterial load. Prolene^® and antibacterial sutures, like Monocryl^® Plus, showed significantly lower bacterial colonization.

Conclusions: Sutures after third molar surgery can promote bacterial attachment, potentially leading to infections that impact wound healing. The evidence suggests that monofilament, synthetic, and antibacterial-coated sutures are preferable for reducing bacterial colonization, whereas multifilament silk sutures should be avoided when possible due to their high bacterial retention.

Objectives: This preliminary in vitro study aimed to clarify the usefulness of the accumulated torque value as a new method for evaluating primary implant stability.

Material and methods: Implants of different sizes (42-10ST and 37-6ST) and simulated bone blocks of different densities (D1 to D4) were used. The implant osteotomy was prepared following the manufacturer's drilling protocol in simulated bone blocks, and the implants were inserted (n = 10). The implant insertion torque value was measured at 0.05 seconds intervals. The peak value was recorded as the peak torque value (PTV), and the sum of the torque values measured from the start to the end of the implant insertion was recorded as the accumulated torque value (ATV). After implantation, the implant stability quotient (ISQ) was measured. Correlations among ATV, PTV, and ISQ were analysed.

Results: The ATV increased with the density of the simulated bone block. A strong correlation was observed between the PTV value and ATV value (42-10ST [P < 0.05, r = 0.99], 37-6ST [P < 0.05, r = 0.99]). In addition, a correlation was observed between the ATV and ISQ ISQ (42-10ST [P < 0.05, r = 0.81], 37-6ST [P < 0.05, r = 0.83]). The PTV was higher in the 42-10ST group than in the 37-6ST group from D1 to D4.

Conclusions: The accumulated torque value varied according to the density of the simulated bone block, and a correlation was observed with the existing implant stability evaluation method. This suggests that this method may be useful as a novel approach for evaluating primary implant stability.

Objectives: Plasma surface activation of dental implants has been proposed to enhance osseointegration by improving titanium surface chemistry. However, clinical data in humans remain limited. This randomized controlled clinical trial aimed to evaluate the effect of vacuum plasma treatment applied to titanium implants immediately prior to insertion on their stability pattern during the early phases of healing in human subjects.

Material and methods: In this single-blind, split-mouth randomized controlled trial, 24 patients requiring two contralateral implants were enrolled. Each patient received one plasma-treated implant and one untreated control implant. Vacuum plasma activation was performed immediately before insertion using a specific system (Plasma X^® Motion - MegaGen Implant Co., Ltd.). Implant stability was assessed at placement and at 7, 14, 21, 28, 42, 60, and 90 days using resonance frequency analysis (implant stability quotient [ISQ]).

Results: All 48 implants achieved osseointegration at 90 days, with no adverse events or complications. Mean insertion torque did not differ significantly between groups (P = 0.86). Both groups exhibited a typical initial reduction in stability, with the lowest ISQ values at 21 days. Plasma-treated implants showed a more favourable recovery pattern, with significantly higher ISQ values than controls at 60 and 90 days (P = 0.04 and P = 0.03, respectively). The absolute difference in ISQ values between groups remained limited.

Conclusions: Vacuum plasma activation of titanium implants may contribute to a more favourable early stability pattern, although both plasma-treated and untreated implants demonstrated predictable osseointegration outcomes. Further research with larger cohorts and longer follow-up is needed to assess the clinical significance of these findings.

Objectives: The objective of the present systematic review was to test the hypothesis of no difference in implant outcome following transcrestal maxillary sinus membrane elevation using osseodensification compared with osteotome-mediated sinus floor elevation or maxillary sinus floor augmentation applying the lateral window technique.

Material and methods: MEDLINE (PubMed), Embase, and Cochrane Library search combined with hand-search of relevant journals were conducted through March 19, 2025. Randomised controlled trials with an observation period of at least six months were included. Survival of suprastructures and implants were primary outcome, while duration of surgery, implant stability quotient (ISQ), peri-implant marginal bone loss, complications, endo-sinus bone gain, bone density, and patient-reported outcome were secondary outcome, as evaluated by descriptive statistics and meta-analysis including 95% CI.

Results: Six short-term randomised controlled trials characterised by high risk of bias and low GRADE fulfilled inclusion criteria. Comparable high implant survival was revealed. Transcrestal maxillary sinus membrane elevation using osseodensification (TSMEOD) disclosed statistically significant higher ISQ, at implant placement and abutment connection compared with osteotome-mediated sinus floor elevation (OMSFE) and maxillary sinus floor augmentation (MSFA). Duration of surgery, complications, and days using analgesics were diminished following TSMEOD. Endo-sinus bone gain was statistically significant reduced following TSMEOD compared with MSFA, while no statistically significant difference was revealed between TSMEOD and OMSFE.

Conclusions: Transcrestal maxillary sinus membrane elevation using osseodensification is associated with equivalent implant survival compared with osteotome-mediated sinus floor elevation and maxillary sinus floor augmentation, in short-term studies. Long-term randomized controlled trials are, therefore, needed before one treatment may be considered superior to another.