Stomatologija最新文献

Objective: Diagnosis of odontogenic maxillary sinusitis (OMS) often is misdiagnosed as rhinosinusitis, the main symptoms of these diseases are the same: facial pain, postnasal discharge, and congestion. However, OMS and rhinogenic sinusitis require different treatments. Without addressing dental factors in odontogenic sinusitis, conventional rhinitis treatment will often fail, and symptoms will persist. This review aims to assess the most recent literature about OMS causes, symptoms, and treatment.

Material and methods: Literature analysis was carried out on the basis of PRISMA guidelines. Eligible articles no older than 5 years were included, with a few exeptions. An electronic search was performed using MEDLINE (PubMed), The Cochrane Library, and ScienceDirect databases.

Results: More than one possible cause for the development of OMS has been identified. The literature indicates that anaerobic microorganisms are found in the case of sinusitis, but there is no consensus regarding the initial exact causative bacteria of this disease. Symptoms of OMS can be one-sided facial pain, purulent anterior rhinorrhoea, headache, cacosmia, pressure or nasal congestion, post-nasal drip. For better diagnostic of OMS imaging modalities are used. Management of OMS requires dual treatment. The treatment of the disease should begin with the need to remove the causative factor. Antibiotic therapy alone is not used for the treatment of odontogenic sinusitis, but can be used to relieve symptoms. It should be prescribed in accordance with the antibiogram after causative factor is removed. When the dental and medical treatment is not enough for sufficient management of OMS surgery is required.

Conclusion: It is evident that the etiology of OMS includes more than one etiological factor, just as the causative agents of this pathology are various bacteria. Therefore, one of the key elements in choosing the treatment of OMS should be a proper diagnosis.

Objective: The aim of this case report was to show the marginal bone level (MBL) variation, after 28 months, around an aesthetic post-extraction implant immediate loading positioned in a 46-years-old woman.

Material and methods: After a careful evaluation of the X-rays and CBCT images, a 4×13 conical implant was placed in seat 21 after the atraumatic extraction of the fractured element and the management of the infected area. Correct primary stability (torque 70 Ncm) was obtained by inserting the implant in a palatal position with respect to the alveolus. To complete the surgery, regeneration procedures were carried out using a granular bone substitute (Geistlich Bio-Oss®) covered with a connective tissue graft taken from the palate. Just three days later, a straight titanium abutment Curvomax™ with gold tite (UNIHG) was screwed (35 Ncm) and a lithium disilicate glass ceramic crown was cemented.

Results: The radiographic analysis of the MBL at 28 months of follow-up shows a significant stability of the peri-implant bone confirmed by an excellent aesthetic integration of the soft tissues around the prosthetic crown.

Conclusions: A careful and dedicated surgical planning accompanied by the use of appropriate materials and an accurate surgical protocol, seems to allow the rehabilitation of frontal areas that is difficult to manage, obtaining excellent aesthetic, functional and predictable results over time. We believe that the goal, in this case, is also linked to the immediate delivery of the final crown which has significantly reduced operating times and improved aesthetic parameters, translating into better patient satisfaction.

Objective: The study aimed to fabricate and test the biocompatibility of a polylactic-co-glycolic acid (PLGA) based guided tissue regeneration membrane impregnated with 'simvastatin' to promote sustained drug delivery near osseous defects and evaluate the regenerative potential of the membrane histologically.

Materials and methods: We tested the mechanical properties and cytotoxicity of an indigenously fabricated PLGA membrane incorporated with simvastatin (1 mg/cm2). An animal study evaluated the regenerative potential of the membrane. Twenty-four adult Wistar rats, approximately 175 g in weight, were used in this study. The rats were divided randomly into four groups based on the postoperative healing periods into ten days, 1, 3, and 6 months. Within each time group, six rats were divided into three subgroups: Subgroup A - sham surgery controls; Subgroup B - PLGA without Simvastatin; Subgroup C - PLGA with simvastatin tests. The radiographic examination intervals were ten days, 1 and 3 months, while the histological assessment was around 1, 3, and 6 months.

Results: Simvastatin content was distributed uniformly in all the prepared membranes and was equivalent to 1 mg/cm². 100 mg PLGA membrane with simvastatin demonstrated uniform drug release over time, excellent mechanical properties, and biocompatibility. The rat models in Subgroup C had better bone tissue formation radiographically and histologically.

Conclusion: The study suggested that 'PLGA with Simvastatin' has the requisite properties to serve as a third-generation barrier membrane with the potential for local drug delivery.