Horizontal Bone Loss Research Articles

Presenting pre-radiotherapy dental status of head and neck cancer patients in the novel radiation era.

Objectives Dental assessment remains a key intervention for head and neck cancer (HNC) patients pre-radiotherapy (RT). The purpose of this study was to identify the variation in dental status of patients pre-treatment, with respect to population and oncological demographics.Materials and methods The study reviewed dental panoramic radiographs of HNC patients seen on a dedicated pre-RT dental clinic from 2011-2017. Only patients who had undergone intensity-modulated radiotherapy treatment were included within this study. Relevant dental and oncological data were collected.Results A total of 886 patients were included in this study, with oropharyngeal cancer constituting 36% of the cohort. The average number of teeth in HNC patients was <21 at the pre-RT phase, which is below the recognised threshold for a functional dentition. Smoking status has a significant impact on overall DMFT (decay/missing/filled teeth), severity of horizontal bone loss and the number of third molars present (p <0.001). In the latter, males had a higher mean number of third molars compared to females (p <0.005). Comparing dental status of patients based on their tumour sub-site identified significant (p <0.0005) variation in all aforementioned categories.Conclusion There are distinct differences in the dental health of HNC patients due to commence RT, compared to the general population. It varies by cancer sub-site and this should be taken into consideration at dental assessment to tailor a dental care plan to the needs of the individual. Consideration should be given to balancing masticatory function against the risks of osteoradionecrosis on the background of increasingly extended survivorship.

Diagnosing periodontal and dental indicators with horizontal and vertical bitewing radiographs.

The aim of this study is to compare information provided by the 2 orientations of bitewing radiographs, horizontal (HBW) and vertical (VBW) taken in a dental school. Radiographic records were reviewed at Tufts University School of Dental Medicine (TUSDM) for patients showing posterior bone loss who had both HBW and VBW. 320 records were reviewed with 6 criteria: visibility of crestal bone from the distal of the cuspids to the distal of the most posterior tooth, visibility of horizontal or angular bone loss, the crestal density of bone, visibility of interproximal contact areas, visibility of the entire anatomical crown, and visibility of furcations. Significantly higher number of VBW compared with HBW (P<0.0001) showed the levels of alveolar bone loss (52.81% vs. 3.75%), the type of loss (angular or horizontal) (50.94% vs. 3.75%), the crestal bone density (28.75% vs. 0.63%), the contact areas (20.63% vs. 14.38%), and the furcations (43.44% vs. 1.25%). A greater number of HBW showed the entire anatomical crown compared with VBW. No significant difference was detected in the number of radiographs taken per HBW and VBW set. For patients with alveolar bone loss, VBW are superior to HBW when assessing bone levels, density, morphology, tooth furcations, and evaluating interproximal contact areas for caries. It is recommended that the vertical bitewing technique be taught as a standard in dental, dental hygiene, and dental assisting schools for adult patients showing evidence of posterior interdental bone loss.

Prevalence of horizontal alveolar changes in edentulous patients: a retrospective tomographic study

Horizontal bone loss after tooth extraction is a common finding that demands bone reconstruction in various cases. The aim of this study was to assess the horizontal alveolar status in partially and completely edentulous patients using cone-beam computed tomography (CBCT). In total, 1516 CBCT scans of 1404 adult patients were analyzed. Assessment of the images was performed in accordance with the previously published horizontal alveolar change (HAC) classification, which categorizes horizontal bone defects into four classes: HAC 1, HAC 2, HAC 3 and HAC 4 (from the least severe to the most severe condition). Analysis of 1048 scans from partially edentulous patients presented a distribution of 63.55%, 22.14%, 13.36% and 0.95% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Analysis of 468 scans from completely edentulous patient images presented a distribution of 19.87%, 28.63%, 41.67% and 9.83% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Based on these results, as in HAC 4, no cancellous bone was found between the cortical buccal and lingual/palatal bone plates, it seems reasonable to state that the absence of cancellous bone is higher in completely edentulous patients than in partially edentulous patients. Therefore, the absence of cancellous bone seems to be higher in completely edentulous than in partially edentulous patients.

Effect of peri-implantitis associated horizontal bone loss on stress distribution around dental implants – A 3D finite element analysis

Bone loss due to Peri-implantitis leads to a decrease in the length of implant in contact with bone at any given time. This further is expected to create a scenario wherein there are higher stresses at the bone–implant interface. Failure to adopt corrective measures to treat the same can hence lead to implant failure due to mechanical overload. Geometric models were generated for parallel walled dental implants with V-shaped threads, placed in mandibular molar area in fully and partially osseo integrated situations corresponding to Implant-bone assemblies simulating various levels of horizontal bone loss. Functional occlusal load of 118.2 N and maximal occlusal load of 275 N were applied at an angle of approximately 75 degrees to the occlusal plane and biomechanical analysis was performed. Peak values of corresponding von Mises stress were recorded. At attempt was also made to assess the occlusal loads which generate ultimate stress in the cortical bone, and correlate them to the safety factor of load-carrying dental implants.

Assessment of Oral&amp;ndash;Systemic Disease Association amongst Dental Patients: A Retrospective Panoramic Radiographic Study

The association between oral health and overall health has been broadly documented in the past few years and is supported by a rapidly growing body of evidence. Interventional studies were able to establish a linkage between dental intervention and its influence on medical situations. This study tried to determine whether the overall health of a subject may be correlated to radiographically noticeable dental pathology. There was a need to test a null theory of whether subjects having good oral health state had fewer systemic illnesses. This was a retrospective panoramic radiographic study of 400 radiographs of 200 women and 200 men. Subjects were divided into a control group of subjects with no medical history, and a second group with patients who had presented with a medical history. A panoramic radiograph was observed for periapical radiolucency, caries, remaining teeth, remaining root, horizontal, and vertical bone loss. The oral index (OI) was calculated and correlated with the medical status of the patient. Men demonstrated a higher incidence of horizontal bone loss and missing teeth. On the contrary, women showed higher incidences of vertical bone loss, compromised periapical index, and a greater number of root canal treated teeth. Patients having a medical history had a significant percentage of the increased number of periapical lesions, tooth loss, poor quality root canal treatment, and periapical index. Patients with both diabetes mellitus (DM) and hypertension [HTN (61.3%)], anemia (75%), prostate disease (100%), and disabilities such as hearing impairment and mental retardation (100%) had significantly higher percentages of the bad OI. Most patients with medical history demonstrated a significantly poor OI than those with no medical history. The present research contributes to scientific works by probing the relationship between oral health and the overall well-being. Increasing the sample size and interventional studies are needed as an extension of the current research. Panoramic radiograph is commonly practiced as a screening radiograph in a dental setup. By calculating an OI of each patient based on certain dental conditions, it can help in revealing the burden of medical diseases on oral health and vice versa.

Accuracy of Cone Beam Computed Tomography in the Assessment of Mandibular Molar Furcation Defects

Objective: To evaluate the accuracy of cone-beam computed tomography (CBCT) in the assessment of mandibular molar furcation defects. Material and Methods: Thirty patients with furcation defects were selected, oral hygiene instructions, scaling, and root planing with ultrasonic devices and hand instruments and occlusal adjustments were performed. Pre-surgical clinical measurements were carried out at the buccal aspect of the selected mandibular molars. The horizontal furcation measurements were measured with a Nabers Probe starting at the furcation entrance to the greatest horizontal depth. The degree of furcation involvement was graded from 0 to III. Bone loss in the horizontal and vertical direction and the width of the furcation entrance were measured on CBCT and after reflecting the full-thickness flap and debridement of the defects. The data were analyzed using t-test and Pearson’s correlation coefficient. Results: The width of furcation entrance in clinical method was 3.27 ± 0.77, while in CBCT method was 3.35 ± 0.71, clinically the vertical bone loss was 3.61±1.09, while in CBCT was 3.57 ± 1.15, horizontal bone loss in clinical method was 5.08 ± 2.21, while in CBCT was 5.11 ± 2.23. No significant difference between the two methods was noted, and a high correlation between the two methods was observed. With regards to the agreement between the two methods of assessment, the width of furcation entrance revealed a difference between the two methods by 0.08 ± 0.21, while vertical bone loss showed difference between the two methods by -0.04 ± 0.19, the horizontal bone loss showed a mean difference between the two methods by 0.03 ± 0.21. Conclusion: CBCT provided high accuracy for the furcation involvement detection and anatomy of surrounding periodontal tissues.

Serum High-Sensitive C-reactive Protein May Reflect Periodontitis in Patients With Stroke.

Chronic infectious diseases are believed to increase the risk of stroke. We aimed to evaluate the prevalence of periodontal disease and its association with systemic inflammatory processes in patients suffering an acute stroke/transient ischemic attack (TIA). Altogether 36 acute stroke/TIA patients underwent clinical, laboratory and radiological examinations. The level of systemic inflammation was analyzed both with routine measurements of plasma C-reactive protein (p-CRP) and serum high-sensitivity CRP (s-hsCRP) to analyze their associations with periodontitis. The diagnostic criteria for periodontitis included increased probing depth (>4 mm) measured from four different sites, bleeding on probing, and horizontal (>1 mm), vertical (>1 mm) or apical bone loss observed on orthopantomography. Twenty-six (72.2%) patients were diagnosed with periodontitis. Only five of the patients with periodontitis (19.2%) had elevated p-CRP values whereas the majority, (17/26; 65.4%) had elevated s-hsCRP values (p<0.01). Absolute s-hsCRP values in patients with periodontitis (8.9±12.5 mg/l) were significantly higher than in patients without periodontitis (2.3±3.0 mg/l; p<0.05). Absolute p-CRP concentrations did not differ (2.3±5.8 vs. 2.4±5.1 mg/l; p=not significant). The total number of periodontitis findings was significantly associated with s-hsCRP values (r=1.83) but not with p-CRP values. Conversely, seventeen of the nineteen patients with elevated s-hsCRP (89.5%) indicative of systemic inflammation had periodontitis. Periodontitis is a common finding among patients with acute stroke/TIA as over 80% of patients with cryptogenic stroke/TIA had periodontitis. S-hsCRP is a useful tool for detecting subclinical systemic inflammation.

Immediate implant placement in anterior teeth with grafting material of autogenous tooth bone vs xenogenic bone

BackgroundThe aim of the study was to compare the efficacy of the autogenous tooth bone and xenogenic bone grafted in immediate implant placement with bone defect.MethodsThirty patients whose compromised anterior teeth need immediate implant placement were enrolled. Autogenous tooth bone made from the extracted teeth by chair-side or the xenogenic bone were used to repaired bone defect. Clinical examination, radiographic assessment about the horizontal bone change in the level of 0 mm, 3 mm and 6 mm below the implant neck and the marginal bone loss were made immediately, 6 and 12 months after implant placement. Questionnaire of the feelings about the surgery were made at the time of removing the sutures.ResultsAll implants achieved the success criteria without any complications at the follow-up period. The percent of the horizontal bone change and the marginal bone loss at 6 and 12 months were almost the same between two groups (P > .05). The horizontal bone loss at the first or the latter 6 months was almost the same (P > .05). But the horizontal bone loss at the 6 mm level was less than the 0 mm and 3 mm levels at 6 and 12 months (P < .05). Meanwhile patients seem more satisfied with the autogenous tooth bone derived from the questionnaire.ConclusionThe bone volume change in the facial part of the implant after immediate placement is almost the same between two groups. Providing clinical evidence that the autogenous tooth bone made from compromised tooth can be an acceptable bone graft material.

Impact of Implant and Site Characteristics on the Pattern of Bone Loss in Peri-implantitis

To assess the pattern of bone loss in peri-implantitis in partially edentulous patients and relate patient and implant/site characteristics that may influence such patterns. In this retrospective study, the records of partially edentulous patients with dental implants were stratified according to sex, age, smoking, and diabetes. Implants were stratified according to site, number of years in function, presence of adjacent implants, diameter, bone-grafted site, and implant platform. All these variables were obtained from previous periodontal charts and radiographs. The implants were then classified into two main groups: (1) bone loss as defined by the presence of progressive marginal bone change found on radiographs at least 12 months following prosthesis placement compared to a baseline with a threshold ≥ 2 threads of bone loss; and (2) no bone loss as defined by no detected bone change or bone level change with a threshold < 2 threads. The bone loss group was further divided into three subgroups according to pattern: vertical, horizontal, and combined. Descriptive analyses were applied to assess the frequency of the pattern of bone loss (horizontal, vertical, and combined). A statistical regression model was used to find if there was a significant correlation between patient/implant characteristics and the pattern of bone loss. A total of 304 charts with 540 implants met the inclusion criteria. One randomly selected implant per patient through Microsoft Excel software was included in this study. Of these, 157 (51.6%) of examined charts were men and 147 (48.4%) were women. The patients' mean age was 63.9 ± 11.4 years (range: 27 to 85 years) at implant placement, and implants had been in function for 12 to 120 months (median: 37 months). The percentage of implants that had bone loss was 24.7% (75 out of 304). The pattern of bone loss was 65%, 22%, and 13% for vertical, horizontal, and combined, respectively. Implants that had been placed in surgically bone-grafted sites had increased odds of vertical bone loss with either narrow or wide implants (OR = 2.5 [P = .04] and 3.1 [P = .01], respectively). The presence of adjacent implants had significantly (P = .003) increased odds of horizontal bone loss (OR = 5.1). Approximately one-quarter of dental implants (24.7%) developed bone loss beyond normal physiologic remodeling. Vertical bone loss around single implants was the most common pattern (65%), particularly around implants placed in bone-grafted sites with odds ratio of 2.5 for narrow implants vs 3.1 for wide implants. In the presence of adjacent implants, the odds of horizontal bone loss was 5.1 (P = .003).

Periodontal disease defects and mandibular cortical index in lupus patients

Objective:Systemic lupus erythematosus is an autoimmune disease that affects multiple organs. It is well known that lupus patients have higher risk of osteoporosis, but if the disease affects mandibular cortical bone and alveolar bone is not fully established. The objective of this study was to evaluate periodontal disease defects and mandibular osteoporotic alterations in patients with lupus as compared to healthy patients using panoramic radiographs.Material and Methods:The panoramic radiographs of 72 patients with lupus and 360 healthy patients were evaluated for the presence of bone loss secondary to periodontal disease, classified as horizontal and vertical bone loss. We also assessed mandibular osteoporotic alterations by using the mandibular cortical index. Logistic regression analysis was applied to estimate the risk of mandibular osteoporotic alterations as well as horizontal and vertical bone loss in patients with lupus as compared to healthy patients.Results:There were no statistically significant differences between groups in the presence of horizontal bone defects and mandibular cortical indexes. However, patients with lupus demonstrated that patients with lupus were 2.17 more likely to present vertical bone loss than healthy patients.Conclusions:Patients with lupus might have higher risk of vertical bone loss than healthy patients due to pathophysiology of their disease. Further larger prospective studies should be performed to confirm our findings.

Induced periimplantitis in a novel mini‐pig model‐ description and defect characterization

Background The use of animals to evaluate clinical response and progression of several oral diseases has been used toward time. For periodontology and implant dentistry several dog models were described and extensively used during the last 70 years. More recently, due to a series of movements against the use of canine models has restrained precluded the use of dogs for biological evaluation in several countries. Thus the use of other animals such as mini-pigs has gained space on oral research. Aim/Hypothesis This study has the original intention of compare treatments for induced Periimplantitis. The collected data until this time point will be presented in order to characterize the disease induction in this new model. Materials and Methods Eight Mini-pigs from the same breeder (Minipig br1) received eight implants each. After 8 weeks, healing abutments were installed and are 2 more weeks, silk ligatures were placed and left to accumulate plaque in association with a was wetted to a slurry food during 8 more weeks for plaque accumulation disease induction+ after 8 weeks radiographic data when collected to evaluate bone loss and the ligature were maintained for additional 8 weeks, when a bone loss of at least 30% of the implant could be detected, the ligatures were removed + after 3 more weeks, the clinical signs of disease were evaluated and periimplant bone loss was measured by x-rays. The treatment of the induced lesions was performed, and the defects characterization was recorded trans-surgically. This study will show the characteristics of the defects and data from two animals that died before the end of the study. Results The ligatures successfully induced progressive bone loss and ligature removal reduced the signs of acute inflammation. The progression rate was slower than the obtained in a previous study of our group in dog model. There were circumferential defects as well as horizontal bone loss, buccal and lingual bone dehiscence were not frequent and occurred mainly in the presence of horizontal bone loss. Vertical defects appeared mainly at interproximal areas (2.84 mm SD 2.35 mm). The defects configuration was similar to humans but, as this model does not control the pattern of bone loss, different defects can be found in the same experimental unit. Conclusion and Clinical Implications The use of mini-pig as a model to study periimplantitis produced defects comparable to human periimplantitis lesions with acute and chronic characteristics and might be a feasible alternative to the already described dog model.

Short term dimensional bony changes following teeth extraction in the esthetic zone and the use of PRF as a sole grafting material: Randomized controlled trial

Background: Bone loss after teeth extraction is a repeated observation in dental practice. Many bio materials were used inalveolar socket augmentation including platelet rich fibrin (PRF) to decrease bone loss.Purpose: The aim of this study was to investigate the effect of PRF when used as a sole grafting material on the ordinarydimensional bony changes following teeth extraction in the aesthetic zone.Patients and Methods: 42 fresh extraction sockets in 27 patients were included in this study. Subjects were randomly allocatedinto 3 groups. Study group included sockets augmented with PRF, second group included sockets augmented with xenograftand the third negative control group included patients were extraction was done with no augmentation. Subjects were assessedradiographically after extraction and before implant placement at 3 and 6 months post extraction using CBCT superimpositionto assess horizontal and vertical bone loss.Results: The amounts of horizontal and vertical bone loss were significantly higher at 3 and 6 months in PRF group whencompared to xenograft group. PRF as a socket grafting has no additive effect on decreasing bone resorption in the short termperiod after teeth extraction in the esthetic zone.

Finite element analysis of the dental pulp under orthodontic forces.

To evaluate the stress at the apical third of the pulp and neurovascular bundle (NVB) during 5 types of orthodontic movement at different levels of bone loss. Furthermore, correlations among bone loss, orthodontic appliances, and stress increase were assessed. Based on cone-beam computed tomography datasets, 10 models of the mandibular second premolar were created. Each of these models was subjected to a gradual horizontal bone loss simulation (0-8mm). Orthodontic forces of 20g, 60g, and 120g were applied during the finite element analysis (FEA). For each bone loss level, stress values were evaluated with the use of Abaqus at the apical third of the pulp and the NVB. The stress manifested at the apical third of the pulp was smaller than that at the NVB. The highest apical NVB stress was found for rotation (0.000546N/mm2 for 8mm bone loss) whereas the lowest stress resulted after translational movements (2.35E-04 MPa for 8mm bone loss). The FEA showed that Proffit's indicated orthodontic forces did not significantly disturb the pulpal blood flow and damage the apical NVB. Up to a doubling of the NVB stress, bone loss correlated with the force reduction to obtain similar stress levels compared with teeth with no bone loss. The present findings indicate that the stress manifested at the apical third of the pulp is smaller than that at NVB. Rotational movements induce the highest stress and translational forces develop the lowest stress related to the physiologic capillary blood pressure. Furthermore, in situations with reduced periodontium, lower forces are needed to reach the maximum tolerable stress compared with teeth with intact periodontium.

Condensing osteitis in the diagnosis consultation at Egas Moniz University Clinic

Introduction: Condensing Osteitis or Focal Sclerosing Osteomyelitis Condensing is characterized by the formation of periapical sclerotic bone; it consists on a focalized osseous reaction leading to bone growth resulting from inflammatory stimuli or local low intensity trauma [1–3]. Although described as a result of periapical of pulp inflammation and /or infection [3], it’s also observable in vital teeth as a consequence of occlusal trauma [1,2,4] and, thus, aetiologically not associated with pulp aggression, which may lead to misdiagnosis [5]. Clinically, in most cases, there is absent or mild pain, no lymphadenopathy and no cortical expansion [6]. Radiologically, these radiopaque lesions are associated with previously restored teeth or teeth undergoing trauma [1], mostly in the molar region of the mandible [1,7,8]. Condensing Osteitis is less frequent in the maxilla probably due to lower cortical thickness and abundant irrigation [6]. Its radiological appearance remains even with exodontia of the involved tooth [1]. The objective of this study was to statistically analyze condensing osteitis lesions detected in ortopanthomographies in the diagnosis consultation of the I.U.E.M. university clinic. Materials and methods: Observational study. The defined study group included patients who attended the diagnosis consultation at Egas Moniz University Clinic. 1947 patients were randomly selected. Frequency tables were determined according to the following criteria: sex, age, location, presence or absence of paresthesia. Non vital teeth and edentulous spaces were excluded. Statistical results were rounded to the centesimals. This paper has been conducted in an ethical and responsible manner, and is in full compliance with all relevant codes of experimentation and legislation. Results: 62 cases were observed (3,2%). More frequent in female patients (53,22%). No maxillary lesions (0%) were observed in the sample group (100% mandible lesions). Mandibular molars (53,23%) and premolars (43,54%) were the most frequently affected teeth, more specifically tooth 46 (20,97%), tooth 45 (19,35%) and tooth 36 (16,13%). 2 canines (3,23%) were observed to be associated with condensing osteitis. Lower right mandibular teeth were observed to have a higher incidence of condensing osteitis cases (54,84%), when compared to lower left mandibular teeth (45,16%). No cases of paresthesia were observed. Mean age was found to be 39,1 years old. Discussion and conclusions: Condensing osteitis was observed only in a small minority of the selected study universe and, thus, it can be considered as statistically infrequent. Mandible molar teeth were most frequently affected, which is in accordance to the referenced bibliography. Statistically, only slight differences were observed when considering the gender factor and thus these lesions are expected to occur in both male and female patiens. Aetiological treatment of pulp inflammation or occlusal trauma is recommended. In other cases, biopsy should be considered and differential diagnosis should include cement-osseous dysplasia, osteoma, cementoblastoma, osteoblastoma, hipercementosis [1]. Although statistically infrequent, Condensing Osteitis must be considered clinically relevant, not only regarding its differential diagnosis, but also because bone biopsies present the clinical implications of being invasive procedures, which can lead to vertical and horizontal bone loss, thus requiring immediate or further surgical procedures for local regeneration and rehabilitation. Furthermore, in the premolar and molar regions of the mandible, the risk of nerve lesion must be considered when performing a bone biopsy.

Efficacy of injectable platelet-rich plasma in reducing alveolar bone resorption following rapid maxillary expansion: A cone-beam computed tomography assessment in a randomized split-mouth controlled trial.

To evaluate the effectiveness of platelet-rich plasma (PRP) with its growth factors in minimizing the side effects of rapid maxillary expansion (RME) on the periodontal tissue of anchoring teeth using cone-beam computed tomography (CBCT). A randomized, split-mouth clinical trial was conducted on 18 patients aged 12-16 years (14 ± 1.65) with a skeletal maxillary constriction who underwent RME using a Hyrax appliance. The sample was randomly divided into two groups: intervention and control sides. PRP was prepared and injected on the buccal aspect of supporting teeth in the intervention group. High-resolution CBCT imaging (H-CBCT) was carried out preoperatively (T0) and after 3 months of retention (T1) to study the buccal bone plate thickness (BBPT) and buccal bone crest level (BBCL) of anchoring teeth. Changes induced by expansion were evaluated using paired sample t-test (P < .05). Results showed that there was no significant difference in BBPT and BBCL between the two groups after RME (P > .05). The prevalence of dehiscence and fenestrations was increased at (T1) in both groups and the percentage was higher in the PRP group. RME induced vertical and horizontal bone loss. PRP did not minimize alveolar defects after RME.

Periodontal status at diagnosis predicts non-disease-specific survival in a geographically defined cohort of patients with oropharynx squamous cell carcinoma

Background: The aim of this study was to examine periodontal status with a time-efficient screening method from a cohort of newly diagnosed oropharynx squamous cell carcinoma (OPSCC) patients and to study to what extent dental disease level predicted survival.Aims/objective: Can measuring level of dental pathology based on a blind investigation of a routine orthopantogram (OPG) obtained during diagnostic workup reveal prognostic information?Materials and methods: We included 97 patients diagnosed between 2003 and 2010. Radiographic alveolar bone loss was measured. At least 4 mm bone loss from cement–enamel junction on at least two teeth was registered as periodontal pathology. The number of missing and filled teeth (MFT), residual roots and apical radiolucencies were noted. Clinical data were determined through hospital patient records.Results: The horizontal bone loss discriminated between hr-HPV(+) versus hr-HPV(−) status, but secondary to age and smoking history at diagnosis. Vertical and horizontal bone loss predicted survival directly, and adjusted by gender, patient, smoking history, TN stage and hr-HPV tumor infection at diagnosis.Conclusions: Degree of periodontal OPG pathology at the time of OPSCC diagnosis to some extent predicted hr-HPV infection, but predicted non-disease-specific long-term survival.Significance: Degree of periodontal OPG pathology at diagnosis predicts prognosis.

The Diagnostic Yield of Dental Radiography and Cone-Beam Computed Tomography for the Identification of Dentoalveolar Lesions in Cats.

The objective of this study was to evaluate the diagnostic yield of dental radiography (DR) and 3 cone-beam computed tomography (CBCT) software modules for the identification of 32 pre-defined dentoalveolar lesions in cats. For 5 feline cadaver heads and 22 client-owned cats admitted for evaluation and treatment of dental disease, 32 predefined dentoalveolar lesions were evaluated separately and scored by use of dental radiography and 3 CBCT software modules [multiplanar reconstructions (MPR), tridimensional (3-D) rendering, and reconstructed panoramic views]. A qualitative scoring system was used. Dentoalveolar lesions were grouped into 14 categories for statistical analysis. Point of reference for presence or absence of a dentoalveolar lesion was determined as the method that could be used to clearly identify the disorder as being present. Accuracy, sensitivity, specificity, and positive and negative predictive values were calculated with the McNemar χ2 test of marginal homogeneity of paired data. When all 3 CBCT software modules were used in combination, the diagnostic yield of CBCT was significantly higher than that of dental radiography for 4 of 14 categories (missing teeth, horizontal bone loss, loss of tooth integrity, feline resorptive lesions), and higher, although not significantly so, for 9 categories (supernumerary teeth, supernumerary roots, abnormally shaped roots, vertical bone loss, buccal bone expansion, periapical disease, inflammatory root resorption, and external replacement root resorption). In conclusion, we found that CBCT provided more clinically relevant detailed information as compared to dental radiography. Therefore, CBCT should be considered better suited for use in diagnosing dentoalveolar lesions in cats.

Bone Block Augmentation - A Long Term Follow-Up

Introduction Autogenous bone block grafting is used for both vertical and horizontal augmentation of the upper and lower jaw. The bone block could be provided using extraoral or intraoral donor location. Aim The aim of this study was to observe the survival rate, the marginal bone level and the bleeding on probing (BOP) for a period of 4 to 6 years of implants, inserted in autogenous bone block graft. Materials and Methods We considered advanced horizontal bone loss, where guided bone regeneration with simultaneous implant placement could not be performed and/or vertical bone loss, where vertical augmentation of the alveolar bone of more than 3 to 6 mm is required, as indications for the bone block grafting procedure. As an intraoral donor site was used the mental area. Results and Discussion The mean observation period was 4.81 years. The mean marginal bone loss was 0.442 mm, as bone resorption was established in 48% of all cases, BOP was observed in 17.7 % of the cases. No correlation was found between BOP and bone loss. The survival rate of the implants placed into bone augmented using autogenous bone block graft was 98.7 %. Conclusion For an implant placement we considered a period of 4 months after the procedure enough to provide high survival rate of the implants. The implants placed in bone augmented using autogenous bone block grafting according to our methodology demonstrated high survival rate and unstable marginal bone level.

Evaluation of autogenous mandibular bone block resorption in horizontal alveolar ridge augmentation

To perform a prospective evaluation of splitted bone block resorption after augmentation procedure using cone beam computed tomography, and evaluation of clinical results. Bone blocks were harvested from the external oblique line of the mandible in 100 patients aged from 23 to 68 years, (64 females and 36 males). All of them underwent ridge augmentation using splitted bone blocks (SBB) technique. Three CBCT scans series were performed for each patient: before bone augmentation, at 14 days and 4 months after the surgical procedure. Alveolar crest dimensions were evaluated using s Ez3Dplus software ('Vatech', Seoul, Korea). Splitted bone blocks have shown low rate of graft resorption and high predictability. The mean horizontal and vertical bone loss between 2 and 16 weeks was 9.6%. The number of implants with insertion torque ≥35 N/cm was 94.4%. Statistical studies did not reveal significant differences by sex and age, as well as the width of the ridge before the operation. Autogenous bone blocks is a predictable option for the augmentation of the narrow alveolar crest. Splitted bone blocks provided effective alveolar restoration prior to implant placement. Further studies are needed to improve the outcomes of bone grafting.

Evaluation of nitric oxide levels in chronic periodontitis patients treated with initial periodontal therapy and probiotic food supplements: a double blind, randomized controlled clinical trial

The aim of the present study was to analyse the nitric oxide (NO) levels in gingival crevicular fluid (GCF) of patients with chronic periodontitis (CP) treated with probiotic-containing food supplements as an adjunct to initial periodontal therapy (IPT). The present study was a randomized, double blind clinical trial conducted in Yeditepe University Dental Hospital, Istanbul, Turkey. Thirty-six CP patients, with ≥2 nonmolar teeth in each quadrant with probing depth (PD) of 5–7 mm at proximal sites and radiologically detectable horizontal alveolar bone loss were randomized into two treatment groups. The test group received IPT + probiotic-containing food supplements, whereas the control group received IPT + placebo. GCF sampling was performed at the baseline and 3 and 6 months after treatment. The biochemical evaluation of NO in GCF was performed using the Griess colourimetric method. Statistical analysis was performed by using statistical software. Significant reductions in GCF volume and GCF NO levels were detected in each group after the treatments (p < 0.05). Intergroup comparison of the NO levels revealed statistically significant differences in favour of the test group at both 3 and 6-month evaluation periods (p < 0.05). Adjunctive usage of probiotic comprising food supplements to IPT yielded significant reduction of the NO levels compared to the control for up to 6 months of follow-up. The present study is registered at Thai Clinical Trials Registry (TCTR identification number: TCTR20171114003).