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International Journal of Oral and... Jan 2024This study aimed to evaluate the effectiveness of autologous platelet derivatives (APD), specifically platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), combined... (Meta-Analysis)
Meta-Analysis Review
This study aimed to evaluate the effectiveness of autologous platelet derivatives (APD), specifically platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), combined with autogenous iliac crest bone grafts in secondary alveoloplasty for patients with cleft lip and palate. Electronic databases, relevant journals, and reference lists of included studies were searched until July 2022. Best-evidence synthesis was performed to draw conclusions. After the search strategies, 12 randomized controlled trials were included that provided data on six outcomes: newly formed bone, mean bone loss in height and width, bone density, functionality, and postoperative complications. Two authors independently assessed the risk of bias, and the certainty of evidence was assessed using the GRADE approach. The pooled results suggest that there is uncertainty as to whether the combination of APDs with autogenous iliac crest bone grafts improves the percentage of newly formed bone, as the certainty of the evidence was assessed as very low. It may slightly improve the functionality of patients (with low certainty of the evidence) and probably slightly reduces the incidence of postoperative complications (with moderate certainty of evidence). Further randomized clinical trials with standardized methodologies are required to validate these findings.
Topics: Humans; Cleft Lip; Alveoloplasty; Cleft Palate; Bone Transplantation; Postoperative Complications
PubMed: 37730524
DOI: 10.1016/j.ijom.2023.08.008 -
Quintessence International (Berlin,... Nov 2023Patients taking antiresorptive medications in dental clinics are at risk of medication-related osteonecrosis of the jaw (MRONJ), which poses daily challenges for their...
OBJECTIVE
Patients taking antiresorptive medications in dental clinics are at risk of medication-related osteonecrosis of the jaw (MRONJ), which poses daily challenges for their clinicians. This paper aimed to summarize and revisit the three most recognized practice guidelines for the management and prevention of MRONJ, which were proposed by the American Association of Oral and Maxillofacial Surgeons (AAOMS), and presented by the Journal of Bone and Mineral Research (JBMR) and the Journal of Clinical Oncology (JCO). Results and case studies: The AAOMS position paper focused on risk stratification by different medications, management decision trees, risk factors, pathophysiology, and disease staging. The JBMR international consensus presented eight focused questions, which were addressed by systematic reviews. The JCO clinical practice guideline presented six clinical questions, and each concluded with practical recommendations. Practical information was summarized and converted into an adoptable patient care workflow for clinicians to follow and apply in daily practice. Three case studies presented were treated following these guidelines. Each patient underwent advanced surgeries including alveoloplasty, tooth extraction, implant placement, and particulate bone grafting. Some of the considerations not fully informed were discussed and illustrated in each step of the patient care workflow, which included specifics for risk communication, updates on the use of antibiotics, biomarkers, and drug holidays.
CONCLUSION AND PRACTICAL IMPLICATIONS
Structured risk communication with official informed consent documentation should be considered before initiating invasive treatments. Disease control phase with home care therapy should be provided prior to staged reconstructive therapy. Drug holidays and antibiotics coverage can be customized based on individual conditions and related procedures with interprofessional coordination.
Topics: Humans; Bisphosphonate-Associated Osteonecrosis of the Jaw; Workflow; Bone Density Conservation Agents; Patient Care; Anti-Bacterial Agents; Diphosphonates
PubMed: 37449761
DOI: 10.3290/j.qi.b4213007 -
Journal of Prosthodontics : Official... Jun 2024This article presents a technique for fabricating two-piece labial guides using resin and cobalt-chromium for guided alveoloplasty, implant placement, and immediate...
This article presents a technique for fabricating two-piece labial guides using resin and cobalt-chromium for guided alveoloplasty, implant placement, and immediate full-arch implant-supported fixed complete denture placement. This technique reduces tissue damage and overcomes the negative effect of the anatomical position of the palatal neuropore and mobility of the tissue flap on the positioning and stability of the guide. The use of labial retention metal guides with improved mechanical properties of cobalt-chromium and fixation plugs allows the unilateral placement of the guide. Thus, minimally invasive implant surgery can be performed owing to the absence of large palatal flap elevation and obstruction. Such a design provides better stability of the guides and clear visual access during surgery.
Topics: Humans; Dental Prosthesis, Implant-Supported; Workflow; Alveoloplasty; Computer-Aided Design; Immediate Dental Implant Loading; Surgery, Computer-Assisted
PubMed: 37632329
DOI: 10.1111/jopr.13759 -
The International Journal of... 2024Tooth autotransplantation is an effective treatment to replace missing teeth. Digital planning can facilitate successful autotransplantation. Guiding templates are...
Tooth autotransplantation is an effective treatment to replace missing teeth. Digital planning can facilitate successful autotransplantation. Guiding templates are highly recommended when performing cases in healed ridges in the posterior area to reduce excessive bone loss and increase the chances of fitting the donor tooth in the new socket. This case report highlights the use of 3D planning tools and fully guided drilling templates for successful tooth autotransplantation in the posterior area. Two tooth autotransplantations were performed in a 51-year-old patient using mandibular third molars to replace hopeless mandibular first and second molars. Root canal treatments were carried out before the surgeries, and different alveoloplasty techniques were used in each recipient area. The prosthetic phase was carried out after 9 months. Both teeth were asymptomatic, functional, and exhibited no signs of resorption or apical radiolucency and showed complete regeneration of the periodontal apparatus at the 2-year follow-up.
Topics: Humans; Middle Aged; Transplantation, Autologous; Molar, Third; Tooth; Molar; Tooth Socket; Treatment Outcome
PubMed: 37655975
DOI: 10.11607/prd.6801 -
Case Reports in Dentistry 2024Drug-influenced gingival enlargement is a common side effect associated with certain medications, particularly calcium channel blockers like nifedipine, which has been...
Drug-influenced gingival enlargement is a common side effect associated with certain medications, particularly calcium channel blockers like nifedipine, which has been extensively documented. However, the occurrence of nifedipine-influenced masticatory mucosa overgrowth in edentulous patients is rare. Here, we present a case of nifedipine-influenced mucosal enlargement persisting in a 67-year-old edentulous patient 3 months after the extraction of all his teeth. The patient underwent flap surgery and alveoloplasty to excise the overgrown tissue, followed by complete denture restoration. The antihypertensive medication was replaced with valsartan. A 2-year follow-up revealed no recurrence of overgrowth, indicating the effectiveness of this management strategy for such clinical situation.
PubMed: 38576511
DOI: 10.1155/2024/6889574