Implants and biomaterials used in hard and soft oral tissue augmentation are very complex, but predictable to use nowadays, as the technological advances haven�t skipped this field of medicine. Cases that were impossible to treat with implant retained fixed prosthesis some years ago, have become the daily practice of oral surgeons and dentists around the world. The new user-friendly products, together with simplified protocols, increased the practitioners� predictability and success rate, thus the biomaterial industry took a huge leap forward. As the biomaterial industry keeps developing continuously, making better and safer products, the surgical and prosthetic protocols evolve and change as well. On this matter, the implant placement has become safer, using digital surgical guides. Guided implant placement doesn�t just allow the practitioner place the implant in the patient�s bone, but, moreover, it helps him place it in the correct, 3D, prosthetic position. And, thus, guiding the future bone augmentation and regeneration as well, accordingly. So, the implant placement has shifted from bone-orientated to prosthetic-orientated, offering at the same time a better primary stability for the implants, due to the prior planning. The present clinical study aims to analyze the outcome of the digital guided protocol. Unlike the free-handed surgery, the digital guided surgery allows dentists and oral surgeons to place implants according to the future prosthetic position of the crowns, even in conditions of alveolar ridges with bone resorption. Moreover, it makes possible the �one day implant� concept, the dental technician being able to create the provisional crown/s in advance, knowing precisely the future position of the implant placement. So, at the time of the surgery, the provisional crown is also put in place, guiding the soft and hard tissue healing and also giving the patient a greater satisfaction.
The aim of this study was to establish an accurate algorithm for third molar odontectomy in order to help the surgeon to predict the duration and the difficultness of this surgical procedure. As material and methods, we used an algorithm that contains medical and radiographic data regarding lower wisdom tooth which was systematized in a preoperative questionnaire. In this study were included 27 patients with asymptomatic lower third molars during the period of 2015-2017. The prediction of the questionnaire was correlated with the difficulty and duration of the odontectomy. Results of our study showed that this algorithm can successfully predict the degree of difficulty of the lower wisdom tooth odontectomy and can guide the surgeon in the therapeutic decision. Moreover, this method is simple, easy and fast.
It is well known that periodontitis causes rapid destruction of gingival and bone tissues. Topical treatments are suitable because the drug can be delivered in a proper and controlled concentration. Metronidazole proved to be efficient for patients with aggressive periodontitis. By this study we aimed to obtain spongious drug delivery systems for local periodontitis treatment based on collagen, strontium renalate and metronidazole. Collagen spongious forms were obtained by lyophilisation of composite gels based on collagen:strontium ranelate (50:50) and different concentrations of metronidazole. The obtained spongious forms were characterized by FT-IR, water up-take, optic microscopy and in vitro release of metronidazole. The prepared matrices absorbed a maximum amount of water after 30 min. The most absorbent sample is the reference one (only collagen) which absorbed about 35% water; the adding of metronidazole decrease the water absorption due to its lipophilic behavior. The samples with strontium are more compact and they absorbed less water than the ones without strontium. Because the samples were not cross-linked they degrade during 24 hours of water absorption process. The drug percentage released was influenced by the drug and strontium ranelate concentrations. The analysis performed sponges indicate that these composites can be useful as drug delivery supports.
Implants have been around for many years already, having a lot of advantages and high success rates, by some authors even higher than 90%. Nevertheless, throughout the years, problems and failures have occurred in practice which led to bone loss around the implants and even, in some cases, to losing the implant itself. The phenomenon behind this pathological process -peri-implantitis - is believed to be the microleakage which occurs at the implant-abutment interface.This happens due to the existence of a gap present between the implant and the prosthetic abutment. Moreover, the microleakage is amplified because of the, so called, pumo effect. The pump effect occurs when the crown-abutment complex is subjected to occlusal, vertical and oblique, forces. During these micro-movements of the abutment, the microleakage intensifies and the bacteria can easily enter inside the implant, where is impossible to reach and remove through oral hygiene, thus, creating the perfect conditions for peri-implantitis. There are two major types of implant-abutment connections widely used nowadays -internal hex and conical -which are believed to influence the phenomenon and, so, the outcome. In the present study, both types of connections are tested, using Streptococcus Mutans, a common bacteria found in the oral cavity.
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