Friday, December 21, 2012
Please read and save for future reference ! The latest recommendations for a commonly encountered clinical situation.
Wednesday, December 12, 2012
I wonder when robotic surgery will be a reality in dentistry! OMFS will most probably be the place it will make it's first impact. In the meantime I'm going to get started on my video games!
How Videogames Could Help Train the Next Generation of Robotic Surgeons: Doling out death in the virtual world of first-person-shooter games might help the next generation of surgeons save lives in the real world. A new study used simulators to compare the robotic surgery skills of med school residents against college and high school students who spend a lot of their time playing video games -- and the video gamers won.
Friday, December 7, 2012
A very nice and informational brochure. Print it out for your patients or put it up on your wall.
Wednesday, December 5, 2012
Medicine is continuously learning from other fields, perhaps the best example being aviation. It is from aviation that we gained the benefits of checklists, integrated ICUs and ORs, and – most recently – simulators. The first computer-based flight simulators came out 50 years ago and only now are we getting up to speed in terms of developing systems that enable surgeons to rehearse operations in advance.
This past June Medgadget met up with the Surgical Theater team at The White House and discussed how they are turning this vision into a reality – or, rather, the other way around. Their flagship product, the Selman Surgical Rehearsal Platform (SRP), allows surgeons to “pre-live the future” by practicing procedures on their actual patients’ anatomies using pre-operative MRI and CT images. We heard from them recently because the SRP has reached a few milestones in the past six months, including its first purchase by University Hospitals (UH) Case Medical Center in Cleveland and submission for FDA approval.
Friday, November 30, 2012
- Short Implants
- Vertical augmentation using block grafts (autogenous,alloplastic as well as xenogenic).
- Vertical augmentation using tenting screws, and a mixture of autograft and bovine bone mineral covered with a titanium reinforced PTFE membrane barrier.This is quite popular.
- Vertical augmentation as above but using the implants themselves as tenting screws.
- Tilted implants where feasible.
- Transverse placement to avoid the IAN.
- Nerve repositioning/relocation.
- Subperiosteal implants if the resorption is down to basal bone. Not commonly used currently due to the high rate of failure and complications, technique sensitivity and lack of validating studies.
- The interpositional graft used was a FDBA Bone Block from Tata Bone Bank in Mumbai not autogenous bone or particulate graft material..
- No bone plates were used to stabilise the fragments. In some cases this may be necessary.
Tuesday, November 27, 2012
'via Blog this'
Wednesday, November 14, 2012
If someone has access to the original paper I would appreciate if you could mail it to me !
Is Bruxism a Risk Factor for Dental Implants? A Systematic Review of the Literature:
Material and Methods
Tuesday, October 23, 2012
Monday, July 2, 2012
Thursday, May 10, 2012
Bone-to-implant contact after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios in mini pigs
Material and methods
Material and methods
Sunday, April 1, 2012
12 of the creepiest prosthetic mouths in dentistry. More »
A team of scientists from Tufts University and Princeton University have developed a wireless bacteria detection technology which can be interfaced with a number of surfaces, including biological substrates, such as the enamel of a tooth. The researchers used graphene to achieve a very high degree of sensitivity. By printing the graphene onto water soluble silk, the sensor could then be easily transferred to biological surfaces. A patterned resonator coil design on the printed sensor acts as a passive antenna to enable power and wireless communication with the sensor.
Most recently, the researchers have demonstrated their sensor by attaching it to a tooth for monitoring of respiration and bacteria detection in saliva.Their findings have been reported in the March 27 online edition of Nature Communications.
Friday, March 23, 2012
New Gel May Mean No More Dental Anesthesia Shots - Science News - redOrbit:
'via Blog this'
Thursday, March 1, 2012
Membrane Perforation in Sinus Floor Elevation – Piezoelectric Device versus Conventional Rotary Instruments for Osteotomy: An Experimental Study
Purpose: Sinus membrane perforation is the most common intraoperative complication of maxillary sinus floor elevation (MSFE) procedures and frequently causes postoperative problems. Piezoelectric devices have been claimed to reduce the frequency of membrane perforations although no clear evidence supports this view.
Materials and Methods: Ten surgeons with different expertise levels performed 80 MSFEs in selected lamb heads, with rotary and piezoelectric instruments following standard protocols. After the procedures, specimens were coded and perforations or tears determined through a microscope.
Results: No significant differences in terms of thickness either of the sinus lateral wall (xi-xj = 73.2; 95% confidence interval [CI] = 45.3–191.8) or the membrane (xi-xj = 24.2; 95% CI = −29.4 to 77.9) were identified between the specimens allocated to each group. Nine membrane perforations (11.2%) occurred during the study, all within the lower expertise group. Membrane elevation by hand instruments caused five perforations (40%) in the rotary instrument group and one in the piezoelectric group. Expert surgeons produced no membrane perforations, the size of the antrostomy that was smaller in the piezoelectric group being the only significant difference between the rotary and piezoelectric groups.
Conclusions: The use of piezoelectric material for MSFE reduces the frequency of membrane perforation among surgeons with a limited experience.
Soft Tissue Preservation and Pink Aesthetics around Single Immediate Implant Restorations: A 1-Year Prospective Study
Purpose: (1) To document soft tissue aspects using a specific protocol for immediate implant treatment (IIT) following single-tooth removal; (2) to evaluate whether this protocol allows preservation of pink aesthetics as objectively assessed.
Materials and Methods: Patients with a thick gingival biotype and intact buccal bone wall upon extraction of a single tooth in the aesthetic zone (15–25) were consecutively treated. The protocol included flapless extraction and implant surgery, socket grafting, immediate nonocclusal loading with a screw-retained provisional crown, and replacement by a permanent crown 6 months thereafter. The outcome was assessed after 3, 6, and 12 months. Cases demonstrating major alveolar process remodeling and/or advanced midfacial recession (>1 mm) at 3 months were additionally treated with a connective tissue graft (CTG). The emergence profile of the provisional crown was replicated for all permanent crowns.
Results: Twenty-two patients (12 men, 10 women; mean age 50) were treated after tooth extraction for nonperiodontal reasons using a novel bone condensing implant with variable-thread design, conical connection, and platform switch (NobelActive®, Nobel Biocare, Göteborg, Sweden). One implant failed and mean marginal bone loss was 0.1 mm (p = .059). Temporary mesial papilla reduction occurred, whereas distal papilla reduction was permanent (mean 0.5 mm; p = .001). At 3 months, five cases demonstrated major alveolar process remodeling and two advanced midfacial recession. Hence, slight initial decline in the pink esthetic score (PES) (p = .053) was observed. CTG resulted in a steady improvement of the PES after 3 months (p ≤ .037). At 12 months, pink aesthetics (mean PES 12.15) was comparable to the preoperative status (mean PES 11.86; p = .293). Distal papillae had significantly deteriorated (p = .020) in this time span, whereas midfacial contour had significantly improved (p = .005).
Conclusions: Preservation of pink aesthetics is possible following IIT. However, to achieve that, CTG may be necessary in about one-third of the patients. Major alveolar process remodeling is the main reason for additional treatment.
Friday, February 24, 2012
|A Bioactive Nanolayer for Orthopedic and Dental Implants|
|(Nanowerk News) AddBIO AB, a subsidiary of Accelerator Nordic AB, has developed Zolidd®, a proprietary bioactive nanolayer for orthopedic and dental implants that releases bisphosphonate, a bone strengthening drug. A randomized clinical trial, conducted at Linköping University Hospital, Sweden, shows that dental implants with a bisphosphonate nanolayer have improved stability (see paper in Bone:"A bisphosphonate-coating improves the fixation of metal implants in human bone. A randomized trial of dental implants").|
|Millions of people worldwide have dental implants, i.e. screws inserted to support artificial teeth. The first time after surgery, the implant is often not stable enough to enable chewing. It may take several months for the bone around the implant to heal and become strong enough for the patient to regain normal chewing function.|
|"The study shows that local bisphosphonate improves implant stability, meaning that the time until normal chewing function could be shortened, thus reducing the suffering for the patient", says Professor Per Aspenberg, Linköping University Hospital, co-founder of AddBIO.|
|Zolidd is the first application from a platform technology designed for local release of drugs from medical implants, developed by Professors Per Aspenberg and Penti Tengvall, Linköping University. A nanometer-thin protein layer is attached to the metal surface and a bisphosphonate is attached to the protein. When the bisphosphonate is released, a local effect is obtained, which improves implant stability. In the present study, a Zolidd prototype was used to release bisphosphonate in this way.|
|Sixteen patients each received two implants, one with bisphosphonate and one without. After six months, the bisphosphonate treated implant showed improved stability in 15 out of 16 patients. On x-rays, the treated implants showed positive effects already after two months. No complications occurred.|
|"This is an important study. With these results, we are now ready to take the next step in commercializing Zolidd", says Dr. Trine Vikinge, CEO AddBIO.|
|Source: AddBIO (press release)|
Wednesday, February 22, 2012
3DISC Imaging inc., Dulles, VA, a manufacturer of digital imaging products, has developed a compact imaging device that provides reading of reusable dental imaging plates. The FireCR Dental Reader features a tablet computer to immediately view and share imaging results at the chair side and features touch screen software that provides dentists with immediate access to the history of the patient’s dental images.
The reader is DICOM 3.0 compatible with existing systems and uses low-cost, reusable imaging plates in a variety of sizes, including bite-wing and intraoral dental imaging plates.
Sunday, January 8, 2012
A 6-month histological analysis on maxillary sinus augmentation with and without use of collagen membranes over the osteotomy window: randomized clinical trial
Over the years, several modifications have been made to the sinus augmentation technique and to the materials used. However, there is still controversy about the need for using a barrier concurrently with a graft in sinus augmentation procedures. On this basis, the aim of this randomized clinical study was to investigate the effect of resorbable collagen membrane over the osteotomy window on maxillary sinus augmentation healing.
Materials and methods
Patients who required maxillary sinus augmentation were evaluated and selected to enter the study. After maxillary sinus grafting, each patient was randomly assigned to control (membrane over the osteotomy window) or test (no membrane) group. After 6 months, one bone biopsy was harvested from the lateral window and sent to the histology laboratory. The Mann–Whitney nonparametric test was used for comparing the two groups. P-value was set at 5%.
Eighteen patients entered the study and were randomly allocated in control (nine patients) or test group (nine patients). The histomorphometric measurements revealed that newly formed bone was 30.7% ± 15.5% of the total volume from the membrane group (control). The average percentage of connective tissue was 50.6% ± 18.7% and residual graft percentage was 18.4% ± 20.3%. On the other hand, data regarding the nonmembrane group (test) showed that the percentage of newly formed bone was 28.1% ± 19.4%. The mean percentage of connective tissues was 59.3% ± 15.4% and 12.6% ± 12.4% for the residual graft particles. No significant difference was detected in the histomorphometrical evaluation between the two groups.
Our results showed that, compared with sites not covered, the use of the membrane did not substantially increase the amount of vital bone over a period of 6 months. On the other hand, the use of membrane seems to reduce the proliferation of the connective tissue and the graft re-absorption rate. It is plausible that blood supply of maxillary sinus can play a role in such a result. Further studies are needed to explore whether the use of membrane could really be advantageous for the sinus augmentation procedure and to evaluate what influence this method can have on the amount and quality of reconstructed bone.
Histologic and histomorphometric evaluation of a synthetic bone substitute for maxillary sinus grafting in humans
The present study investigated the efficacy of a biphasic calcium phosphate as a bone grafting material for maxillary sinus augmentation in humans.
Materials and methods
Half of the thirty patients selected for sinus augmentation were grafted with biphasic calcium phosphate, whereas the other half were grafted with autogenous bone chips harvested intraorally. After 9 months of healing, bone cores were retrieved from implant sites for histologic and histomorphometric evaluation.
The areas augmented with autogenous bone chips showed newly formed bone with a pattern very similar to that of the native area. Histomorphometry demonstrated that the amount of newly formed bone in the autogenous bone group was significantly greater than in the biphasic calcium phosphate group (P < 0.05). In the biphasic calcium phosphate group, less bone formation was observed in the area further away from native bone interface than in the area closer to native bone interface (P < 0.05), whereas no significant differences were observed between both areas in the autogenous group. In both groups, the implant survival rate was 100% with a minimum 1-year follow-up.
The data presented in this work confirm the osteoconductive properties of biphasic calcium phosphate, as well as its use in association with maxillary sinus floor augmentation procedures with successful outcomes.
Histomorphometric and immunohistochemical analysis of human maxillary sinus-floor augmentation using porous β-tricalcium phosphate for dental implant treatment
This study utilized the constitution and expression of Runx2/Cbfa1 to conduct 6-month-post-operation histomorphometrical and histochemical analysis of osteocalcin in bone regeneration following sinus-floor augmentation procedures using β-tricalcium phosphate (β-TCP) and autogenous cortical bone.
Material and methods
Thirteen sinuses of nine patients were treated with sinus-floor augmentation using 50% β-TCP and 50% autogenous cancellous bone harvested from the ramus of the mandible. Biopsies of augmented sinuses were taken at 6 months for histomorphometric and immunohistochemical measurements.
Runx2/Cbfa1- and osteocalcin-positive cells were found around TCP particles and on the bone surface. Approximately 60% of cells found around TCP particles stained positive for Runx2/Cbfa1. Fewer cells stained positive for osteocalcin. These positive cells decreased apically with increasing vertical distance from the maxillary bone surface. Histomorphometric analysis showed that the augmented site close to residual bone and periosteum contained approximately 42% bony tissue and 42% soft connective tissue, and the remaining 16% consisted of TCP particles. On the other hand, the augmented bone far from residual bone and periosteum contained 35% bony tissue and 50% soft connective tissue.
Our data suggest that TCP particles attract osteoprogenitor cells that migrate into the interconnecting micropores of the bone-substitute material by 6 months. The augmented site close to residual bone contained a higher proportion of bony tissue and a lower proportion of soft connective tissue than did the augmented site far from residual bone.
Chemists from the Otto-Schott-Institute for Glass Chemistry at Jena University in Germany have produced a new kind of glass ceramic with a nanocrystalline structure. The material has high strength characteristics and optical properties which make it ideal for use in dental applications.
The ceramic material comprises magnesium, aluminum and silicon dioxide, a combination known for its high strength properties. So far the new material has demonstrated a strength five times greater than comparable denture ceramics. By making the ceramic optically similar to natural teeth the researchers have overcome the major barrier for use of the material in dental applications.