Adi Lorean

Purpose: This study sought to evaluate treatment outcomes of implant-prosthetic rehabilitation with implants in the edentulous maxilla or mandible that were immediately loaded by fixed prostheses. Special consideration was given to the time of implantation (immediate, delayed, or late implant placement). Materials and methods: Twenty-five patients who received 283 immediately loaded screw-type implants were included in this retrospective study. Data captured included patient file information, panoramic and periapical radiographs obtained during treatment, and clinical parameters examined during the recall period. Clinical and radiographic status of peri-implant soft and hard tissue was evaluated, as well as the function of prostheses and subjective assessment by the patients of the treatment. Survival/success rates were analyzed with respect to the time of implantation. Results: Following a maximum observation period of 120 months (median 29 months) postimplantation and subsequent immediate functional loading, implant survival was 99.6% (one implant failed after 20 months). The success rates were 98.2% for implants and 88% for patients; five implants in three patients did not meet success criteria. Neither the implant site nor the time of implantation were associated with unsuccessful outcomes. Implant-related evaluations revealed a significant association between implant success and implant length of 10 mm or less (P < .018). Conclusion: Within the limits of this study, immediate loading of rough-surfaced, screw-type implants supporting fixed dentures for the treatment of edentulous maxilla or mandible appears to be a reliable treatment option with a high probability of success. The time of implantation did not influence implant survival or success rates.

Third lower molar partially erupted is commonly encountered in dental practice. This situation challenges clinicians with the dilemma whether to remove or to monitor it, because this molar can cause pathology of the adjacent second molar. The aim of this retrospective study is to evaluate the relationship between third mandibular molar and distal cervical caries in second molar. This retrospective study analyzed 55 digital orthopantograms of adult patients and a total number of 95 mandibular third molars were assessed for eruption status, angulation, radiographic evidence of caries or restoration in the mandibular third molar, and radiographic evidence of caries or restoration in the distal surface of the mandibular second molar. The distal cervical caries in second molar is associated with fully erupted and partially erupted wisdom molar in horizontal, mesioangular and vertical position and less with presence of caries in third molar. There are caries lesions in distal second molar...

To the Editor: Epidemiologic data show that, after the third molars, the canines, followed by the premolars, are the most frequently impacted teeth. When impacted teeth are asymptomatic, surgical removal might not be necessary sometimes. Patients, however, seek rehabilitation of the site when the primary canine is lost and the presence of the impacted tooth must be dealt with. Treatment usually requires that either the canine be moved orthodontically to the ridge, when feasible, or the impacted tooth be surgically removed before an implant is placed. Treatment of asymptomatic impacted maxillary canines in adults is inevitable when primary canine becomes lost through extraction or exfoliation or when the impacted tooth becomes symptomatic. The replacement of a single tooth with an implant in the anterior maxilla is a topic of interest for clinicians because of its aesthetic implications. The aim of this article is to present the method of simultaneous removal of impacted maxillary canine and placement of an immediately loaded implant to achieve an aesthetically stable result, with minimal bone resorbtion and shortened treatment period with no incidence of complication. This article describes a case series of 5 patients where horizontally impacted maxillary canine was surgically removed and immediate implant placement with immediate provisionalization was done. All the patients had undergone thorough clinical and radiologic examination preoperatively. Panoramic radiographs were taken in all the 5 patients and cone beam computed tomography scan was done to further evaluate the position of the impacted canine. After confirmation of the exact position, patient was planned for surgery under local anesthesia. Instead of cutting more amount of bone, the crown was sectioned at cement–enamel junction in all the patients. After the removal of crown portion, the root was removed. After that the osteotomy was prepared and the site for placement of implant was prepared. Touareg-S implants (Adin Dental Implant Systems Ltd., Industrial Zone Alon Tavor, Afula, Israel) of the desired diameters and length were placed. The anchorage and stability of the implant was achieved from the bone in canine pillar region successfully. The residual defect was filled with alloplastic bone graft material (OsteoGen Synthetic Bioactive Resorbable Graft Impladent Ltd.). The closure of the wound was done primarily. Temporization of the implant was immediately done within 48 hours of the procedure in all 5 patients. The crowns were cement-retained acrylic crowns and were kept infraocclusion to prevent excessive forces during the healing of implants. After 4 months, the patients were clinically evaluated and radiographs were taken to check the radiographic implant osseointegration. Temporary acrylic crowns were removed, impressions were taken, porcelain fused to metal crowns were fabricated and the restorations were successfully delivered to the patients. Implants were evaluated clinically and radiographically at the end of the healing period, at months, and at on an annual recall. The results were that there were no radiolucency noted around the implants, no abnormal reaction at the bone–implant interface, and there was a good consolidation of the graft at the site of removal of the impacted canine. The removal of impacted canines followed by immediate implant placement and provisionalization minimizes the number of surgical interventions and the waiting time, although increased surgical skill is needed to place the implants. This treatment modality avoids the need for conventional preparation of teeth as part of prosthetic reconstruction or prolonged orthodontic treatment aimed at bringing the impacted canine to the dental arch. Combining the implantation with immediate provisionalization, despite the initial large bone defect caused by the impacted canine extrusion, preserved the alveolar bone and shortened the treatment period.

et al demonstrated that the a2 adrenergic receptors activates the extracellular signal-regulated kinase pathway and stimulates the proliferation of epithelial cells derived from the proximal renal tubule of rat and pig. The study showed that systemic administration of a2 agonists stimulate the proliferation of epithelial cells derived from the proximal renal tubule and modulate regeneration of tubular cells. Although dexmedetomidine is a2 agonists, in the current study we found similar proliferative effect of dexmedetomidine on nasal mucosal tissue in rats via IN and IP administrations as compared with IN saline usage. Iirola et al demonstrated that dexmedetomidine is rather rapidly and efficiently absorbed after IN administration. Compared with intravenous administration, IN administration may be a feasible alternative in patients requiring light sedation. Their study also indicates high bioavailability of IN usage of dexmedetomidine. The strength of our study is the assessment of cytotoxicity of IN dexmedetomidine for the first time. However, usage of one staining method was the limiting point of the study. The results presented are preliminary and the literature concerning this issue is poor. As a result the current study showed that IN administration of dexmedetomidine has not any additional proliferative effect as compared with IN saline. Further studies are needed to support the convenience and safety of this drug.

Osteoporosis is recognized as a common skeletal disorder characterized by low bone mass and microarchitectural deterioration. Osteoporosis also affects maxillary bones where alveolar processes suffer resorption. Prosthetic rehabilitation supported by endoosseous implants is the only oral rehabilitation that preserves the residual alveolar ridge from atrophy. The objective of this study is to evaluate the effect of strontium ranelate on maxillary bone density for patients with osteoporosis candidates for implant therapy. The study included a number of 54 patients with osteoporosis, divided in two groups: group A where patients took 2 grams of strontium ranelate orally daily during one year and group B where osteoporotic patients did not receive strontium ranelate. Maxillary bone density was assessed for both groups at one year interval. The results show that strontium ranelate is associated with increased maxillary bone density.

The aim of this study was to evaluate the success and complications following inferior alveolar nerve (IAN) transposition/reposition for dental implant placement in edentulous or partially edentulous mandibles. This was a multicenter retrospective study; patients who had undergone IAN transposition/reposition at four surgical clinics were retrospectively evaluated. Adverse effects, especially neural disturbances, were recorded and followed. Overall, 68 IAN reposition and 11 nerve transposition procedures were performed in 57 patients (only three patients reported on smoking). The residual bone above the IAN was an average 3.88±1.98mm. A total of 232 dental implants were inserted in the area after transposition/reposition of the nerve. The average follow-up time was 20.62±9.79 months, ranging from 12 to 45 months. One implant loss was observed during the follow-up period. Four patients reported prolonged transient neural disturbances immediately following surgery (5% of the operations). The duration of neural disturbances after the surgery ranged from 1 to 6 months. No permanent neural damage was reported. Thus, within this study&amp;#39;s limitations, it can be concluded that IAN transposition and reposition are useful adjunct techniques for managing severely atrophic edentulous or partially edentulous mandibles with dental implants. The risk of neural dysfunction appears to be low.

PURPOSE This study sought to evaluate treatment outcomes of implant-prosthetic rehabilitation with implants in the edentulous maxilla or mandible that were immediately loaded by fixed prostheses. Special consideration was given to the time of implantation (immediate, delayed, or late implant placement). MATERIALS AND METHODS Twenty-five patients who received 283 immediately loaded screw-type implants were included in this retrospective study. Data captured included patient file information, panoramic and periapical radiographs obtained during treatment, and clinical parameters examined during the recall period. Clinical and radiographic status of peri-implant soft and hard tissue was evaluated, as well as the function of prostheses and subjective assessment by the patients of the treatment. Survival/success rates were analyzed with respect to the time of implantation. RESULTS Following a maximum observation period of 120 months (median 29 months) postimplantation and subsequent imme...

The success of dental restorations is dependent both on clinical phases of treatment to achieve fairness and on rigor to achieve technical phases. In our study we conducted research on metal parts microstructure of metal-ceramic dentures, to investigate the effect of reheating to successive deposits layers of ceramic. We analyzed molded samples and replicates on which were simulated ceramics firing. Applying such heat treatments have resulted in complete dissolution of intermetallic compounds and conducted to a homogeneous microstructure near to thermodynamic equilibrium, which leads to improved behavior in long-term operation of dental restorations.

OBJECTIVES Severe atrophied edentulous posterior mandible with inadequate bone height superior to the inferior alveolar canal may require transposition of the inferior alveolar nerve in order to insert dental implants. Mandibular fractures are considered a rare complication of this procedure. Implant-related spontaneous fractures of the mandible represent 0.2% of patients with inserted implants in an edentulous mandible. This report presents two cases of mandibular fractures that occurred 3 to 4 weeks after inferior alveolar nerve transposition, and were managed successfully by conservative nonsurgical treatments. METHOD AND MATERIALS Overall, 132 procedures of inferior alveolar nerve transposition in 98 patients were performed over a period of 10 years with 379 dental implants inserted in one stage with the procedure. Patients were examined every 2 weeks. The inferior alveolar nerve function was evaluated with various sensory tests. Panoramic radiographs were obtained immediately, ...

OBJECTIVES To evaluate the accuracy, safety, and anticipation effect of a novel electrical conductivity device (SG) in maxillary osteotomy preparation for placement of dental implants. MATERIALS AND METHODS Thirty-seven osteotomies were prepared by three operators with different levels of expertise, using the SG protocol in the maxilla of six fresh frozen cadavers. A pre-op CT measurement of the length of bone in the desired implant location was taken and compared with the final length of the osteotomy created using SG during surgery. A comparison was made between the results of the different operators. RESULTS The pre-op CT bone length measurements and the final depth assessment of the osteotomy with SG had a very high correlation level (0.977) with a significant mean difference of 0.639 mm (P &lt; .0001), with the pre-op CT measurements being longer. The least experienced operator had placed the implants 0.924 mm less deep than the pre-op CT length measurements while the most expe...

UNLABELLED The aim of this paper is to present a technique for segmental dento-alveolar intrusive osteotomy in a posterior maxilla with lack of inter-arch distance for prosthetic rehabilitation combined with sinus floor elevation. METHODS A full thickness flap is elevated exposing the lateral wall of the maxillary sinus. A lateral window is opened and the Schneiderian membrane elevated. Segmental dento-alveolar osteotomy is performed. After complete detachment of the segment, it is adapted and fixed to the new position using the pre-prepared guide, making sure not to damage or perforate the Schneiderian membrane. RESULTS Four cases of segmental dento-alveolar intrusive osteotomy in a posterior maxilla combined with sinus floor elevation were performed utilizing the above-mentioned technique. All surgeries went according to plan, and healing was uneventful except for swelling and pain that lasted for 10-14 days post- operatively. The opposing dentition was later treated by implant pl...

The use of hormonal anti-inflammatory drugs is a common practice in oral and dental surgery. They have proven enhanced efficacy, increasing therapeutic success when the treatment is properly chosen and managed. However, given the complexity of neurophysiologic processes, little is known regarding the consequences of administering glucocorticoids on brain function. This article aims to bring to the attention of dental health professionals the main neurophysiologic mechanisms by which glucocorticoid hormones can affect memory and attention. In addition, in the context of increasing global prevalence and incidence of cannabinoid consumption, both for medical and recreational purposes, the issue of the association of cortisone-derived drugs in the systemic context of these phytocannabinoids is addressed, in terms of memory issues and attention.

The aim of the present study was to evaluate the influence of implant length and diameter on implant survival. A retrospective cohort of 787 consecutive patients from 2 private practices between the years 2008 and 2011 had been evaluated. Patient demographics, site and implant characteristics, and time of follow-up were recorded from the medical files. Overall, 3043 implants were investigated. Overall survival rate was 98.7% with 39 implant failures recorded. Survival rates for narrow- (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;3.75 mm), regular- (3.75-5 mm), and wide- (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;5 mm) diameter implants were 98.2%, 98.7%, and 98.5%, respectively (P = 0.89). Survival rates of short (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;10 mm) and regular (10 mm and above) implants were 97% and 98.7%, respectively (P = 0.22). Implant length and diameter were not found to be significant factors affecting implant survival during the first 2 years of function in the present investigation of this specific implant system by a single manufacturer. Further long-term follow-up studies are warranted because 2-years are only interim short-term results when dealing with dental implants.

VIOLETA HANCU1, RALUCA MONICA COMANEANU1, COSTIN COMAN1, MIHAIL TARCOLEA2*, HORIA MIHAIL BARBU1, ANAMARIA BECHIR1, FLORIN MICULESCU2, ADI LOREAN3 1 Titu Maiorescu University of Bucharest, Faculty of Dental Medicine, 67A Gh. Petrascu Str., 031593, Bucharest, Romania 2 Politehnica University of Bucharest, Faculty of Material Science and Engineering, 313 Splaiul Independentei, 060042, Bucharest, Romania 3 Laniado Hospital, Netanya, Israel

Canine edentulous raises numerous aesthetic and functional problems, and rehabilitation with implant support require special attention during occlusal equilibration due to forces developed at this level. In this paper, we present a case of edentation of 23, prosthesis with a metal-ceramic crowns cemented on a dental implant. Because residual bone crest present inadequate size for implantation, we used an autograft of chin covered by a PRF membrane prior insertion of the implant.

OBJECTIVES To evaluate the effectiveness of 0.2% delmopinol mouth rinse in maintenance of peri-implant tissue health and prevention or inhibition of peri-implant mucositis and peri-implantitis. MATERIALS AND METHODS Four weeks following tooth extraction, eight titanium dental implants, were placed in six dogs&#39; mandibles. Three dogs were assigned to the test or placebo mouth rinse. Eight weeks following implant installation (T2) ligature was placed to induce peri-implant disease. Clinical and radiographic assessment was performed during the study period as well as micro-CT analysis and histologic assessment to evaluate Bone-Implant Contact at the end of the follow-up (T4). RESULTS Plaque at implant sites before ligature placement (T2) was lower for the test group (0.7 ± 1.0 vs 1.5 ± 1.3, P &lt; .05). The ratio of affected implant (PD ≧4 mm) at T2 and T4 in the test group was significantly smaller than that of the placebo group (T2, 17% vs 47%, P &lt; .01; T4, 67% vs 83%, P &lt; .05). The test agent also seemed to be effective in partially preventing bone loss induced by ligature placement according to the Computed Tomography and histologic analysis (test, 1.1 ± 0.8 mm; placebo, 1.5 ± 0.9 mm). CONCLUSIONS Within the limits of this animal model study, the results of the study indicate that the 0.2% delmopinol rinse might play a role in prevention of peri-implant disease development.

The aim of this study is to evaluate the performance of the implant derived minimally invasive sinus floor elevation. A multi-center retrospective study was performed in 5 dental clinics. Patients requiring sinus augmentation for single implant placement were recorded and followed-up. The dental implant used in this trial was a self-tapping endosseous dental implant that contains an internal channel to allow the introduction of liquids through the implant body and into the maxillary sinus. Overall, 37 implants were installed in 37 patients. The age range of the patients was 37-75 (mean: 51.2). The average residual bone height prior to the procedure was 5.24±1 mm. Of all cases, 25 implants replaced the maxillary first molar and 12 replaced the maxillary second premolar. All surgeries went uneventful with no apparent perforation of the Schneiderian membrane. The mean follow-up time was 24.81±13 months ranging from 12 to 65 months. All implant integrated and showed stable marginal bo...

To evaluate the survival rate of dental implants replacing failed implants in grafted maxillary sinuses using the lateral approach vs nongrafted posterior maxillae. A retrospective analysis was conducted to study the survival of secondary dental implants inserted in the posterior maxilla in previously failed implant sites between the years 2000 and 2010. The study group consisted of patients who had also undergone maxillary sinus augmentation, and the control group consisted of patients in whom implants in the posterior maxilla had failed. Clinical and demographic data were analyzed using a structured form. Seventy-five patients with a total of 75 replaced implants were included in the study. The study group comprised 40 patients and the control group, 35 patients. None of the replaced implants in the study group failed, resulting in an overall survival of 100%; three replaced implants in the control group failed (92% survival). The main reason for the primary implant removal was la...

The blood–brain barrier (BBB) is a major obstacle for movement of large molecules to and from the brain. Stimulation of the sphenopalatine ganglion (SPG), the major source of parasympathetic innervation to brain vasculature, is known to vasodilate brain vessels, and has recently ...

David Yarnitsky, MD, Yossi Gross, M.Sc., Adi Lorian, DMD, Alon Shalev, M.Sc., Itschak Lamensdorf, Ph.D., Rinat Bornstein, D.Vet., Shy Shorer, MD, Avraham Mayevsky, Ph.D., Kaushik P. Patel, Ph.D., N. Joan Abbott, Ph.D., and William G. Mayhan, Ph.D.

Six dogs underwent baseline angiography followed by creation of subarachnoid hemorrhage (SAH) by injection of autologous blood into the cisterna magna. Two days later, subarachnoid blood injection was repeated. Seven days later, angiography was repeated and the left ...

The aim of this paper is to present a technique for segmental dento-alveolar intrusive osteotomy in a posterior maxilla with lack of inter-arch distance for prosthetic rehabilitation combined with sinus floor elevation. A full thickness flap is elevated exposing the lateral wall of the maxillary sinus. A lateral window is opened and the Schneiderian membrane elevated. Segmental dento-alveolar osteotomy is performed. After complete detachment of the segment, it is adapted and fixed to the new position using the pre-prepared guide, making sure not to damage or perforate the Schneiderian membrane. Four cases of segmental dento-alveolar intrusive osteotomy in a posterior maxilla combined with sinus floor elevation were performed utilizing the above-mentioned technique. All surgeries went according to plan, and healing was uneventful except for swelling and pain that lasted for 10-14 days post- operatively. The opposing dentition was later treated by implant placement. The average follow...