The study was based on the use of a toothpaste with antiphlogistic activity, containing Australian Melaleuca alternifolia oil (tea tree oil—TTO) and ethanolic extract of Polish propolis (EEP). Fifty-one patients with varying conditions of the gingiva were divided into two groups. The study group received the toothpaste with TTO and EEP, while the control group received the same toothpaste but without TTO and EEP. Approximal plaque index (API), simplified oral hygiene index (OHI-s) and modified sulcus bleeding index (mSBI) were assessed in three subsequent stages. During each examination, swabs were employed for microbiological inoculation. During the period of use of toothpastes with TTO and EEP, a significant reduction of the API was observed, as assessed upon the control visit after 7 days and after 28 days, compared to baseline. A statistically significant reduction of mSBI was observed after 7 and 28 days of using the toothpaste with TTO and EEP, as compared to the value upon the initial visit. Statistically significant differences in the OHI-s value were observed in the study group, which was using the active toothpaste. The use of a toothpaste containing TTO and EEP helps to maintain microbiome balance. The observed stabilisation of bacterial microflora confirms the beneficial activity of toothpaste containing EEP and TTO compared to the control group, where the lack of these substances contributed to the emergence of qualitative and quantitative changes in oral microbiome.
Systematic evaluations regarding the influence of PRF in ridge sealing are still lacking. To the best of our knowledge, this is the first systemic randomized, controlled, clinical approach dealing with the potential of a systematic applied solid PRF on soft tissue socket healing of molar and premolar extraction sockets with evaluation for up to 90 days. Qualitative and quantitative image analysis showed that PRF contributed to a significantly faster ridge sealing, within the period of 7–10 days in both tooth types. This led to a visibly less contraction at the PRF-treated group sites at day 90. Patients’ pain perception demonstrated no statistic significance between both groups (PRF vs. natural healing), but the patients in PRF group seemed to have had less pain throughout the observational period. It becomes evident that PRF is able to serve as a promotor of the secondary wound healing cascade. The guiding capacity of PRF accelerating the process of open ridge healing makes it possible to act as a natural growth factor drug delivery system, providing a more predictable guided open wound healing of the ridge with less contraction of the soft tissue, the latter being a key factor for the subsequent successful dental implantation and oral rehabilitation.
The alveolar ridge undergoes a loss in volume and atrophy after tooth extraction. Understanding the wound healing and bone regeneration process after tooth extraction is a key factor in the insertion of dental implants. Therefore, the aim of the present study was to analyze the socket healing process after the extraction of upper premolars based on cone beam computed tomography (CBCT) over six months. Special focus was placed on the morphological changes in the alveolar crest and within the socket. A retrospective analysis of patients in need of tooth extraction in the upper premolar region was performed in this study. All patients received flapless tooth extraction under local anesthesia and CBCT immediately after tooth extraction. Further CBCT analysis was performed after three months for the first group (n = 18) and after six months for the second group (n = 18). The results showed that all sockets underwent an inward movement of the defect walls towards the defect center, resulting in reduced total alveolar ridge volume and defect volume. This result was observed after three months and persisted after six months. The inward movement was quantified as a vertical socket collapse of up to 30.1 ± 9.0% after three months and 34.3 ± 6.7% after six months. The horizontal inward movement was quantified as a buccal socket collapse of 47.7 ± 12.3% after three months and 55.7 ± 29.1% after six months. New bone formation within the socket was evident, especially in the occlusal part of the socket. Additionally, bone formation was primarily observed as bone apposition along the socket walls and did not reach the defect center in most cases. The combination of socket collapse and bone apposition led to the formation of cavitations inside the socket that were mostly localized under the occlusal part. These novel findings with respect to socket collapse and formation of cavitation represent a paradigm shift and call for reconsidering the current understanding of socket healing. Based on the data, socket healing should be understood as a patient-specific process that requires 3D radiographic analysis for planning dental implants.
The aim of the study was to evaluate 10-years of clinical material referring to the rare dental abnormality of double teeth. The study material consisted of case records, operation-books and radiographic or photographic documentation on patients treated in the Department of Oral Surgery, Silesian Medical University, Katowice, from the 1st of June 2000 to the 31st of May 2010. The following features were considered important: age and sex, the reason why the patient reported for treatment, general state of health, the time of recognition and type of double teeth, location of double teeth, complaints and disturbances connected with double teeth, types of radiographs, the radiographic and macroscopic appearance of double teeth and treatment method. Diagnoses were as follows: eight conrescent teeth, two fused teeth, two geminated teeth and one invaginated tooth. The anomaly of a deciduous tooth was referred to in one case only. Double teeth were most often seen in the region of maxillary incisors and molars but rarely in the mandible. The region of incisors was affected chiefly in children and the region of molars in adults. Double incisors are usually recognized prior to treatment whereas double molars as late as during their extraction. In many cases, neither intraoral radiographs nor pantomographs help to confirm double teeth or provide sufficient information to plan the treatment. In such a situation, CT or CBCT should be used in addition to imaging diagnostics. Double teeth among incisors are usually accompanied by occlusal disorders. Therefore the therapeutic management is conducted by a team, including orthodontists.
Successful implantation in augmented areas relies on adequate bone density and quality, along with thorough planning. The minimisation of the risks involved in the surgery and recovery phases is also of tremendous relevance. The aims of the present research were to clinically and biochemically evaluate the healing process after implant surgery (dental implants) using dynamic surgical navigation following prior bone augmentation. Thirty healthy patients who had implant treatment were analysed. The study participants (30 patients) were randomised between two groups. The 15 patients in the study group were treated with Navident dynamic navigation by using a flapless technique. The control group included 15 subjects in whom the implantation procedure was performed classically using the elevation flap full-thickness method. In all cases, the patient’s clinical condition, the patient’s subjective visual assessment of post-operative pain using the Visual Analogue Scale (VAS), and the levels of the salivary biomarkers interleukin 6 (IL 6) and C-reactive protein (CRP) immediately before surgery on the first post-operative day and on the seventh post-operative day were assessed. The healing process was shown to be faster in patients in the study group due to the low invasiveness of the treatment, which was confirmed by lower levels of pro-inflammatory cytokines in the study group versus the control group. The statistical analysis used Student’s t-test and Mann–Whitney test. The implementation of dynamic navigation and the application of the flapless technique reduced post-operative trauma, leading to a reduced risk of infection, reduced patient discomfort, and faster recovery.
Following tooth extraction, the bone structure is prone to atrophic changes. Alveolar ridge resorption can compromise subsequent implant treatment not only at the extraction site itself but also by affecting the bone support of adjacent teeth. Various techniques, including the use of bone graft materials or autologous blood concentrates for ridge or socket preservation, aim to counteract this process. The efficacy of such methods can be evaluated non-invasively through radiological analysis of the treated region. However, existing radiological evaluation methods often focus only on isolated areas of the extraction socket, limiting their accuracy in assessing overall bone regeneration. This study introduces a novel, non-invasive, and semi-automated image-based analysis method that enables a more comprehensive evaluation of bone preservation using CBCT data. Developed with the open-source software “Fiji” (v2.15.0; based on ImageJ), the approach assesses bone changes at multiple horizontal and vertical positions, creating a near three-dimensional representation of the resorptive process. By analyzing the entire region around the extraction socket rather than selected regions, this method provides a more precise and reproducible assessment of alveolar ridge preservation. Although the approach requires some processing time and focuses exclusively on radiological evaluation, it offers greater accuracy than conventional methods. Its standardized and objective nature makes it a valuable tool for clinical research, facilitating more reliable comparisons of different socket preservation strategies.