Kayvon Javid

Statins have demonstrated positive results in alveolar repair after induced osteoporosis in humans and rats. This study aimed to evaluate the osteogenic potential of rosuvastatin (RSV) solution associated with collagen sponge in post-extraction rat alveoli. An experimental study was carried out at the Fluminense Federal University in 30 Wistar rats (female) randomly distributed into three experimental groups: group I—dental sockets filled with a blood clot (CS); group II—dental sockets filled with collagen sponge (EC); and group III—collagen sponge associated with RSV. Slides stained with hematoxylin and eosin (HE) were used for histomorphometric analysis to evaluate newly formed bone, connective tissue, and biomaterial in the respective groups, comparing them over different periods (7 and 42 days). The Shapiro–Wilk test was used to evaluate the same experimental period, and the Mann–Whitney test was used to compare the different periods between the groups. At 7 days, the clot group showed greater new bone formation (median 23.27; IQR 10.62–4.74) than the sponge group (median 2.25; IQR 3.42–1.53) and RSV group (median 0; IQR 0–0; p = 0.03), respectively. At 42 days, the clot group (median 63.90; IQR 7.54–3.73) showed better results regarding newly formed bone compared to the RSV group (median 26.33; IQR 4.78–2.24; p = 0.003). The present study demonstrated no advantages in the use of RSV in relation to the control group and no statistical difference between groups II and III.

A midpalatal suture contention after rapid maxillary expansion (RME) is a major orthodontic challenge. The objective of this study is to evaluate the effect of systemic simvastatin on suture bone remodeling after disjunction. For that, 15 Wistar rats were used. In 10, orthodontic appliances were installed and activated for 5 days for RME. These animals were randomly divided into two groups: control (CT, n = 5) and simvastatin (SVT, n = 5). Also, animals without intervention (HG, n = 5) were used. In the SVT and CT groups, 5 mg/kg of simvastatin and distilled water were administered by gavage, respectively, for 20 consecutive days. Then, the animals were euthanized and scanned in micro-computed tomography (µCT). The images were analyzed through pixel linear measurement at four different points (P1, P2, P3 and P4), in the intra-incisor distance (DI) and in the suture distance (SD). Microtomographic parameters, such as cortical bone area (Ct.Ar), cortical area fraction (Ct.Ar/Tt.Ar), and cortical thickness (Ct.Th), were obtained. Also, bone volume fraction (BV/TV) and empty space (EV) were extracted. Then, histological slides were prepared for descriptive and histomorphometric analysis. There was a statistically significant difference in the linear measurements, microtomographic parameters, and histomorphometric results between the experimental groups. In conclusion, simvastatin demonstrated an osteoinductive and antiresorptive effect in the palatine suture region after RME.

Osseodensification is a technique that involves compressing bone using specialized drilling instruments to increase bone–implant contact. The present study aimed to evaluate the structure of a xenograft bone (XB) wall created within an implantation site and how it affects the initial stability of dental implants. Six segments of pig ribs, representing low-density bone, were used in the experiment. Four different drilling conditions were created for each section using a tapered bur system associated with bovine xenograft bone: clockwise (cutting mode—CW) or counterclockwise (densification mode—CCW). The bone samples were then placed individually in microtomography equipment to define a volume of interest (VOI) 50% larger than the osteotomy. Mathematical calculations of bone volume, trabecular thickness and separation, and total porosity were performed. An implant with a diameter of 4.0 mm and a length of 11.5 mm was then inserted into each osteotomy. The final insertion torque (IT) and resonance frequency analysis/implant stability quotient (ISQ) values were recorded. The groups were compared using ANOVA and Tukey’s post hoc test. The results show that the use of xenograft bone produced densification at the apex region, with higher bone volume and trabecular thickness, and reduced trabecular separation compared with the CW group (p < 0.05). The CW + XB group demonstrated a similar porosity to the CCW group and similar values of IT and ISQ (p > 0.05). Compared with the other groups, CCW + XB exhibited the lowest percentual porosity and the highest values of IT and ISQ (p < 0.05). We concluded that the use of a xenograft bone wall before implant placement can improve the primary stability of dental implants.

Bone tissue engineering seeks biomaterials that enable cell migration, angiogenesis, matrix deposition, and tissue regeneration. Blood concentrates like platelet-rich fibrin (L-PRF) offer a cost-effective source of cells and growth factors to enhance healing. The present study aimed to evaluate heated serum albumin with liquid PRF (Alb-PRF) and L-PRF clinically and biochemically after placement in dental sockets following mandibular third molar extraction. In a controlled, split-mouth study involving 10 volunteers, 20 extracted molars were treated with either Alb-PRF or L-PRF. Post-extraction, pain, trismus, infection presence, and swelling were measured. The concentrations of different analytes in the surgical sites were also examined. The data were statistically analyzed, with significance defined at p < 0.05 (t-test). No significant difference was noted between the groups for pain and trismus, but Alb-PRF showed a significant reduction in swelling on day seven. The Alb-PRF group showed lower levels of pro-inflammatory cytokines (GM-CSF, IL-1b, IL-6, IFNy, IL-8, IL-15, RANTES, and MIP-1a) after seven days, with only higher expressions of MIP-1b, IL-1b, and MCP-1 found in the L-PRF group. Differences were observed in the release of analytes between L-PRF and Alb-PRF, with Alb-PRF significantly reducing edema after seven days. Alb-PRF reduced edema, while L-PRF increased inflammatory cytokines. When compared to L-PRF, Alb-PRF reduced edema and the release of inflammatory cytokines, suggesting promising effects in socket healing while underscoring the role of growth factors and cytokines in potential applications of blood concentrates.

The present article explores the benefits of combining periodontally accelerated osteogenic orthodontics (PAOO) with Invisalign for optimal orthodontic treatment outcomes. PAOO is an interdisciplinary dental technique that minimizes complications and accelerates tooth movement while enhancing various orthodontic treatments. In conjunction with Invisalign, PAOO provides a discreet and comfortable solution for patients seeking to improve their smile. The study presents two challenging cases successfully treated using this combined approach, emphasizing the technique’s potential to reduce treatment times and improve orthodontic outcomes. The interdisciplinary approach of PAOO ensures long-term success and stability by preserving periodontal structures and addressing potential bony defects. By incorporating bone grafting materials, PAOO helps prevent common concerns in traditional orthodontic treatments, such as bony defects and gingival recession. Furthermore, the combination with Invisalign offers a more aesthetically pleasing and comfortable treatment experience, allowing patients to maintain their self-esteem and confidence throughout the treatment. Despite the potential advantages, dental professionals must manage patient expectations and address potential complications to ensure the best possible results. Overall, the integration of PAOO and Invisalign demonstrates a viable alternative for patients who do not want to proceed with orthognathic surgery, enhancing patient satisfaction and overall treatment outcomes.

Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more “simplified approach” based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.

The present study aimed to evaluate the influence of manual torque (10 Ncm) versus clinical torque (30 Ncm), which is recommended by the manufacturer, on the total length of morse cone implant abutments. Twenty specimens were prepared and distributed into two groups: group 1 with ten analogs for morse cone type implant, and group 2 with ten morse type implants, size 4.3 × 15 cm. In each group, the distance between the implant platform to the top of the prosthetic abutment (abutment height) was measured and subjected to a torque of 10 Ncm. Then, the 30 Ncm torque was applied to the same abutment, and abutment height was measured. The distance between the top of the abutment and the implant/analog base was measured. In order to verify the clinical reproducibility of the experiment, comparisons between the abutment height of the analog at 10 Ncm and the implant at 30 Ncm were performed, showing a greater discrepancy in torque for the 10 Ncm analog (p < 0.05). In order to verify if the change in the laboratory protocol from 10 to 30 Ncm could minimize the differences in the height of the prosthetic abutments, the abutment height in groups 1 and 2 was compared with 30 Ncm, and no significant difference was observed (p > 0.05). The data indicated that the manual torque and the torque recommended by the manufacturer influence the total length of the prosthetic abutments of morse cone implants.

Silane-coating strategy has been used to bind biological compounds to the titanium surface, thereby making implant devices biologically active. However, it has not been determined if the presence of the silane coating itself is biocompatible to osseointegration. The aim of the present study was to evaluate if silane-coating affects bone formation on titanium using a rabbit model. For this, titanium screw implants (3.75 by 6 mm) were hydroxylated in a solution of H₂SO₄/30% H₂O₂ for 4 h before silane-coating with 3-aminopropyltriethoxysilane (APTES). A parallel set of titanium screws underwent only the hydroxylation process to present similar acid-etched topography as a control. The presence of the silane on the surface was checked by x-ray photoelectron spectroscopy (XPS), with scanning electron microscopy (SEM) and atomic force microscopy (AFM). A total of 40 titanium screws were implanted in the tibia of ten New Zealand rabbits in order to evaluate bone-to-implant contact (BIC) after 3 weeks and 6 weeks of healing. Silane-coated surface presented higher nitrogen content in the XPS analysis, while micro- and nano-topography of the surface remained unaffected. No difference between the groups was observed after 3 and 6 weeks of healing (p > 0.05, independent t-test), although an increase in BIC occurred over time. These results indicate that silanization of a titanium surface with APTES did not impair the bone formation, indicating that this can be a reliable tool to anchor osteogenic molecules on the surface of implant devices.

This systematic review (SR) aimed to evaluate implant survival rate, marginal bone loss (MBL), and biological/prosthetic complications of extra-short 4 mm dental implants. An electronic search without language or date restrictions was performed in five databases and in gray literature for articles published until August 2020. Prospective cohort studies and randomized clinical trials (RCTs) that evaluated the clinical performance of extra-short 4 mm dental implants were included. Studies were independently assessed for risk of bias using the Cochrane Collaboration’s tool. The protocol of this SR was registered in the PROSPERO database under number CRD42019139709. Four studies were included in the present SR. There was no significant difference in implant survival rate (p = 0.75) between extra-short 4 mm and long implants. After 12 months of function, the extra-short implants had a significantly (p = 0.003) lower marginal bone loss (MBL) rate when compared to long implants. Extra-short implants had a lower number of biological and prosthetic complications when compared to long implants. After 12 months of follow-up, extra-short 4 mm dental implants placed in the mandible exhibit satisfactory clinical outcomes concerning implant survival rate and MBL when compared to longer implants, with a low number of biological and prosthetic complications. A higher number of RCTs with longer follow-up is necessary for the future.

This study assessed the effects of leukocyte-platelet-rich fibrin (L–PRF) on soft tissue healing and the correlation with the local concentration of growth factors (GF) and cytokines in the dental socket of lower third molars. Forty lower-third molars (20 participants) were included in this randomized, double-blinded, split-mouth study. After extractions, randomized sides received alveolar filling with L–PRF on one side and a natural blood clot on the other side. The pain was assessed for up to seven days and soft tissue healing (Landry index) for 14 days post-extraction. Swabs were collected from the surgical sites for GF and cytokine assessment by flow luminometry. Participants reported lower postoperative pain on the sides grafted with L–PRF, which also presented increased tissue healing scores (p < 0.05). There were increased levels of all GFs and several cytokines at the L–PRF site at day one, while vascular endothelial growth factor (VEGF), IL–10, and IL1–RA remained higher throughout for seven days (p < 0.05). VEGF concentration at L–PRF sites correlated positively with the participants’ blood platelet content (ρ = 0.769). PDGF correlated negatively with pain experience on days 2 and 3, and positively with soft tissue healing scores, while FGFb presented a weak correlation with a reduction of pain on day 3. The use of L–PRF improves the soft tissue healing process and decreases postoperative pain after the third molar extractions, which correlates with an increase in the local concentration of growth factors such as PDGF and FGFb.