Pavel Petruk

Prolonged tooth loss causes alveolar ridge atrophy, complicating implantation, especially in patients with impaired mineral metabolism. This study aimed to develop a personalized titanium mesh for guided bone regeneration and qualitatively evaluate its local tissue response in a vitamin D3-deficient rabbit model. A titanium mesh design has been developed in the form of a plate-shaped profile frame of a truncated pyramid with a solid upper base and perforated side faces. For testing in a rabbit model with vitamin D3 deficiency, a bone defect was created and repaired in the mandible using hydroxyapatite, an individual titanium mesh and a collagen membrane. Histological analysis was performed in the Laboratory of Digital Microscopic Analysis. The optimized geometry and parameters of the mesh openings contributed to effective vascularization and osteogenesis. In the postoperative period (3, 5 and 7 days), moderate edema and hyperemia were noted with their complete leveling by the 7th day (p < 0.05). According to the histological examination, 3 months after the installation of the titanium mesh, the formation of dense connective tissue with signs of active osteogenesis was observed in the defect area, including zones of mineralized bone trabeculae, osteocytes and osteon elements. The findings of this study indicate acceptable biocompatibility of the developed titanium structure and suggest osteoconductive potential, which, however, needs to be confirmed in controlled, quantitatively powered studies.

Background: Tooth extraction is often accompanied by bone tissue loss. This systematic review aims to compare osteoplastic materials for socket preservation. Methods: This systematic review was carried out with the PRISMA statement. To identify relevant studies, a thorough literature search was executed in several databases, such as Medline, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. The inclusion criteria were restricted to randomized controlled trials, and their methodological quality was evaluated with the Cochrane Risk of Bias tool (ROB 2). Results: Based on the predefined inclusion and exclusion criteria, nine randomized clinical trials published before 2024 were selected for analysis, all of them investigating the application of osteoplastic materials. Six studies performed xenogenic bone augmentation; one of them compared alloplastic and xenogenic materials; two studies described synthetic osteoplastic materials; and one described autogenic bone material. Conclusion: Socket augmentation with osteoplastic materials demonstrates effectiveness in preserving alveolar ridge dimensions and creating favorable conditions for further implant placement, though differences in clinical performance highlight the need for careful material selection.

(1) Background: Impacted third molar extraction with a scalpel and rotary instruments is one of the most traumatic surgeries in dentistry. Therefore, it is necessary to discover less traumatic methods and instruments to reduce the risk of postoperative complications. (2) Methods: This study is reported in accordance with the CONSORT guidelines. The study aim is to assess the effectiveness of an Er:YAG laser with a wavelength of 2.94 μm, cutting and rotating instruments in the extraction of lower third molars in comparison with the traditional instruments using clinical and radiology parameters. In the control group, the impacted third molars were extracted with the traditional instruments, like scalpel and rotary instruments; in the test group, the impacted third molars were extracted with an Er:YAG laser. As per the inclusion and exclusion criteria, we enrolled 60 patients who were randomly assigned into two groups (Er:YAG laser group and control group). The efficacy of the Er:YAG laser was assessed by postoperative pain, collateral swelling, mouth opening, and radiology parameters such as radiographic infrabony defects and radiographic bone height after tooth extraction. (3) Results: The results showed that the clinical postoperative parameters like pain, collateral swelling, and mouth opening were less pronounced in the Er:YAG laser group than those in the control group (p < 0.001). According to the data of the radiology parameters (RBH and RID), the regeneration of the socket after extraction was better in the laser group than in the control group (p < 0.001). (4) Conclusions: Based on the obtained results of clinical and radiology parameters assessment, it was shown that third molar extraction using an Er:YAG laser is a less traumatic method than extraction using a scalpel and rotary instruments.

(1) Background: Antibiotics are used in every medical field including dentistry, where they are used for the prevention of postoperative complications in routine clinical practice during the third molar extraction. (2) Methods: This study is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The present systematic review aimed to evaluate and systematize the use of antibacterial drugs in order to prevent postoperative complications in outpatient oral surgery for wisdom teeth extraction. We conducted a systematic review using electronic databases such as Medline PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. Considering inclusion and exclusion criteria, we included randomized clinical trials published up to 2021 investigating the antibiotic prescription for third molar extraction. (3) Results: We selected 10 studies after the application of inclusion and exclusion criteria. The results showed that the most widely used antibiotic was amoxicillin both with and without clavulanic acid, in different dosages and duration. There were no statistically significant differences between treatment groups for development of postoperative complications. (4) Conclusions: Based on the analysis of the included studies, penicillin is currently the most widely prescribed group of antibiotics. The widespread use of this antibiotic group can lead to antimicrobial resistance (AMR). Due to increasing prevalence of bacteria resistance to penicillins, clinicians should carefully prescribe these antibiotics and be aware that the widespread use of amoxicillin may do more harm than good for the population.

Recently, numerous articles have been published describing atypical lesions of the jaw bones related to treatment with medications based on phosphorus or analogs of its compounds, particularly bisphosphonates. Goal: To conduct a comparative analysis of the quality of life after radical surgery of the jaw in patients with medication-related osteonecrosis. A total of 82 patients were interviewed, of which 39 (47.6%) patients were in the control group (conservative treatment) and 43 (52.4%) patients in the main group had radical surgical treatment. The mean age of patients in both groups was 66.8 ± 10.03 years. Treatment of patients in the control group in terms of conventional conservative protocol included the local application of 0.05% chlorhexidine solution 1–2 times a day, antibacterial therapy (clindamycin—150 mg 4 times daily for 7 days) and NSAIDs (nimesulide). Patients in the main group (n = 43) underwent segmental resection of the jaw. Thirty days and then 6 months after the treatment, all patients were asked to assess the intensity of pain using a numerical scale, where 0 = no pain, 5 = moderate pain and 10 = the most severe pain imaginable, and to fill in the SF-36 Quality of Life Questionnaire. Results: An analysis of the results obtained with the Numeric Pain Rating Scale demonstrated that the mean pain intensity before treatment was 8.9 points in the control group, and 9.7 in the main group. These values were indicative of “unbearable pain”. After treatment (30 days), the pain score in the control group decreased and amounted to 4.1, which is evidence of the persistence of “moderate pain” in patients. In patients who underwent segmental jaw resection, the mean pain intensity was 0.5. There was no relationship with gender, but there was a direct relationship between the intensity of the pain and the stage of the process (CI = 95%). The SF-36 quality of life questionnaire showed that in the control group, who were treated conservatively, bodily pain (BoP) decreased from a score of 91.2 to 34.3, and the mental health score increased from 34.2 before treatment to 36.3 after treatment, which indicates the persistence of discomfort. The remaining parameters improved after treatment, but no complete recovery was achieved. Before radical surgery, the main group of patients also had a high level of bodily pain (95.2), but after surgery this decreased to 12.4. The remaining parameters also showed a significant difference before and after radical surgery, indicating a positive trend. Radical surgery allows us to improve the quality of life of patients, thereby confirming that surgical volume is a secondary aspect if there is no relapse after the treatment.