The Role of Vitamin D in Implant Success

Vitamin D is a multifunctional hormone that is mostly produced in the skin following exposure to ultraviolet B sunlight. It coordinates the physiological functions by controlling calcium and phosphate metabolism, promotes growth, and induces necessary remodeling of the bones and teeth. As known high serum vitamin D levels have beneficial effects on oral health and that exposure to safe sunlight can reduce the risk of periodontal disease and thus affect implant success. In order to prove this hypothesis, we conducted a detailed literature review. In the literature review, 3 clinical studies and 2 case reports of implant and vitamin D were found. Although vitamin D is highly correlated with bone metabolism, and expected a very close relationship with implant success, a large number of experimental studies and few clinical studies unfortunately showed contradictory results and no direct studies showing vitamin D and implant success were found. Therefore, it is necessary to demonstrate the existence or absence of this relationship by conducting much broader studies.

Survival of Chemically Modified Titanium Surfaced Implants in Irradiated Jaws of Oral Cancer Patients

Objective: To investigate the clinical performance of implants with chemically modified surfaces in irradiated bone in a period of five-years. Patients & Methods: 15 (6 females, 9 males, 50.2 years with a range of 38 - 60 years) patients who had been operated for oral tumors and had undergone radiotherapy were enrolled and 40 SLActive surface implants were placed (24 in the maxilla, 16 in the mandible). Implants were allowed to integrate for a period of 90 days and the stability of the implants was measured with Resonance Frequency Analyzer/Osstell? Mentor (Integration Diagnostics, Savedalen, Sweden) at implant placement, 30 days later and at the end of the 90th day. Patients follow up periods after the implant placement varied from 20 months to 60 months (mean: 45 months). Results: Two implants were lost in maxilla in healing period as a result of osseointegration failure. The survival rate was 95%. During the observation period, totally 4 implants were lost. The overall success rate was 90%. 3 of the lost implants were in maxilla and one was in mandible. The initial ISQ values of the implants differed from 20 - 71;the second values were between 24 - 71 and the last values were between 30 - 89. The implants which were lost could not show a value greater than 35. Conclusion: There was no any complication on the SLActive surface implant placed bones due to irradiation. Within the limitations of this study, it may be concluded that osseointegrated implants can be placed in irradiated bones, unless a careful patient selection and treatment planning is performed.

Congenital Epulis of the Newborn:A Case Report

Background: Congenital epulis (CE) also known as congenital granuler cell tumor is a rarely encountered pathology the majority of which originates from the gingival mucosa, particularly the anterior portion of the maxillary alveolar ridge. CE mostly seen in girls. CE with unclear histogenesis and etiology is seen at birth as a solitary mass in oral cavity. Apart from non-congenital epulis, it contains granular cells. So lesion is named congenital granular cell tumor. CE has a benign histopathology and after surgery there is no recurrence reported in the literature. Aim: The purpose of this case report, is to present, 5 day-old female neonatal girl who was seen CE on the left maxillary alveolar ridge on the region of the future incisors. Case Presentation: The tumoral lesion was well-circumscribed and 10 mm in diameter, smooth surfaced and red in colour much like alveolar mucosal tissue. Tumoral lesion was affecting oral feeding due to obstruction. Excisional biopsy was performed under topical anesthesia. The histopathology was reported as congenital epulis. During the 4 months follow-up, we have seen no complication. Conclusion: CE is a neonatal congenital tumor which is very rare. The treatment of CE is surgical excision. Unless the early treatment is not executed, tumor may cause difficulties in oral feeding and respiration. Therefore it should be excised in an early period.

Changes in Alveolar Bone Width Following Bone Expansion

The placement of implants in edentulous areas is often compromised because of atrophic alveolar ridges. Several techniques have been suggested in the literature to increase inadequte bone width which includes bone grafting, distraction osteogenesis and bone expansion. Bone expansion technique is one of the most widely used methods which can also be utilized to increase the width of alveolar ridge and to provide sufficient bone volume for implant placement. The purpose of this study, is to measure the increase of the width of alveolar ridge after bone expansion following implant placement. Between 2013-2016, 30 consecutive, healthy, non-smoking, adult patients with atrophy of the maxilla and mandibula had 149 implants inserted. There were 18 women and 12 men, mean age 51.34 years (range 34 - 67). The initial width of the alveolar ridge measured from 2.5 to 3 mm (mean 2.83 ± 0.2) with Cone beam computed tomography (CBCT). The mean increase of bone width was achieved 1.25 mm (between 0.64 mm and 1.73 mm). Before prosthetic rehabilitation, width of expanded alveolar bone was calculated from 3.50 to 4.75 mm with CBCT. During follow-up, 140 implants survived and 9 implants failed. The rate of implant survival was 93.95% after average 5 years follow-up. In conclusion, we suggest that, bone expansion is useful for managing the unsufficient ridges for implant placement.

Benefits of Using CBCT in Bilateral Maxillary Impacted Canines Extraction:A Case Report

Aim: Canines are the second most impacted teeth in jaws after third molars. Perforation of the anatomic structures, such as maxillary sinus and nasal fossa, are some of the complications of the surgery. In this case, bilateral maxillary impacted canines’ extraction, with the guidance of CBCT is done without any complication. Case: A 24-year-old female patient was referred to Istanbul University, Oral and Maxillofacial Surgery. Left and right deciduous canines and swelling at the right maxillary canine’s labial area were seen during the intraoral examination. Bilateral impacted canines were determined after evaluating the present CBCT images of the patient and orthodontic treatment was advised to the patient. Due to the refusal of orthodontic treament, extractions of the impacted teeth were decided. After the evaluation of CBCT images, the maxillary right canine was determined at the labial site while the maxillary left canine was determined at the palatinale site. Results: Right maxillary canine was lying between the right first incisor and right first molar and It was extracted with mucoperiosteal vestibule flap procedure. For the extraction, the tooth was divided into two pieces from the enamel-cement junction. Left maxillary canine was lying between the left first incisor and left first molar and It was extracted with mucoperiosteal palatinale flap procedure. Flap was stitched primarly with 3/0 silk sutures. Palatinal plaque, which was prepared before the surgery, was applied. Antibiotic, analgesic and moutwash were prescribed to the patient. 1 week following the surgery, stitches were removed and the healing was optimal. Conclusion: Impacted canines are a common clinic condition which requires a multi-discipliner approach. CBCT can increase the success of the treatment by preventing possible complications with determining the proximity of the anatomical structures and the localization of the impacted teeth. There were no sign of complication and the healing was optimal.