2 articles
Guided bone regeneration (GBR) is a surgical method that allows the formation of new bone in areas of atrophy of the maxillary bone. The integration of the graft or the augmented bone under the mucosal flap and the primary healing of the soft tissues are essential conditions for preventing the exposure of the regeneration site and infectious complications that inevitably lead to the failure of the GBR procedure.
This study presents the results of a cohort study that includes 70 patients who underwent GBR. The research involved techniques for forming muco-periosteal flaps: the Modified Periosteal Releasing Incision (MPRI) according to the principle of the double flap technique (DF) and the coronal advanced lingual flap (CALF). The study group included patients who underwent GBR using perforated titanium membrane, while the second group underwent GBR using bioresorbable poly-4 hydroxybutyrate (P4HB) synthetic mesh. The patients were evaluated periodically to monitor postoperative progress, the cases of dehiscence of the area related to augmentation site were recorded, measured and classified according to Fontana. Statistical results were generated and processed by the R Studio program.
In the study groups, a total of 8 cases of gingival dehiscence were registered, 4 cases in each group. In two cases, partial removal of the titanium membrane was performed by milling it, and the remaining 6 cases of dehiscence were remedied with rinses with oral antiseptic solution and scheduled visits for local care until the appearance of granulation tissue and epithelization.
Protective membrane, flap formation, thread tension and suture relaxation all play crucial roles in guided bone augmentation without dehiscence. In our study, the small number of dehiscence cases recorded as complications did not provide significant statistical results, namely due to the technique of performing the flap according to contemporary methods, a fact also described by the specialized literature.
Surface electromyography has proven to be a useful instrument for the assessment of success rate for different dental treatments. However, due to numerous variables that may influence the data like age, gender, fat tissue thickness etc. it is necessary to adjust the obtained values to a reference group with the same parameters.
A number of 33 patients were included in the study (21 women and 12 men) aged between 43-67 years old (mean 54± SD1.26). Surface electromyography of masticatory muscles was used in these patients to assess the average value in a time span and overlapping coefficients. Totally 10 parameters from each patient were recorded: TAL, TAR, MML, MMR, PocTA, PocMM, BAR, Asym, TORS, Impact. Data were stored in an Excel spreadsheet and then analyzed statistically using RStudio software.
Based on the results of our study, the main EMG activity indices in middle-aged Moldavian individuals had the following values: for the left temporalis (TAL) was 42 µV, median 18.8 with a minimum of 3.8 and a maximum of 190 µV. For the right temporalis (TAR) the mean was 51.4 µV, median – 32.9, a minimal value of 7.9 and a maximum of 248 µV. The left masseter had a mean of 48.7 µV, median 12.3, a minimal value of 1.5 and a maximum value of 439 µV. The right masseter had a mean of 42.1 µV, a median of 16.3, minimum value 11.4 and maximum 243 µV. The overlapping coefficients deviated with 20.5% from the normal range provided by the manufacturer.
Electromyographic activity of masticatory muscles in healthy patients can be used for comparison with patients that had various dental treatment but have the same age, gender, ethnicity, etc. The overlapping coefficients did not perfectly match in the normal range provided by manufacturer even if these subjects had previously minimum dental procedures.