Chapters authored
Application of Photodynamic Therapy in the Treatment of Osteonecrosis of the Jaw By Marko Vuletić, Božana Lončar Brzak, Igor Smojver, Luka Marković, Mato Sušić and Dragana Gabrić
Osteonecrosis as term represents the death of bone tissue in the body and causes of necrosis can be different. Medication-related osteonecrosis of the jaws (MRONJ) is nowadays known as an inability of the alveolar bone to respond to a local trauma and it can result in severe local and systemic complications. In the etiology of medication-related osteonecrosis there are antiangiogenic and antiresorptive agents which have great effect on alveolar bone, producing an imbalance between resorption (osteoclastic activity) and deposition (osteoblastic activity). The exact mechanisms of development are not todays completely resolved. It is thought that it is a result from combination of medication interactions, microbiological contamination of the area and local tissue trauma. Typical signs and symptoms are painful mucosal lesions, swelling, exposed necrotic bone in the jaws, discomfort and dysesthesias. There is currently no gold standard or clearly defined treatment protocol for the disease itself. Process of treatment is demanding and main goal is to eliminate pain, control infection of soft and hard tissue and minimize progression of osteonecrosis. Besides the conventional surgical treatment, photodynamic therapy can be a viable supportive tool of initial and advanced stages of osteonecrosis and may contribute to improvements of patient′s quality of life.
Part of the book: Photodynamic Therapy
Evaluation of the Antimicrobial Efficacy of Different Types of Photodynamic Therapy on the Main Pathogenic Bacteria of Peri-Implantitis By Dragana Gabrić, Ana Budimir, Ivona Bago, Luka Marković, Verica Pavlić and Bleron Azizi
Every year, with the increasing number of dental implants placed, there is an increase in the incidence of peri-implantitis. The treatment of peri-implantitis is very complex and among other things includes mechanical and chemical decontamination of the implant surfaces, which is very challenging and often not predictable due to the surface properties of the implants. Photodynamic therapy recently has emerged as a potential treatment alternative or adjuvant treatment to peri-implantitis. Its potential to decontaminate implant surfaces without damaging the surface and the implants surrounding tissues has generated much interest in the scientific community. The possibilities of photodynamic therapy in treatment of peri-implantitis are opening new challenges in establishing optimal conditions for the clinical application of aPDT. Due to its non-invasiveness and ease of use this method can be effective when applied alone or as an adjunct therapy to conventional methods for treating peri-implantitis.
Part of the book: Photodynamic Therapy
The Effect of Implant Surface Design and Their Decontamination Methods in Peri-Implantitis Treatment By Dragana Rakašević and Dragana Gabrić
Different titanium implant surfaces are prone to microbial colonization and dental plaque accumulation contributing to peri-implantitis pathogens adherence and growth. In conjunction with systemic, local, and implant-based factors such as micro- and macro-designs, implant location, and region, these pathogens can cause a complex inflammatory response resulting in peri-implantitis and deleterious bone loss. Implant surface decontamination plays a crucial and important step in peri-implantitis therapy. The primary goal of implant surface decontamination is to eradicate bacteria and their products outside of implant pits and grooves reducing inflammation and promoting tissue regeneration and/or reparation. Various implant surface decontamination methods such as mechanical, chemical or physical methods have been proposed to prevent bacterial resistance development or/and surface damage. The chapter aimed to assess if implant microdesign could influence the decontamination method choice.
Part of the book: Current Concepts in Dental Implantology
Perspective Chapter: Ameloblastoma – Present and Future Concepts of Managing By Dragana Gabrić, Roko Bjelica, Mato Sušić and Marko Vuletić
Ameloblastoma is a benign odontogenic tumor of epithelial origin with locally aggressive behavior. It affects a broad age range of patients and it is most commonly found in the mandible, especially posterior area. The majority of ameloblastomas are conventional (multicystic), which are more difficult to eradicate than the unicystic or peripheral types. Although most of ameloblastoma cases can be treated predictably with radical surgical treatment, the management of recurrent and metastasizing ameloblastomas remains a major challenge. Surgical treatment is standard, but the extent of resection is controversial. Radical resection with segmental and marginal mandibulectomy or curettage and enucleation with better quality of life, but with higher recurrence rate. Besides the conventional surgical treatment, novel therapy options like neoadjuvant molecular targeted therapy and decompression in young patients could make a significant improvement in the management of the disease. The aim of this chapter was to determine the present and future concepts of treatment and discuss significant factors responsible for recurrence.
Part of the book: Bone Tumours
Use of Statins in Dental Implantology and Their Impact on Osseointegration: Animal Studies By Tomislav Katanec and Dragana Gabrić
Statins are one of the most commonly used drugs for the prevention of atherosclerosis and ischemic heart disease. Statins have an antibacterial effect against oral pathogens, especially against Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Studies on animals that we analyzed in this chapter show that statins promote angiogenesis and osteoblast differentiation. Data on the effect of statins on the process of osseointegration are important in clinical practice and should be an integral part of dental education. PubMed, Cochrane Central, and Web of Science database search was performed for animal studies on statin effects on dental osseointegration. Fifteen studies performed on laboratory animals were identified where statins were applied systemically, locally, orally, subcutaneously, or intraosseously. Titan implants of different diameters were placed in tibia and femur of animals. Statins improved osseointegration and enhanced contact of implant surface with the newly formed bone, as well as significantly increased the volume of newly formed bone in lab animals. The purpose of this chapter is to prove the relationship between local use of statins and better osseointegration, as well as a larger amount of newly formed bone around the implant. Knowledge of the effect of frequently prescribed medications on dental procedures and osseointegration is necessary for both students and physicians.
Part of the book: Dosage Forms
Use of Statins after Bone Osteotomy and Augmentation and their Antibacterial Effect: Narrative Review of Literature By Tomislav Katanec, Tihomir Kuna and Dragan Gabrić
Statins, a class of cholesterol-loweringdrugs, have been investigated for their potential benefits in oral surgery, particularly in bone osteotomy and augmentation procedures. Recent studies suggest that statins may stimulate bone formation and enhance the osseointegration of dental implants. This review examines the current evidence on the effects of statins on bone osteotomy and augmentation in oral surgery. The available data indicates that while patients with a history of bisphosphonate use may not face a higher risk of dental implant failure or marginal bone loss, they may be more susceptible to bisphosphonate-related osteonecrosis of the jaw. Further research is needed to fully elucidate the impact of antiresorptive drugs, including statins, on dental implant outcomes and to identify optimal strategies for managing patients undergoing oral surgical procedures. The practice of fixed bridges and partial prosthesis can be and are iatrogenic to the existing teeth and bone. Dental implants have become a viable treatment option when there is sufficient quantity and quality of bone to achieve the desired functional and esthetic results. Horizontal ridge augmentation and contextual implant placement with a resorbable membrane and particulate grafting material can be used to reconstruct three-dimensional atrophic edentulous areas of the jaws, allowing for correct implant positioning and avoiding mechanical and prosthetic failures. The reduction in bone volume has many etiologies, including periodontal disease, pneumatization of the maxillary sinus, long-term ill-fitting dentures, and the general progression of osteoporosis with aging. Interestingly, recent studies suggest that statins, a class of cholesterol-lowering drugs, may have a positive effect on bone osteotomy and augmentation in oral surgery. Statins have been found to stimulate bone formation and enhance the osseointegration of dental implants.
Part of the book: Osteotomy Essentials
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