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Purpose Two different graft materials, s-tricalcium phosphate (Cerasorb) and autogenous bone, were used in the same patient. The objective was to determine whether donor site morbidity could be avoided by using pure-phase s-tricalcium phosphate (Cerasorb). Materials and Methods Bilateral sinus grafting was performed on 20 selected patients; Cerasorb was used on the experimental side, and autogenous bone was used on the control side. In each patient, one side was randomly designated the experimental side. In 10 of the 20 patients, the maxilla reconstruction included sinus grafting and onlay bone grafting. Implants were placed 6 months after the procedure. In addition to routine panoramic radiographs, in 10 of the 20 patients, 2- and 3-dimensional computerized tomographic examinations were performed pre- and postoperatively and after implantation. Eighty bone biopsy specimens were taken at the time of implant placement. Results Histologically and histomorphometrically, there was no significant difference between the experimental and control grafts in terms of the quantity and rate of ossification. For each histologic sample, the total surface area, the surface area that consisted of bone, and the surface area that consisted of graft material were measured in mm 2 , and bone and graft material were analyzed as percentages of the total. The mean percentage bone areas were 36.47% ± 6.9% and 38.34% ± 7.4%, respectively; the difference was not significant ( P =.25). Discussion and Conclusion Comparisons with other studies reveal that s-tricalcium phosphate (Cerasorb) is a satisfactory graft material, even without autogenous bone.— Reprinted with permission of Quintessence Publishing .

The aim of this study was to show the importance of Cone Beam Computerized Tomography (CBCT) to volumetrically quantify temporomandibular joint (TMJ) damage in patients with juvenile idiopathic arthritis (JIA), measuring condylar and mandibular real volumes. Methods. Thirty-four children with temporomandibular involvement by JIA were observed by CBCT. Four were excluded because of several imaging noises. The mandible was isolated from others craniofacial structures; the whole mandibular volume and its components' volumes (condyle, ramus, emibody, emisymphysis on right side and on left side) has been calculated by a 3D volume rendering technique. Results. The results show a highly significant statistical difference between affected side volumetric values versus normal side volumetric values, above all on condyle region (P0.01), while there was no statistical difference between right versus left side. Conclusion. The CBCT represents a huge improvement in understanding of the condyle and mandibular morphological changes, even in the early stages of the JIA. In children the JIA can lead to TMJ damage with facial development and growth alterations.

Background We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments. Method A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques. Results HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity. Conclusions Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to 1200 μm had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.

The introduction of "surgery first" has resulted in a new requirement to compare and resolve medical legal problems which previously did not exist in traditional orthognathic surgery. The first issue relates to the relationship between the doctor and the patient and, in particular, the need to create a new informed consent form for surgery first. The second problem that has arisen with the arrival of surgery first concerns the relationship between health workers, namely the surgeon, and the orthodontist. The authors of this article propose a new template for informed consent specifically created for surgery first and also a model for the new working relationship between surgeons and orthodontists which will facilitate and improve co-operation between them. This will improve results, and guarantee a greater level of protection for the surgeon. It will also enable the identification the individual responsibilities of each person.