The aim of the present study was to compare dynamics of the bone healing process after different types of osteotomies. In total, 24 Wistar rats were subjected to different types of osteotomy performed with standard steel bur, piezosurgery, contact, and non-contact Erbium:yttrium-aluminum-garnet (Er:YAG) laser ablation. The animals were randomly divided into four groups, to be euthanized immediately after the procedure, or at 1, 2, or 3 weeks after surgery. The obtained bone samples were analyzed by scanning electron microscopy (SEM). Immediately after surgery, there were significant differences in the appearance of the bone defects, with presence of bone fragments and debris after standard steel bur preparation, compared with the clean smooth walls and relatively sharp edges in all other groups. The initial bone formation in defects prepared by piezosurgery was observed to be the most rapid. After 3 weeks, all bone defects were completely restored; although, differences in the healing pattern were noted, with a modest initial delay in healing after laser preparation. The first stage of the bone healing process was delayed when contact and non-contact Er:YAG laser modes were used and accelerated by piezosurgery; however, the results after 3 weeks demonstrated similar restitution of defects in all tested groups.
Najcesci etioloski faktori gubitka trajnogzuba u fronti kod djece su povezani s dentalnim i maksilofacijalnim traumama. Zatim slijedi genetski nedostatak zubnog zametka, od kojih su najcesce hipodoncije. Kirurski aspekt zauzima važno mjesto u terapiji, od prezervacije traumatizirane alveole radi kasnije ugradnje dentalnog implantata, ali i citav niz augmentativnih tehnika koje prethode implantologiji.
Disfunkcije i boli u kraniofacijalnom podrucju pogađaju cetvrtinu populacije modernog industrijaliziranog svijeta. Međutim, samo dio njih potraži lijecnicku pomoc, od kojih samo manji dio zahtijeva lijecenje. Patofizioloski mehanizmi u podlozi boli u žvacnim misicima obuhvacaju pretjeranu uporabu normalno prokrvljenog misica ili ishemiju funkcijski zdravog misica, simpaticke reflekse koji uzrokuju promjene u opskrbi krvlju i misicnom tonusu te promjene psihickih i emocionalnih stanja. Neuroni koji provode osjet boli koji potjece iz misica podložni su djelovanju modulirajucih cimbenika poput bradikinina, serotonina, tvari P, prostaglandina i ostalih neuropeptida koji mogu podražiti nociceptore. Tako bolna stanja u misicima cesto dovode do povecane osjetljivosti perifernih nociceptora i posljedicne hiperalgezije posredovane djelovanjem sredisnjeg živcanog sustava. Takva, vrlo cesto kronicna bolna stanja razlog su zbog kojega pacijent traži pomoc lijecnika. Prema ucestalosti drugi su uzrok dolaska u stomatolosku ordinaciju nakon zubobolje. Dva su glavna simptoma poremecaja žvacnih misica: bol i disfunkcija.