Maxillary sinusitis is important because of its frequency, high absences from work in relation to it and the increasing prescription of antibiotics, which affects the development of resistance to antibiotics in the population. The following are the modern guidelines for the treatment of acute sinusitis in relation to relevant literature. Acute maxillary sinusitis is too often treated with antibiotics according to the modern understanding of the pathogenesis. The guidelines on antibiotics of first and second line are also changing. Chronic maxillary sinusitis infection is often present with other systemic or local situation, the latter mostly anatomical changes in the upper respiratory and inflammatory diseases of the upper molars and premolars. With proper treatment of acute and chronic maxillary sinusitis can significantly influence both the quality of the treatment such as antibiotic resistance. In terms of prevention we can successfully work against the danger factor for sinusitis.
B.04 Guest lecture
COBISS.SI-ID: 30399705Introduction: Bisphosphonates (BPs) have been used for the management of bone metabolic diseases. Currently their therapeutic use has increased, as also have their adverse effects. The most important adverse effect is the bisphosphonate-related osteonecrosis of the jaw (BRONJ). Until now, the physiopathology of BRONJ remains unclear, and its treatment is uncertain. Although the literature provides several treatment options, there is no defined protocol. We present our experience with treatment of BRONJ. Material and method: A total of 24 patients treated with either i.v. or peroral BPs requiring extractions of unsalvageable teeth were included in the study. Classic extraction and atraumatic extraction with orthodontic elastics were performed. The data were obtained retrospecitvelly and different measures were assessed. Our purpose was to compare classic extraction and atraumatic extraction with orthodontic elastics in patients with BRONJ. Results: Between 24 observed patients, women were predominant in 66,7%, the average age was 70,6 years, 50% of patients were treated with i.v.BPs. The mean time of i.v. BP treatment was 33 months, the mean time of peroral BP treatment was 32,3 months. In 18 patients classic extraction was performed and in 6 patients atraumatic extraction with orthodontic elastics was performed. 11 patients developed BRONJ after classic extraction, 6 of them were successfully treated with systemic antibiotic therapy and local surgical debridement of the open wound. The rest developed BRONJ and still have bone exposure, although the same therapy was used, 4 of them were in i.v. BP treatment. When atraumatic extraction with orthodontic elastics was used, there was no BRONJ. Mandible was affected in 64,3% of patients. Conclusion: Our study revealed, that BRONJ is more common in patients with i.v.BP therapy after classic extraction and our experience with treatment of BRONJ is that the best extraction results come with atraumatic extraction with orthodontic elastics, which should be considered in patients with i.v. BP therapy. However, there is still no difined protocol for evaluatement of patients on BP therapy.
B.03 Paper at an international scientific conference
COBISS.SI-ID: 30222809BACKGROUND: Resorption of the alveolar ridge is process that occurs after teeth loss. Its severity can seriously compromise the successful outcome of implant treatment. Several methods for augmentation with different typse of bone grafts exist but unfortanately none of them prevails. AIM: The aim of our clinical study is to present our experience and success rate in treating severly resorbed alveolar pridges with calvarial free bone grafts. METHODS: We have performed augmenatation with calvarial free bone grafts in five female patients age from 28 to 84 because of severe alveolar ridge atrophy. In one patient the augmentation was performed on a vascularized fibula bone graft. Two patient received a bone grafts in the maxilla and in the other two patients in both jaws. In one patient 3D augmentation of the alveolar ridge was per{ormed. The graft elevation in three patients was performed with surgical handpice using bone chisels and in two patients with piezosurgery. A11 patients received antibiotic and analgesic therapy post operatiyely. The postoperative early and late complications were followed. The bone gain was measured on panoramic X-ray immediately post operation to evaluate the gra{t position and wlth CB-CT three mounts be{ore implant placement. Bone gain measured was {rom 3 7 mm height ar,d 6-9 mm of width. In four patients additional bone particles and xenogenic bone gra{ts were used. In three patients the grafts were covered with membrane. Eighteen implants were inserted in the augmented areas. All implants were covered with xenogenic bone grafts. The primary stability was achieved in a1l patients and was measured with Osstell expressed with ISQ values. The implant placement and bone resorption were radiologically foltowed. RESULTS: In none of the patients we did not observed serious complications during graft harvesting. In one patient we had moderate bleeding from the dioploic vessels that was stopped with loca1 haemostatic measures. In two patients the durra was exposed without neurological complications. We did not observed total grak rejection. In two patients partial graft exposure occurred and in one patient only screw exposure. During the implant insertions no complications occurred, all implants were primary stable. No implant exposure and bone resorbtion occurred after loading. CONCLUSION AND CLINICAL IMPLICATION: Despite minor complications associated with the donor site augmentation of atrophic jaws with calvarral bone grafts is predictable and reliable procedure. This is due to the membranous origin of the calvarial bones and their compact structure.
B.06 Other
COBISS.SI-ID: 30228953