Bojarskas, Stasys

Objectives: The increasing resistance of microorganisms that cause odontogenic cellulitis to empirically administered antibiotics increases the duration of hospitalization. The aim of this retrospective cohort study is to evaluate the latest data on maxillofacial odontogenic cellulitis in order to provide valuable information for optimizing the treatment of this pathology.

Material and Methods: The medical records of patients treated for maxillofacial odontogenic cellulitis at the Hospital of Lithuanian University of Health Sciences (Kauno klinikos), between 2018 and 2023 were analysed. Data on age, gender, general health status, duration of intensive care unit treatment, total duration of treatment, and complications were analysed. The results of the microbiological culture of the pus were used to analyse the primary pathogen, its resistance, and sensitivity to antibiotics and antibacterial treatment.

Results: The streptococcus group (41.4%) was the most common pathogen. The duration of treatment did not differ significantly between the different localizations of cellulitis. The most commonly used antibiotics were a combination of penicillin and metronidazole. The highest success rate (76.9%) was observed with empirically administered combinations of cephalosporins and metronidazole. Antibiotic therapy was changed in 33.3% of cases.

Conclusions: The most frequently detected pathogens - the streptococcus group - are characterized by a high sensitivity to penicillin and clindamycin as well as third-generation cephalosporins. The most effective empirical antibiotic therapy is a combination of cefazolin and metronidazole and cefuroxime and metronidazole. Diabetes mellitus, lung disease, alternating antibiotic therapy and complications prolong the duration of treatment.

Objective. The purpose of the present study is to provide the efficacy of autologous platelet rich fibrin in bone augmentation and bone regeneration procedures in regard of soft and hard tissue healing in oral surgery treatment. Material and methods. An electronic search on PubMed database was performed regarding the placement of autologous platelet rich fibrin at tooth extraction sockets, bone and soft tissue augmentation procedures associated with implant placement and infrabony defects. The search was constrained to English language articles published during last five years and includes only clinical trials. Results. In total, 25 articles were included in this literature review. The studies were divided into five main groups, depending on the application: 1) utilization of autologous platelet rich fibrin at 3rd molar extraction sockets preservation, 2) any extraction socket preservation, 3) bone augmentation/sinus lift procedures with implant placement, 4) augmentation of periimplant tissues, and 5) treatment of infrabony defects. Conclusion. The application of autologous platelet rich fibrin (PRF) show benefits in promoting soft tissue healing and bone regeneration in different surgical procedures. Furthermore, it is an autologous biomaterial which has low cost and does not need administration of any additives. Nevertheless, further studies with a bigger sample size and longer follow up duration are necessary to facilitate more substantial evidence of the efficacy of PRF in promotion of soft and hard tissue healing.

Objectives. Understanding the mechanisms of bone morphogenesis is essential in solving problems related to reconstruction of bone defects. In a field of bone morphogenesis enormous array of biologically active substances have been proved as having more or less influence on bone growth, but no ideal guiding path for a new bone formation has been established yet. Therefore, bone tissue engineering, based on the laws of osteogenesis, becomes a significant niche for investigation. The aim of this article is to review recent scientific information concerning the role of bio substances in osteogenesis, their potentials in and future prospects. Material and methods. Medline library database was searched, focusing on stem cells, osteoblast differentiation, bone growth factors and bone tissue engineering. Limits were review, research support. A quality assessment was carried out. Results. A total of 62 articles matching our criteria were found: 19 reviews summarizing topics of growth factors, stem cells, tissue engineering and 43 articles representing studies of growth factors impact in osteoblast differentiation, bone regeneration and bone engineering. Conclusions. The interactions among growth factors in osteoblast differentiation cascade are not fully understood. Moreover, methods of conversion of laboratory processes into clinically effective, reproducible, safe, economically viable and competitive products need to be improved.

Stomatognathic system is the whole system of organs that performs speech, respiratory and nutritional functions. Stomatognathic malfunction of the system certainly affects an individual’s quality of life. A number of factors can attribute to the damaging of the main functions of the system and one of them is the parafunction of the stomatognathic system. Study objectives. To formulate an accurate definition of the parafunction of the stomatognathic system. To classify parafuntions into classes according to their etiology. To select the parafunctions which have an effect on the appearance of TMJ dysfunctions. Material and methods. Analysis of scientific publications. The reviewed literature material covers 70 authors and 90 different publications that deal with the problem of stomatognathic parafunctions. Discussion/Conclusions. All authors attribute the following to the stomatognathic or mouth parafunctions: bruxism, nail or pencil chewing, thumb sucking, etc... Those are habits that make up only one part of all parafunctions of the stomatognathic system. Until now, there is no unanimously agreed opinion in the world about the definition, classification, research and treatment methods of the parafunctions of the stomatognathic system. According to the literature, the parafunction of the stomatognathic system can be defined as unnecessary use of physiological stereotypical function without anatomical structures pathology and the consequence of this function is the dysfunction of any part of the stomatognathic system. Having analised the scientific literature, we find out that the TMJ dysfunction is an important issue in today’s society, especially among young people.The data from ‘TMJ Association’ show that 35 million people suffer from TMJ dysfunction in the U.S. Several studies have been done in the world which demonstrate a direct influence of parafunctions to the occurence of TMJ dysfunction. However, t

Introduction. Morphogenesis refers to a consistent development of specific tissue or organ. A science of tissue engineering explores composition and production of biologic tissues, entailing principles of cellular and molecular biology, appropriately managed by bioengineering and biomechanics. One of the biggest unresolved problems in today’s medicine is qualitative and quantitative bone tissue regeneration management. Materials and Methods. Review of 50 scientific articles analyzing bone bioengineering and morphogenesis, published during period of 2008-2013. Discussion. The tissue engineering aims 3 main targets for investigation of morphogenesis: induction signals, cells-targets and extracellular matrix. Among the numerous tissues of human body, the bone has a high potential for regeneration. Traditionally, morphogenetic signals for the germ cells, biological materials acting in bone tissue morphogenesis (bone morphogenetic protein BMP and a series of others), bone inductive signals are being studied. Fibroblasts, osteoblasts, chondrocytes, adipocytes and mioblasts originate from mesenchymal stem cells, found in the bone marrow of adults, in peripheral blood, umbilical cord blood, periodontal ligament and dental pulp as well. Mesenchymal stem cell when differentiating to the osteoblasts is involved in a myriad of biological signals. In general, bone growth signals can be divided into the following: 1) Signal molecules (Wnt signalling pathway, etc.). 2) Growth factors (IGF, FGF, BMP, TGF-β, PDGF etc.). Bone healing is a specialized process where consistent cellular and molecular factors interact producing new bone. Adult human bone regeneration takes place in the normal embryogenetic way, except emerges occurring in inflammation phase. In the context of inflammation, cytokines , such as IL-1, IL-6, TNFα, are released and is believed to initiate bone regeneration cascade. Growth factors, having great importance...

In Lithuania arthognathic surgery has been development in Vilnius University and Kaunas Medical University clinics. Some operations are done in Klaipėda. The first Le Fort I osteotomy done by Juozas Olekas (1996), whereas fist mandibular osteotomies in Vilnius were performed by prof. Petras Sileikis, more than 15 years ago. Since 2003 orthognathic surgery in Vilnius has been developed by Simonas Grybauskas with the help from Riga. The first contemporary bimaxillary osteotomy only by Lithuanian surgeons was performed in 2004 by S. Grybauskas, L. Zaleckas and G. Kapusinskas. Now annually about 60 orthognathic operations in Vilnius are performed by S. Grybauskas, about 90% of them being double jaw surgery. In Kaunas first vertical ramus osteotomy done by Pranas Tercijonas, Gintautas Sabalys and Vladas Steponavicius (1986). First BSSO done by Pranas Tercijonas, Gintautas Gumbelevicius and Irena Navakauskiene (1992). First bimaxillary surgery (1993) done by Pranas Tercijonas and Rasa Babicenko. Presently in Kaunas 10-15 orthognathic operations annually are carried out by Stasys Bojarskas and Ricardas Kubilius. [...].

Background: The purpose of this study was to determine the indications, efficacy, and advantages of the support immersion endoscope (SIE) method for extraction socket assessment. Methods: Twelve patients (four women and eight men; mean age: 28 years) in need of extraction with implant placement participated in the study. The teeth extracted included eight upper central incisors and six upper lateral incisors. Extraction sockets were evaluated with a conventional extraction site evaluation (CESE) method alone or with CESE + SIE. CESE includes: visual evaluation; periodontal probing; ridge mapping with calipers, dental mirror, and orthopantomogram; and diagnostic wax-up. Results: CESE + SIE had significantly better accuracy in examining extraction socket labial plate vertical position, labial plate thickness, and bone quality compared to CESE alone. The results obtained from CESE assessment were inconsistent because of poor visualization. Conclusion: The SIE can be used as an adjunct tool in assessing extraction socket morphology and bone conditions without flap elevation.

Introduction. Surgical procedures involving bones of facial skeleton are closely related to exposure of the peripheral branches of Trigeminal nerve (TN). Injury and functional recovery of the nerve depends on the grade of nerve injury and treatment methods applied during operation and after the surgery. Objective assessment of the functional state of the nerve can be processed applying sensometry. [...].