Kubilius, Ričardas

Šiuo metu naudojamos statinės skaitmenizuotos dantų implantacijos (sSDI) sistemos skiriasi chirurginio gido konstrukcijos komponentais, naudojamais instrumentais bei instrumentų navigavimo principais. Trūksta tyrimų ir vertinant chirurginio gido atramos įtaką dalinės adentijos sSDI tikslumui. Atraminių dantų tipas, skaičius ir pasiskirstymas gali skirtis, atsižvelgiant į dantų eilės defektą. Šie veiksniai gali įtakoti chirurginio gido pasyvų nusėdimą, stabilumą bei galiausiai - implantacijos tikslumą. Dėl įrodymais pagrįstų protokolų stokos klinikinėje praktikoje chirurginio gido modeliavimas ir sSDI sistemos parinkimas dažnai grindžiamas empirinėmis prielaidomis. Šiame darbe įvertinti atraminių dantų skaičiaus, instrumentų navigavimo mechanizmo ir implantavimo srities įtaką dalinių viršutinio žandikaulio dantų eilių defektų statinės skaitmenizuotos dantų implantacijos tikslumui. Standartizuotomis eksperimentinėmis in vitro sąlygomis įvertintas dviejų dažniausiai klinikinėje praktikoje naudojamų gidinės implantacijos sistemų (su gręžimo kreipikliu ir be gręžimo kreipiklio) tikslumas šešiose viršutinio žandikaulio dalinės adentijos implantacijos vietose (pavieniai priekinio, prieškrūminio ir krūminio danties defektai, ribotas priekinis defektas ir prieškrūminio ir krūminio dantų sritys galiniame neribotame defekte). Taip pat įvertinta atraminių dantų skaičiaus įtaka sSDI tikslumui, lyginant tris skirtingus atramos variantus: dviejų, keturių dantų ir viso lanko atramą. Gauti rezultatai prisidės prie rekomendacijų formulavimo, susijusių su optimalios atramos ir gidinės implantacijos sistemos pasirinkimu – tiek bendrai, tiek specifinėse implantavimo vietose. Tyrimo rezultatai prisideda prie įrodymais pagrįsto statinės skaitmenizuotos implantacijos protokolų tobulinimo ir sudaro pagrindą tęsti klinikinius tyrimus. Sukurtas eksperimentinis tyrimo modelis ir protokolas gali būti naudojamas ateities in vitro tyrimams vertinti kitus įtakos sSDI tikslumui turinčius veiksnius.

Background: Deviations in guided implant surgery are of cumulative origin. They reflect overall inaccuracies occurring during clinical, digital and manufacturing stages of guided implant surgery. Type of surgical guide support is a step in the workflow that can be controlled. The aim of the study is to evaluate the influence of surgical guide support in different implantation sites on accuracy of static guided implant surgery using a keyless drilling system.

Description of the procedure: Two prototypes of partially edentulous dental models were digitally designed. Dental models simulated anterior and posterior single-tooth gaps (FDI: 21, 15, 26) as well as extended anterior (12–11–21–22) and posterior (15–16–17–18) edentulous areas. Sixty polyamide-12 dental models were fabricated using SLS technology. For each implantation site surgical guides were designed with 2-teeth, 4-teeth or full-arch support. A total of 210 replica implants were placed. Actual implant positions were determined using optical scan data and compared to preplanned positions with ZEISS INSPECT optical 3D software. For assessment of accuracy 3D deviations at implant crest and apex, linear vertical and angular deviations were measured. The data was analysed using non-parametric tests with 0.05 significance level.

Outcomes: Full arch support was associated with increased deviations compared 2-teeth and 4-teeth supported guides which showed similar accuracy (p < 0.05). Higher 3-Dimensional and angular accuracy was observed in posterior locations compared to anterior (p < 0.05). Posterior teeth support significantly increased accuracy. As observed in anterior region where single tooth gap (21) was associated with higher 3D deviations compared to extended edentulous areas (12, 22) (p < 0.05). Similarly posterior site with distal extension (17) was associated with higher 3D apical and vertical deviations compared to posterior single tooth gap (26) (p < 0.05).

Conclusions: Guide support and site of implant placement significantly affect the accuracy of static guided implant surgery. Shorter guide support and posterior edentulous location with posterior teeth support increased accuracy.

To evaluate the influence of guide support on the accuracy of sCAIS using a keyless guiding system in different cases of partial edentulism.

Background and Objectives: Static Computer-Assisted Implant Surgery (sCAIS) can be performed with different drill guiding systems. This study aimed to compare the accuracy of two guiding concepts of sCAIS in partially edentulous cases. Materials and Methods: Forty polyamide models of partially edentulous maxillae with seven implantation sites were fabricated. In total, 140 replica implants were placed with keyless (KL) and drill-key (DK) guiding systems using static, full-arch, tooth-supported surgical guides. Three-dimensional crestal and apical, angular and vertical deviations from the planned implant positions were compared using Mann–Whitney U and Kruskal–Wallis H tests. Intergroup homogeneity of variance homogeneity was examined using Levene’s test to assess the precision. Results: Overall median 3D crestal and apical deviations of implants placed in the KL group were significantly higher compared to the DK group (0.86 mm [0.63–0.98] vs. 0.72 mm [0.52–0.89], p = 0.006 and 1.26 [0.98–1.52] vs. 1.13 [0.70–1.45], p = 0.012). In the subgroup analysis, implants placed with a KL system showed higher 3D crestal (p = 0.029), 3D apical (p < 0.001) and angular (p < 0.001) deviations in the extended anterior area, higher 3D crestal (p < 0.001) deviations in the proximal posterior single-tooth gap and higher vertical (p < 0.001) deviations in the distal site of free-end situation. Contrarily, the KL group showed lower 3D crestal (p = 0.007), 3D apical (p < 0.001), angular (p < 0.001) and vertical (p = 0.003) deviations in the distal posterior single-tooth gap, lower 3D apical (p = 0.007) and angular (p = 0.007) deviations in the distal site of free-end situation and lower vertical (p = 0.019) deviations in the proximal site of free-end situation. Conclusions: The deviations of both guiding concepts did not exceed the recommended safety margins. Statistically significant differences in deviations were found between two guiding concepts. Guiding concepts with superior accuracy varied across different sites of implantation.

Background. Dental or skeletal anchoring plays a significant role in the orthodontic treatment of various malocclusions. Miniscrews are now regarded as stable skeletal anchoring. Despite their popularity, miniscrew success rates in studies range from 83.9 to 93.3%. Surface treatment is one of its properties that is now being extensively researched and enhanced. Consequently, the purpose of this systematic review is to ascertain how miniscrew surface treatment affects insertion torque, success rate, and removal torque. Materials and methods. The protocol for conducting a systematic literature review followed the PRISMA criteria. The keywords "mini-implant", "mini-screw", "orthodontic mini screws", "survival rate", and "surface treatment" were used to search electronic databases. This systematic review included human studies published in English within the previous five years that compared the success rates of miniscrews with and without changed surfaces. Results. Four included studies assessed the effect of surface modification on the success rate; two of them examined the impact on insertion torque, one the removal torque, and one assesed the periotest value. The rough surface group achieved a higher success rate than the non-modified group, although the difference was not statistically significant. The treated surface group had higher removal torque than the non-treated group, but the difference was not statistically significant. Conclusions. Quantitative and qualitative analysis revealed that surface-treated miniscrews had a greater success rate and insertion torque than non-treated ones, although the difference was not statistically significant.

Relevance of the problem and aim of the work. Chronic fungal maxillary sinusitis is an increasingly diagnosed condition in clinical practice. The diagnostic and therapeutic processes remain complex due to the nonspecific nature of clinical manifestations and the absence of standardized management protocols. The objective of this study is to assess the reliability and efficacy of current diagnostic and therapeutic methods based on recent scientific evidence. Materials and methods. A systematic literature review was conducted following PRISMA guidelines. PubMed, ScienceDirect, and Cochrane Library were searched for English-language articles (2016–2024) on diagnostic and therapeutic approaches for chronic fungal maxillary sinusitis. Results. The analysis revealed that diagnostic and treatment strategies for chronic fungal sinusitis depend on the clinical form. MRI and histopathology proved most accurate for diagnosing invasive sinusitis, while CT was more suitable for non-invasive types. Clinical symptoms were common but not specific enough for definitive diagnosis. Surgical treatment alone was effective for non-invasive cases, whereas invasive forms required both surgery and antifungal therapy. Allergic fungal sinusitis was primarily managed with systemic corticosteroids. Conclusions. Effective management of chronic fungal maxillary sinusitis relies on accurate classification of the disease form. Radiological imaging and histological analysis are the most reliable diagnostic methods. Treatment should be form-specifi c: surgery for non-invasive cases, combined surgical and antifungal therapy for invasive forms, and corticosteroids for allergic fungal sinusitis.

Background and Objectives: Acute skin wounds present significant challenges, necessitating effective therapeutic strategies. This study investigates the potential of extra­cellular vesicles (EVs) in combination with hydrogel matrices for improving wound healing outcomes. Materials and Methods: A literature review was conduc­ted following PRISMA guidelines to identify relevant studies. Inclusion criteria comprised prospective in-vivo trials utilizing standardized acute skin wounds on healthy subjects. Key treatments involved topical application of EVs incorporated into hydrogel matrices. Electronic literature searches were conducted in PubMed, Science Direct, and Cochrane Library using specific keywords. Results: Among 541 initially identified publications, 37 studies met inclusion criteria. After full-text analysis, six studies were included in the review. Findings revealed significant advancements in wound healing outcomes when EVs were combined with hydrogel matrices. These combinations demonstrated accelerated wound closure, enhanced tissue regeneration, and increased collagen deposition compared to controls. Conclusions: The integration of EVs with hydrogel matri­ces represents a promising approach for improving acute skin wound healing. Synergistic effects observed in the reviewed studies underscore the potential of this com­bination therapy. However, further research is needed to standardize protocols, optimize dosage and delivery mechanisms, and evaluate long-term safety and efficacy. Overall, this study highlights the potential of EVs and hydrogel matrices in addressing the unmet clinical needs associated with novel acute skin wound management.

Aim. The aim of this meta-analysis was to determine the influence of surgical margins on the prognostic parameters of patients with oral squamous cell carcinoma. Materials and methods. The literature review was carried out according to PRISMA principles and the database search was performed using following keywords: “Carcinoma, Squamous Cell (Mesh)”, “Squamous Cell Carcinoma of Head and Neck (Mesh)”, “Margins of Excision (Mesh)”. The review included studies with humans, published in English, no longer than 10 years ago, in which patients underwent resection of the primary tumour and the resections were examined histologically and the margins between healthy tissues and tumour were speicified. Results. 5 of the included studies examined the impact of surgical margins on overall survival and 10 on local recurrence. In all 5 studies, surgical margins were considered an effective prognostic indicator for the overall survival. Examining the impact of surgical margins on the local recurrence, 7 studies indicated that it is an effective prognostic parameter. Quantitative analysis of the data revealed that a 3 mm surgical margin was safe. Conclusions. Primary tumor surgical margins are an effective prognostic parameter for the overall survival and the local recurrence in patients with oral squamous cell carcinoma. 3 mm surgical margins can be concidered as a safe distance and minimum acceptable separation point between close and involved margins.

Introduction The floor of the mouth is the horizontal U-shaped space under the tongue between the sides of the lower jaw [1]. The floor of the mouth contains the sublingual and submandibular glands, important vascular and nervous elements [2]. This type of cancer accounts for 28-35% of all oral cancers [1]. Harmful habits such as smoking, excessive alcohol consumption, and poor diet cause chronic inflammation which can develop into cancer [3]. IL-1α and IL-1β are encoded by two different genes with a low degree of sequence similarity. They are both synthesised as pro-IL1α and pro-IL-1β preform proteins. To be active, pro-IL- 1β is converted by inflammatory caspases into IL-1, while pro-IL-1α is active and its cleavage into IL-1α modulates its activity. IL-1α can be localised in the nucleus, where it acts as a transcription factor that regulates cell differentiation in normal cells and neoplasia in cancer cells [4,5]. IL-1β is also an important mediator of chronic inflammation and has been implicated in many cancers [3]. IL-1β - rs16944 and IL-1α - rs1800587 polymorphisms could be a predictor of prognosis, stage and response to treatment as molecular markers. [...].

Introduction During the postoperative phase, large functional and visual discomfort is caused by the inflammatory process that is set off by tissue trauma from third molar surgery. This process frequently results in pain and swelling [1, 2]. Systemic corticosteroids are frequently used during surgery to manage inflammatory reactions following the extraction of third molars [3]. Synthetically produced as a prednisolone analogue, dexamethasone (DX) is a long-acting corticosteroid with strong anti-inflammatory properties [4]. But there are two types of this medication – submucosal (SB) or intravenous (IN) dexamethasone, which could have a different effect.