Gervickas, Albinas

Objectives: The one-abutment-one-time protocol has been proposed to improve peri-implant tissue stability by minimizing repeated abutment manipulation. This systematic review and meta-analysis evaluated the effect of one-abutment-one-time compared with repeated abutment disconnections on peri-implant marginal bone loss and secondary clinical outcomes in platform-switched, conical-connection dental implants. Material and Methods: A PRISMA-guided systematic review of randomized controlled trials published between 2018 and 2025 was conducted. Studies included adult patients restored with bone-level, platform-switched implants with an internal conical connection. Marginal bone loss (MBL) was the primary outcome; probing depth (PD), implant survival, and biological and prosthetic complications were secondary outcomes. Meta-analyses were performed using random-effects models. Results: Seven randomized controlled trials were included. All studies reported numerically lower MBL with one-abutmentone-time (OAOT). Pooled analysis of six parallel-group trials demonstrated a statistically significant reduction in MBL favouring OAOT (mean difference -0.23 mm; 95% CI = -0.44 to -0.02). No significant differences were observed for PD. Implant survival rates were high and comparable between protocols, and complication rates were low with no consistent intergroup differences. Conclusions: The one-abutment-one-time protocol is associated with a modest but consistent reduction in peri-implant marginal bone loss in platform-switched, conical-connection implants, without clear benefits for other peri-implant clinical outcomes.

Background and Clinical Significance: Meningiomas are among the most common primary intracranial tumors, usually benign and slow-growing. Extracranial extension is exceptionally rare, particularly when arising from convexity meningiomas extending into the temporal fossa. Such cases pose unique diagnostic and therapeutic challenges due to their atypical growth patterns and anatomical complexity. Case Presentation: A 63-year-old woman previously treated for a right temporal convexity meningioma with subtotal resection and Gamma Knife radiosurgery demonstrated progressive extracranial tumor growth over five years, while the intracranial component remained stable. MRI revealed infiltration of the temporalis and lateral pterygoid muscles and erosion of the temporal bone. Due to extensive extracranial involvement and limited neurosurgical accessibility, resection was performed by a maxillofacial surgical team through a preauricular approach. Intraoperatively, the tumor was encapsulated but adherent to the deep temporal fascia and zygomatic arch. The temporal branch of the facial nerve was identified and preserved. Histopathology confirmed a meningothelial meningioma, WHO Grade I, with low proliferative activity (Ki-67 < 1%). Postoperative recovery was uneventful, with transient facial nerve weakness that resolved within weeks. Conclusions: This report adds to the limited literature describing temporal fossa involvement by convexity meningiomas and illustrates the value of collaboration between neurosurgical and maxillofacial teams. Regular MRI surveillance every 6–12 months is advised for early detection of recurrence.

Gydytojai odontologai ir odontologai specialistai privalo suprasti, kad gydo ne tik dantis ir burną, bet gydo pacientą kaip visumą, kuriam dėl šiuolaikinės medicinos pasiekimų vis anksčiau ir tiksliau diagnozuojamos ligos, sėkmingiau taikomi nauji veido ir žandikaulių srities gydymo metodai. Specialistui nepakanka žinoti apie siauros srities ligas ir jų gydymą, gydytojo pareiga į žmogaus organizmą, gretutines ligas, jų gydymą ir procesų bei veiksnių sąveiką žvelgti plačiau. Medicinoje, kaip ir gyvenime, susiduriama su priežasties ir pasekmės santykiu. Bet koks invazyvus gydymas turi pasekmių, kurios gali būti laukiamos, nes gydo ligą, ir, deja, nepageidaujamos, sukeliančios neigiamą poveikį. Kalbėdami apie invazyvų gydymą, omenyje turime ne tik chirurginį, bet ir medikamentinį gydymą. Jau nuo seno laikomasi vieno iš pagrindinių chirurgijos principų – „žeisdamas gydau“. Gydymo sėkmė priklauso nuo tinkamai parinkto gydymo veiksmingumo, trukmės, optimalaus stiprumo ir t. t. Šie principai pritaikomi ir chirurginiams, ir konservatyviems gydymo metodams. Deja, medikamentinis gydymas taip pat gali sukelti šalutinį poveikį. [...].

Background and objectives. Prophylactic antibiotics are frequently prescribed following outpatient oral surgical procedures to minimize the risk of surgical site infections. However, the overuse of antibiotics contributes to microbial resistance and increases the likelihood of adverse side effects. This highlights the need for a rational approach in assessing the necessity and appropriate dosing of antibiotics after outpatient oral surgeries. The primary aim of this study was to systematically analyze the literature on the use of prophylactic antibiotics in outpatient oral surgery. Materials and methods. Scientific articles were selected following PRISMA guidelines. The review included randomized controlled trials (RCTs) published in English between 2013 and 2023. Data searches were conducted on PubMed, ClinicalKey, and Cochrane Library databases. Results. A total of 15 RCTs involving 3,032 participants were included in this review. Of these, six studies reported no statistically significant differences between groups in terms of post-operative outcomes. In contrast, six studies focusing on tooth extraction reported significant differences in pain, swelling, trismus, and bleeding between the groups. Additionally, three studies on dental implant procedures revealed significant differences concerning implant failure rates, flap closure, and pain levels. Despite these findings, the overall evidence did not demonstrate statistically significant benefits of prophylactic antibiotics in reducing post-operative infectious complications. Furthermore, no evidence was found to support the importance of timing in the administration of prophylactic antibiotic therapy. Conclusions. The findings of this systematic review do not support the routine use of prophylactic antibiotics for healthy patients to prevent post-operative infections in outpatient oral surgical procedures. Further research is needed to establish clear guidelines on the necessity and optimal timing of antibiotic use in such cases.

Maxillofacial skeletal deformities affect the functional activity of the masticatory muscles. The combination of orthodontic treatment and orthognathic surgery is recommended as an effective way to correct dentofacial deformities beyond the capabilities of orthodontic treatment. This systematic review aims to assess the effect of orthognathic surgery on the changes in the electromyography of the masticatory muscles. A comprehensive electronic search was carried out in compliance with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. An electronic search was conducted using the following terms: (masticatory muscle activity) AND (electromyographic activity) AND (orthognathic surgery). After an initial search, 2070 scientific records were found, 5 studies that met the eligibility criteria were included in the final analysis. The Joanna Briggs Institute (JBI) tool was utilized to assess the methodological quality of the studies. An average improvement in masticatory muscle activity was observed six months post-orthognathic surgery, according to the analyzed studies. Longer post-surgical follow-up and additional interventions are needed to ensure that the masticatory muscles adapt better to the occlusion and skeletal morphology.

Introduction. This article comprehensively explores Dirofilariasis, focusing on Dirofilaria repens and Dirofilaria immitis as rare zoonotic ailments. Emphasis is placed on their prevalence, life cycle intricacies, and symptoms, particularly the rising incidence of Dirofilaria repens in Europe, notably Lithuania. The report details three cases of oral dirofilariasis, presenting clinical histories, diagnostics, interventions, and species identification. The discussion highlights the rarity of maxillo-mandibular dirofilariasis, addressing diagnostic challenges and diverse treatment options. Objective. The objective is to investigate the emergence, clinical aspects, and management of Dirofilariasis, with a focus on Dirofilaria repens, emphasizing its prevalence in Europe, particularly Lithuania. Materials and methods. The article presents three cases of oral dirofilariasis, providing detailed clinical histories, diagnostic procedures, interventions, and species identification. A thorough examination of Dirofilaria repens prevalence and characteristics in Europe, especially Lithuania, is conducted. Results. The discussion reveals insights into the rarity of maxillo-mandibular dirofilariasis, highlighting diagnostic challenges and diverse treatment options. The cases contribute valuable information on clinical and diagnostic aspects, enhancing the understanding of this unusual condition. Conclusion. The conclusion emphasizes the critical need for heightened awareness and a comprehensive diagnostic approach in managing oral dirofilariasis. It serves as a reminder to healthcare professionals about the importance of increased awareness for effective management in medical practice.

To summarize the latest scientific literature regarding the concentrations of biomarkers in saliva and peri-implant crevicular fluid (PICF) of healthy implant (HI) patients and patients with peri-implant mucositis (PIM) and peri-implantitis (PI).

Platelet-rich fibrin (PRF) is the second generation of platelet concentrates collected on a single fibrin matrix that contains various autologous cytokines and immune cells. PRF is extracted from plasma through centrifugation of autologous peripheral blood. Platelet concentrates can be used in alveolar socket to accelerate both soft and hard tissue healing by releasing growth factors. This systematic review aims to evaluate the efficacy of a local application of PRF on postoperative healing after an impacted mandibular third molar extraction. A comprehensive literature search using the advanced features of PubMed, Cochrane Library, and Scopus databases was carried out. 7 study articles accomplished the selection criteria and were included in this review. The results indicated that the local application of autologous PRF in the alveolar socket after impacted mandibular third molar extraction has a beneficial effect on postoperative outcomes. It significantly releases pain, reduces swelling. The increase of growth factors enhances bone healing. Unfortunately, no significant positive effect on postoperative trismus between PRF and control groups was observed in this review.

Objective. Evaluate the infl uence of different wound closure methods in terms of pain, swelling, trismus, infection and healing time after third molar extraction. Material and methods. A literature analysis was performed according to PRISMA guidelines in search of clinical trials published between 2015 and 2020. Databases were searched using different combinations of the following keywords: mandibular impacted OR retained wisdom teeth OR third molar removal OR extraction AND surgical removal AND discomfort OR pain OR trismus OR swelling AND drain OR drainage. The literature search resulted in a total of 364 publications. Finally, 12 study articles were used in the present review, following a selection based on the preestablished eligibility criteria. Results. The signifi cant difference between various wound closure ways and postoperative pain, swelling and trismus has been found in 8 of 12 analyzed articles. Three of fi ve established benefi cial effect of drain application. In other articles, examining different wound closure methodologies, signifi cant benefi ts were found by using buccally based triangular, buccal mucosaladvancement, and modifi ed envelope fl ap. Suture-less anterior releasing incision and secondary wound closure also could be favorable after removing impacted third molars. Conclusion. There was no signifi cant effect of a rubber drain on swelling, pain, trismus, or wound infections after removal of the asymptomatic impacted third molar(s). Secondary wound closure was found to ensure lower pain, swelling and trismus ratio with comparison to primary wound closure.

The aim of this study was to compare the bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation.Forty patients requiring tooth extraction in anterior maxilla were randomly allocated to the four following treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM) and Plasma Rich in Growth Factors alone (PRGF). Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, the newly formed non-mineralized tissue, and the residual bone grafting material (if applicable). Statistical analysis was performed for descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4±15.2% vs 75.5±16.3%), control/(BBM/CM) (46.4±15.2% vs 20.3±21.9%), control/(FDBA/CM) (46.4±15.2% vs 7.2±8.6), PRGF/(BBM/CM) (75.5±16.3 vs 20.3±21.9%), and PRGF/(FDBA/CM) (75.5±16.3 vs 7.2±8.6) groups. The new mineralized tissue formation was in the following order: PRGF > control > BBM>FDBA. Alveolar ridge preservation in aesthetic zone with PRGF has been the most effective in bone regeneration of the alveolar ridge.