Purpose: To investigate peri-implant bone resorption around 108 ITI dental implants 1 year after prosthetic loading using extraoral panoramic, conventional intraoral periapical, and digital radiologic techniques.
Materials and Methods: A total of 108 implants were placed (59 in the maxilla and 49 in the mandible) in 42 patients (16 men and 26 women) with a mean age of 44.2 years (range 14 to 68 years). Orthopantomographic, conventional periapical, and digital radiographs were obtained at loading and again 1 year later. Bone loss was calculated from the difference between the initial and final measurements.
Results: Mean loss in alveolar bone height was determined to be 1.36 mm by extraoral panoramic radiography, 0.76 mm by intraoral periapical radiography, and 0.95 mm by digital radiography. The implants located in the maxilla and those placed in patients who smoked 11 to 20 cigarettes per day were associated with significantly greater bone loss.
Discussion: The results in relation to peri-implant bone loss in the first year after loading were similar to those published by other authors.
Conclusion: Conventional periapical films and digital radiographs were more accurate than orthopantomography in the assessment of peri-implant bone loss. Smoking and implant location in the maxilla were associated with increased peri-implant marginal bone resorption.

This article describes a method for harvesting intramembranous bone from the paranasal bone around the piriform aperture for lateral alveolar ridge augmentation and simultaneous implant placement in the anterior maxilla. In particular, the technique is recommended for situations where a maxillary incisal implant is being placed and ridge augmentation is needed to cover exposed threads. Surgical access is simple and can be accomplished by the same incision, and bone harvesting can be accomplished under local anesthesia. Postopertaive morbidity is not yet known.

The failed implant in the maxillary rigth central incisor area. The implant´s failure was related to failed bone grafting procedures.	After removal of the implant and the bone graft, little bone was left on the labial cortex.
Bone from below the piriform aperture was removed carefully with a trephine.
In the CT scan examination, the existence of bone on the labial side of the implant placed was demonstrated.
After exposure of the implant, new bone was evident on the labial surface of the implant.

Richie Yeung, BDS, MB, ChB (CUHK), FRACDS, FRCS, FCSHK

This is uncertainly regarding the role of preemtive analgesia in preventing postoperative pain. Most previous studies were of parallel design completed under general anesthesia with many confounding inter-patient's variables. The present study evaluated the efficacy of preemptive ketorolac in a crossover desing in patients undergoing bilateral mandibular mandibular third molar surgery. This was a double blind, randomized, placebo-controlled study where 34 patients had each of their identical impacted mandibular third molars removed under local anesthesia on two occasions. Each patients acted as their own control; one side was pretreated with intravenous ketorolac 30 mg before surgery followed by placebo injection after surgery, and for the other side, the patient was given placebo injection before surgery and post-treated with intravenous ketorolac 30 mg after surgery. The difference in postoperative pain between pretreated and post-treated side in each patient was assessed by four primary end-points: pain intensity as measured by a 100-mm visual analogue scale hourly for 12 h, time to rescue anlagesic, postoperative analgesic consumption, and patient's global assessment. Throughout the 12-h investigation period, patients reported significantly lower pain intensity scores in the ketorolac pretreated sides when compared with the post-treated sides (P = 0.003). Patients also reported a significantly longer time to rescue analgesic (8.9 h versus 6.9 h, P = 0.005), lesser postoperative analgesic consumption (P = 0.007) and better global assessment for the ketorolac pretreated sides (P = 0.01). Pretreatment with intravenous ketorolac has a preemptive effect for postoperative third molar surgery and extended the analgesia by approximately 2 h.

Mean pain intensity scores (in mm) as recorded on a 100-mm plain VAS throughout the 12-h investigation period for the sides pretreated and post-treated with ketorolac.
Violin plot comparing the median, the spread, and the distribution pattern of the time to rescue analgesia between the sides pretreated and post-treated with ketorolac. The median is shown by the circle, the interquartile range (IQR) is shown by the length of the thick line, and the distribution of data is shown by the density trace. Mean = 6.9, median = 6.0 for post-treated sides. Mean = 8.9, median = 8.5 for the pretreated sides.
Box plot comparing the total postoperative analgesic consumption (number of tablets of acetaminophen) between the sides pretreated and post-treated with ketorolac. The top and bottom of the box are the 25th and 75th percentiles. The line drawn through the middle of the box is the median (the 50th percentile). The length of the box is the interquartile range (IQR). The box represents the middle 50% of the data. Median = 6.0 for post-treated sides, median = 4.0 for the pretreated sides.
A temporay screw-retained resin restoration is connected to the implant after 24 hours. A periapical radiograph taken in a standardized manner.