0000000000083473
AUTHOR
Eduard Valmaseda-castellón
Is measurement of the gingival biotype reliable? Agreement among different assessment methods.
Background To determine agreement among the most commonly used methods for assessing the gingival biotype. Material and Methods An electronic survey was sent to a sample of dentists practicing in Spain. The questionnaire was based on the evaluation of 5 cases involving different gingival biotype assessment methods. Dentists were required to classify the cases as having a “thin”, “thick” or “not able to classify” biotype. Each case was assessed using a frontal intraoral photo of the anterior teeth; an enlarged photo of the buccal aspect of the tooth with a periodontal probe inserted inside the sulcus; and the real thickness measured in mm with a calibrated needle. Agreement among the classif…
Effect of bone loss on the fracture resistance of narrow dental implants after implantoplasty. An in vitro study
Background Implantoplasty (IP) involves polishing of the exposed surface of implants affected by peri-implantitis (PI). A study was made to determine whether the degree of bone loss influences the fracture resistance of implants with or without IP. Material and Methods An in vitro study was carried out on 32 narrow (3.5 mm) dental implants with a rough surface and external hexagonal connection. Implantoplasty was performed in half of the implants of the sample. Both the IP and control implants were divided into two subgroups according to the amount of bone loss (3 mm or 7.5 mm). Standardized radiographic assessment of implant width was performed using specific software. The main outcome var…
Pilomatrixoma. Review of 205 cases.
Podeu consultar la versió en castellà del document a: http://hdl.handle.net/2445/153543
Bupivacaine 0.5% versus articaine 4% for the removal of lower third molars. A crossover randomized controlled trial.
Objective: To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed. Study Design: Triple-blind crossover randomized clinical trial. Eighteen patients underwent bilateral removal of impacted lower third molars using 0.5% bupivacaine or 4% articaine in two different appointments. Preoperative, intraoperative and postoperative variables were recorded. Differences were assessed with McNemar tests and repeated measures ANOVA tests. Results: Both solutions exhibited similar latency times and intraoperative effic…
A prospective, randomized, triple-blind comparison of articaine and bupivacaine for maxillary infiltrations
Objectives: To compare the clinical anesthetic efficacy of 0.5% bupivacaine and 4% articaine (both with 1:200.000 adrenaline) for anterior maxillary infiltration in healthy volunteers. Material and methods: A triple-blind split-mouth randomized clinical trial was carried out in 20 volunteers. A supraperiosteal buccal injection of 0.9 ml of either solution at the apex of the lateral incisor was done in 2 appointments separated 2 weeks apart. The following outcome variables were measured: latency time, anesthetic efficacy (dental pulp, keratinized gingiva, alveolar mucosa and upper lip mucosa and tissue) and the duration of anesthetic effect. Hemodynamic parameters were monitored during the p…
Evaluation of the effectiveness of the photobiomodulation in the treatment of dentin hypersensitivity after basic therapy. A randomized clinical trial
Background: Dentin hypersensitivity (DH) in one of the most common causes of patient discomfort in the general population and its prevalence is higher in patients who have received basic or surgical periodontal treatment. Efficiency of the diode laser with different wavelengths has been studied by several authors, showing an improvement rate of the DH between 60-98%. The aim of the present study was to evaluate the effect of photobiomodulation (PBM) treatment on the reduction of DH after non surgical periodontal treatment. Material and methods: A randomized split mouth clinical trial was performed involving 30 patients (120 teeth) diagnosed with DH after scaling and root planning. Two teeth…
Immediate implants placed in fresh sockets associated to periapical infectious processes: a systematic review
Objetives: The development of treated implant surfaces, added to the increase of the aesthetic requirements by the patients has led to a change in the treatment protocols as well as the development of techniques such as the onefase implants and the immediate prosthetic loading. One of the usual contraindications of the implant treatment is the presence of periapical disease associated to the tooth to be replaced. The aim of this paper is to review the published literature on immediate implant placement in extraction sockets of teeth with periapical pathology, considering the level of scientific evidence, and following the principles of medicine and evidence-based Dentistry. Material and Met…
Sensibility and taste alterations after impacted lower third molar extractions. A prospective cohort study
Objectives: To determine the incidence, severity and duration of lingual tactile and gustatory function impairments after lower third molar removal. Study Design: Prospective cohort study with intra-subject measures of 16 patients undergoing lower third molar extractions. Sensibility and gustatory functions were evaluated in each subject preoperatively, one week and one month after the extraction, using Semmes-Weinstein monofilaments and 5 different concentrations of NaCl, respectively. Additionally, all patients filled a questionnaire to assess subjective perceptions. Results: Although patients did not perceive any sensibility impairments, a statistically significant decrease was detected …
Impacted lower third molars and distal caries in the mandibular second molar. Is prophylactic removal of lower third molars justified?
Background The objective of this study was to evaluate the association between the presence of mandibular third molars and the occurrence of carious lesions in the distal aspect of the mandibular second molar. Material and methods A retrospective cohort study comprising 327 lower third molars extracted in the Oral Surgery and Implantology Master's Degree program of the School of Dentistry of the University of Barcelona (Barcelona, Spain) was carried out. A descriptive and bivariate analysis was made. The diagnosis of caries in the second molar and the position of the mandibular third molar were evaluated through panoramic radiographies. Results The sample included 203 patients, 94 males (46…
Histologic evaluation of thermal damage produced on soft tissues by CO2, Er,Cr:YSGG and diode lasers
Objective: The aim of this in vitro experimental study was to perform histological evaluation of the thermal effect produced on soft tissue irradiated with CO2 , Er,Cr:YSGG or diode lasers. Study design: Porcine oral mucosa samples were irradiated with Er,Cr:YSGG laser at 1 W with and without water / air spray, at 2 W with and without water / air spray, and at 4 W with water / air spray, with CO2 laser at 1 W, 2 W, 10 W, 20 W continuous mode and 20 W pulsed mode and diode laser at 2W, 5W, and 10W pulsed mode. The thermal effect was evaluated measuring the width of damaged tissue adjacent to the incision, stained positively for hyalinized tissue with Hematoxylin-Eosin and Masson Trichrome st…
Inflammatory fibro-epithelial hyperplasia related to a fixed implant-supported prosthesis : a case report
The gingival overgrowth is a common finding in the clinical practice with a diverse etiology. There are no treatment guidelines defined for this oral lesions. These can provoke discomfort to the patient and often, can alter the function of the stomatologic system. This article presents a case report of a bilateral gingival overgrowth in a 68 years old woman wearing a fixed upper-arch implant-supported prosthesis placed five years ago. The clinical exam after removing the prosthesis showed an intense accumulation of plaque around the intermediate abutments associated to a mucosal enlargement with suppuration on touching the buccal area of the implant in position 1.5 and a probing depth of 8m…
Vascular labeling of the head and neck vessels : technique, advantages and limitations
Background Vascular staining techniques have been used to describe the vascular structures of several anatomic areas. However, few reports have described this procedure in the head and neck region. This paper describes a head and neck vascular labeling procedure, and describes some of the technical complications that may occur. Material and methods Fifteen specimen cadaver heads were prepared. After drying the vascular system, the internal carotid arteries were ligated and a solution with latex and a gelling agent was injected into the internal carotid arteries and external jugular veins. Two different colors were employed to differentiate arteries from veins. A total of 60ml latex was inje…
Influence of information concerning a computerized anesthesia system on dental anxiety: a randomized controlled clinical trial
Background A single-blinded randomized controlled trial among patients requiring an upper third molar extraction was performed to evaluate the anxiety degree after receiving information or not about the functioning of The Wand system. Secondarily, perceived pain and the need of re-anesthesia were assessed. Material and Methods Patients were randomly assigned to the experimental group (detailed explanation about The Wand) or control group (no specific information). Local anesthesia with The Wand consisted in a supraperiosteal infiltrative technique injection 1.6 mL at the buccal and 0.2 mL at the palatal side. Distinct questionnaires for assessing dental anxiety and 100-mm visual analog scal…
Patient perception about the need for antibiotics after tooth extractions: A cross-sectional study
Background: Although the current scientific literature does not support the routine use of antibiotics after dental extractions, patients believe that these drugs offer clear benefit during the postoperative period. The main objective of this study was to describe patient perception of the need for antibiotics after routine tooth extraction and to assess knowledge about the benefits and adverse effects of antibiotic therapy. Material and methods: A cross-sectional study was carried out. A total of 452 participants requiring tooth extraction and seen in the Dental Clinic of the University of Barcelona (Barcelona, Spain) were given a specific questionnaire on the need for antibiotics after de…
Antibiotic prescription for the prevention and treatment of postoperative complications after routine dental implant placement. A cross-sectional study performed in Spain
Background As there are no established guidelines for antibiotic prescription after dental implant placement a study was made to determine the current prescribing habits of several groups of practitioners regarding antibiotics to prevent and/or treat postoperative complications - early failures and infections - in relation to routine dental implant placement. Material and methods An electronic survey was sent to postgraduate students and professionals with experience in routine dental implant placement who practice in Spain. The questions asked were related to whether antibiotics were routinely prescribed either pre- or postoperatively to prevent and/or treat postoperative complications dur…
Sharp mandibular bone irregularities after lower third molar extraction: incidence, clinical features and risk factors
Objectives: The purpose of this study was to determine the incidence and clinical symptoms associated with sharp mandibular bone irregularities (SMBI) after lower third molar extraction and to identify possible risk factors for this complication. Study Design: A mixed study design was used. A retrospective cohort study of 1432 lower third molar extractions was done to determine the incidence of SMBI and a retrospective case-control study was done to determine potential demographic and etiologic factors by comparing those patients with postoperative SMBI with controls. Results: Twelve SMBI were found (0.84%). Age was the most important risk factor for this complication. The operated side and…
Bimaxillary simultaneous immediate loading of full-arch restorations : a case series
Aim To describe a bimaxillary simultaneous immediate loading protocol with full-arch implant-supported fixed prostheses. Material and Methods A prospective case series of 8 patients who required full-arch rehabilitation was conducted. The main inclusion criteria were patients with teeth that required extraction. At least 1 molar per arch was temporarily employed to stabilize the surgical template and the provisional prosthesis during intraoral relining. Results Two upper implants failed in 1 patient. Structural fracture was registered in 3 patients, around 3 months after loading. All of them had bruxism. Three esthetic complications were registered: midline deviation, canting of the oclusal…
Development and viability of biofilms grown on experimental abutments mimicking dental implants: an in vivo model
Background To determine whether an experimental abutment mimicking the macro- and microstructure of a dental implant is a suitable method for recovering biofilm, and to describe the features of biofilms formed around such abutments on healthy implants. Material and Methods Experimental abutments were used in 15 patients without peri-implant diseases. After 14 days’ absence of dental hygiene in this area, the abutments were retrieved and analyzed through confocal laser scanning microscopy and scanning electron microscopy. The biofilm formation on the surface of the first 5 abutments was determined by a fluorescence-staining method using SYTO9 nucleic acid stain. In order to study the biofilm…
Peripheral giant cell granuloma associated with a dental implant : a case report
Peripheral giant cell granuloma (PGCG) is a reactive exophytic lesion classified as a benign tumor of the oral mucosa. Although its etiology is not clear, it may be a consequence of local chronic irritation or persistent trauma. The objective of this case report was to document the main clinical and histopathological characteristics of a patient with a PGCG associated with a dental implant. A 36 years-old man presented a partly-ulcerated violet-colored sessile-based tumor in the buccal aspect of an implant placed in the fourth quadrant. Radiographically, the implant had one third of marginal bone loss. Differential diagnosis included PGCG and pyogenic granuloma. The implant and the lesion w…
Erythritol-enriched powder and oral biofilm regrowth on dental implants: an in vitro study.
Background Peri-implant mucositis and peri-implantitis are the main biological complications associated with dental implants. Since most authors agree that bacteria play a major etiological role, the main aims of this study were to determine if a formulation of erythritol and chlorhexidine applied with an air polishing system inhibits biofilm regrowth over dental implants and to compare the decontamination capacity of this therapy with that of mechanical removal by saline and gauze. Material and Methods A multispecies biofilm (P. gingivalis, A. actinomycetemcomitans, F. nucleatum, A. naeslundii, V. parvula and S. oralis) was grown for 14 days on 52 dental implants in an artificial mouth. Th…
Salivary gland choristoma in the buccinator muscle: A case report and literature review
Salivary gland choristoma (SGCh) is defined as the presence of normal salivary tissue in an abnormal location. It is a rare entity in oral and maxillofacial region and its ethiology is unknown. The typical presentation of salivary gland heterotopia is an asymptomatic mass that may or may not produce saliva. Some examples of ectopic salivary tissue in the pituitary gland, in the lymph nodes, in the middle ear, in the neck, in the jaw, in the thyroid gland, in the mediastinum and in the rectum have been documented in literature. We report the case of a 61-year-old male presented with a bilateral tumorlike mass in the cheek. The mass was painless, of fibrous consistency and had size change wit…
Anesthetic efficacy of Oraqix versus Hurricaine and placebo for pain control during non-surgical periodontal treatment
Objectives: To evaluate the efficacy of Oraqix® during scaling and root planing (SRP) in comparison with 20% benzocaine and placebo. Study Design: 15 patients requiring 4 sessions of SRP were enrolled. For each patient, Oraqix®, Hurricaine®, vaseline or no anesthetic product were randomly assigned each to a quadrant. Treatment pain was evaluated on a 100 mm Visual Analog Scale (VAS) and on a Verbal Rating Scale (VRS). The amount of product administered, the need to re-anesthetise, patient and operator satisfaction and the onset of side-effects were also recorded. Results: Oraqix® was significantly better than nothing, with a reduction of VAS score to 13.3 units, but without significant diff…
Accuracy and the role of experience in dynamic computer guided dental implant surgery: an in-vitro study
Background To compare the accuracy of implant placement using the conventional freehand method and a dynamic navigation system; to assess the role of the surgeon’s experience in implant placement using these two methods. Material and Methods A randomized in-vitrostudy was conducted. Six resin mandible models and 36 implants were used. Two researchers with differing clinical experience (novice and experienced) placed implants using either the Navident dynamic navigation system (navigation group) or the conventional freehand method (freehand group). Accuracy was measured by overlaying the real position in the postoperative CBCT on the virtual presurgical placement of the implant in a CBCT ima…
Quality of life following third molar removal under conscious sedation
Aim: The aim of this study was to assess quality of life (QoL) and degree of satisfaction among outpatients subjected to surgical extraction of all four third molars under conscious sedation. A second objective was to describe the evolution of self-reported pain measured in a visual analogue scale (VAS) in the 7 days after extraction. Study design: Fifty patients received a questionnaire assessing social isolation, working isolation, eating and speaking ability, diet modifications, sleep impairment, changes in physical appearance, discomfort at suture removal and overall satisfaction at days 4 and 7 after surgery. Pain was recorded by patients on a 100-mm pain visual analogue scale (VAS) ev…
Aesthetic perception of single implants placed in the anterior zone. A cross-sectional study
Background: Several aesthetic indexes have been described to assess implant aesthetics. The aim of this study was to compare the aesthetic assessment made by dental professionals and students of single-tooth implants placed in the upper incisors. Material and Methods: A cross-sectional survey study using a subjective questionnaire to assess the aesthetics in 3 implant supported single-tooth cases in the anterior maxilla was performed. The interviewed subjects were divided into 4 groups: dentists with experience in implant treatment, dentists without experience in implants and 3rd and 5th year dental students. The questionnaire consisted of 2 visual analogue scales (VAS) to evaluate aestheti…
Clinician-related factors behind the decision to extract an asymptomatic lower third molar. A cross-sectional study based on Spanish and Portuguese dentists
Background: Scientific literature estimates that around 18 to 40 % of asymptomatic third molars are extracted. The aims of the present study were to determine the indications for extraction of asymptomatic lower third molars in a sample of Spanish and Portuguese dentists, and to relate these indications to the clinicians’ training and professional experience. Material and Methods: A survey consisting of 15 cases of asymptomatic lower third molars was emailed to Portuguese and Spanish dentists. The clinicians were asked to assess the level of difficulty of the extractions and to make a reasoned recommendation based on the panoramic radiographs, gender and age of the patients. Results: 381 cl…
Quality of life after upper third molar removal: a prospective longitudinal study
Background Third molar extraction is a very common procedure in Dentistry. The aim of this study was to evaluate the quality of life (QoL) and satisfaction of patients undergoing extraction of an upper third molar under local anesthesia. A second objective was to describe the evolution of self-reported pain measured in a visual analogue scale (VAS) in the 7 days after surgery and its relationship with pre- and intraoperative factors. Material and Methods A prospective longitudinal cohort study was made. Fifty-five patients received a questionnaire assessing social and working isolation, eating and speaking ability, diet modifications, sleep impairment, physical appearance, discomfort at sut…
Study of two MTA cements
Introduction: To determine and compare the pH, conductivity and calcium release of an experimental Portland cement (PE) consisting of trioxid mineral aggregate and a comercially available modified Portland cement (C.P.M.) after 1, 2, 3, 4, 8, 10, 15 and 30 days. Material and Methods: Cements were mixed following the manufacturer's instructions, with a powder: liquid ratio of 3:1. Each cement was placed in 12 PVC tubes 1 mm in diameter and 10 mm in length and allowed to set. Four empty tubes were used as negative controls. Tubes were submerged in plastic flasks containing 10 ml deionized water and stored at 37ºC and 100% humidity. After 1, 2, 3, 4, 8, 10, 15 and 30 days tubes were removed fr…
Effect of the local administration of betamethasone on pain, swelling and trismus after impacted lower third molar extraction. A randomized, triple blinded, controlled trial
Objectives: The aim of this study is to compare the analgesic and anti-inflammatory effects of the local postoperative administration of a single 12-mg dose of betamethasone after the surgical removal of impacted lower third molars. Study Design: A split-mouth, triple-blind, randomized, placebo-controlled clinical trial of 25 patients requiring the surgical removal of symmetrical lower third molars was performed. In the experimental side, a 12-mg dose of betamethasone was administered submucosally after the surgical procedure, while in the control side a placebo (sterile saline solution) was injected in the same area. To assess postoperative pain, visual analogue scales and the consumption …
Fracture resistance after implantoplasty in three implant-abutment connection designs
Background To assess the effect of implantoplasty and implant-abutment design on the fracture resistance and macroscopic morphology of narrow-diameter (3.5 mm) dental implants. Material and Methods Screw-shaped titanium dental implants (n = 48) were studied in vitro. Three groups (n = 16) were established, based on implant-abutment connection type: external hexagon, internal hexagon and conical. Eight implants from each group were subjected to an implantoplasty procedure; the remaining 8 implants served as controls. Implant wall thickness was recorded. All samples were subjected to a static strength test. Results The mean wall thickness reductions varied between 106.46 and 153.75 µm. The me…