0000000000616725
AUTHOR
David Peñarrocha-oltra
Introduction to Immediate Loading in Implantology
Branemark traditional recommendation was to perform implant rehabilitation in two stages: the first entry was only for implant placement; after 3–6 months of undisturbed submerged healing for mandible and maxilla, respectively, a second surgical entry would have allowed loading of the implants. The rationale behind this approach was that implant micro-movements as consequence by an inadequate primary stability, caused by functional forces at the bone-implant interface in the early wound healing stages, could have induced fibrous tissue formation rather than new bone, eventually causing clinical failure. The main request was to reduce the overall rehabilitation time from surgery to final res…
Virtual articulator for the analysis of dental occlusion: An update
The future of dental practice is closely linked to the utilization of computer-based technology, specifically virtual reality, which allows the dental surgeon to simulate true life situations in patients. The virtual articulator has been designed for the exhaustive analysis of static and dynamic occlusion, with the purpose of substituting mechanical articulators and avoiding their errors. These tools will help both odontologists and dental prosthetists to provide the best individualized treatment for each patient. The present review analyzes the studies published in the literature on the design, functioning and applications of virtual articulators. A Medline-PubMed search was made of dental…
Influence of the prosthetic arm length (palatal position) of zygomatic implants upon patient satisfaction
Background: To assess the influence of the prosthetic arm length (palatal position) of zygomatic implants upon patient comfort and stability, speech, functionality and overall satisfaction. Material and Methods: A retrospective clinical study was made of patients subjected to rehabilitation of atrophic maxilla with complete maxillary implant-supported fixed prostheses involving a minimum of two zygomatic implants (one on each side) in conjunction with premaxillary implants, and with 12 months of follow-up after implant loading. Subjects used a VAS to score general satisfaction, comfort and stability, speech and functionality, and the results were analyzed in relation to the prosthetic arm l…
Satisfaction and quality of life with palatal positioned implants in severely atrophic maxillae versus conventional implants supporting fixed full-arch prostheses
Background: To evaluate satisfaction and quality of life in patients with palatal positioned implants supporting fixed full-arch prostheses to rehabilitate edentulous maxillae with horizontal atrophy and compare them with conventional well-centered implants placed in non-atrophic supporting fixed full-arch prostheses. Material and Methods: A clinical retrospective study was performed of patients that were rehabilitated with full- arch fixed implant-supported maxillary prostheses and had a minimum follow-up of 5 years after implant loading. Patients were divided into 2 groups: patients with class IV maxilla according to Cawood and Howell and treated with palatal positioned implants (test) an…
Clinical parameters of implants placed in healed sites using flapped and flapless techniques: A systematic review
Background: Dental implant placement using flapless surgery is a minimally invasive technique that improves blood supply compared with flapped surgery. However, the flapless technique does not provide access to allow bone regeneration. Objectives: The aim of this systematic review was to evaluate the clinical parameters following implant surgery in healed sites, using two procedures: flapped vs. flapless surgery. Material and Methods: A detailed electronic search was carried out in the PubMed/Medline, Embase and Cochrane Library databases. The focused question was, “How do flapped and flapless surgical techniques affect the clinical parameters of dental implants placed in healed sites?”. Al…
In-vitro fatigue and fracture performance of three different ferrulized implant connections used in fixed prosthesis
Background/purpose: The aim of the present in vitro study was to evaluate fatigue resistance of dental fixtures in three different types of fixture/abutment finishing line. Materials and methods: Transmucosal dental implants, with or without ferrulized neck, underwent fatigue tests (static and dynamic load) using the following standard protocol: UNI EN ISO 14801:2016. Two types of loading devices (screw- or cement-retained restoration) were also tested, and fatigue cycle tests were run to failure. Data of static and dynamic load tests were analyzed by proper statistical methods. Results: Following standard protocol for fatigue testing, the ILC type (Implant Level with ferrulized neck and ce…
Additional file 4 of Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies
Additional file 4. Measurement of FAB thickness with CEJ as reference point analyzed by meta-regression of the geographical study setting at CI, LI and C.
Implant treatment in atrophic posterior mandibles: Vertical regeneration with block bone grafts versus implants with 5.5-mm intrabony length
Purpose: To retrospectively compare the outcomes of implants placed in posterior mandibles vertically regenerated with onlay autogenous block bone grafts and short dental implants. Materials and Methods: Consecutive patients with vertical bone atrophy in edentulous mandibular posterior regions (7 to 8 mm of bone above the inferior alveolar nerve) were treated with either implants placed in regenerated bone using autologous block bone grafts (group 1) or short implants (with 5.5-mm intrabony length) in native bone (group 2) between 2005 and 2010 and followed for 12 months after loading. The procedure used was the established treatment protocol for this type of patient at the Oral Surgery Uni…
Microbiological assessment of the implant-abutment interface in different connections: cross-sectional study after 5 years of functional loading.
Objective To evaluate the bacterial microflora present inside the implant connection and in the peri-implant sulcus fluid of healthy implants, and to analyze the relationships between these harboring sites for four different implant systems after at least 5 years of functional loading. Materials and methods A cross-sectional study was performed involving 40 patients treated with metal-ceramic cemented bridges supported by at least two healthy implants functionally loaded for 5 years. Four different implant-abutment connections were studied: external hexagon (control group), double internal hexagon (test group 1), internal hexagon with external collar (test group 2), and conical connection (…
Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies
Abstract Background Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest. Methods An electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The…
Coronectomy of impacted mandibular third molars: A meta-analysis and systematic review of the literature.
Background: Coronectomy is an alternative to complete removal of an impacted mandibular third molar. Most authors have recommended coronectomy to prevent damage to the inferior alveolar nerve during surgical extraction of lower third molars. The present study offers a systematic review and metaanalysis of the coronectomy technique. Material and Methods: A systematic review and meta-analysis was performed based on a PubMed and Cochrane databases search for articles published from 2014 and involving coronectomy of mandibular third molars located near the inferior alveolar nerve canal, with a minimum of 10 cases and a minimum follow-up period of 6 months. After application of the inclusion and…
Marginal bone loss in relation to platform switching implant insertion depth: an update
A review is made, analyzing marginal bone loss in relation to the depth of implant insertion with platform switching, according to the position of the neck (supracrestal, crestal or subcrestal), and evaluating survival of the implants. A PubMed search was made of the studies in animals and humans published between 2005 and 2011, specifying platform insertion depth (supracrestal, crestal or subcrestal) and registering marginal bone loss from the time of prosthetic restoration to the end of follow-up (minimum 6 months). A total of 30 studies were included. The bone loss associated with implants placed at supracrestal level was slightly smaller than in the case of implants placed at subcrestal…
Risk factors associated with early failure of dental implants. A literature review
The aim of the study was to examine articles published on risk factors associated with early failure of dental implants. We conducted a search on PubMed for articles published between January 2000 and December 2009 using the keywords 'dental implants' and 'early failure'. Seven studies that specified the number of early failed implants and studied the associated risk factors were included. Early failures are caused by the inability of tissue to establish osseointegration prior to prosthetic restoration; however the causal factors and mechanisms are unclear. In the reviewed literature there was a higher percentage of early than late failures; nevertheless, few articles were found that analyz…
Bone-Healing Pattern on the Surface of Titanium Implants at Cortical and Marrow Compartments in Two Topographic Sites: an Experimental Study in Rabbits
This study evaluates the bone-healing patterns on the surface of titanium implants at the cortical and marrow compartments of bicortically-installed implants in the diaphysis and metaphysis of rabbit tibiae. In 27 New Zealand rabbits, two implants, one for each macro-design and with equal resorbable blasted media (RBM) implant surfaces, were randomly implanted in the diaphysis or metaphysis of each tibia. The flaps were sutured to allow submerged healing. The animals were sacrificed after two, four, or eight weeks, with nine weeks used for the period of healing. Ground sections were prepared and analyzed. No statistically significant differences were found between the two groups for newly f…
Hemodynamic variations and anxiety during the surgical extraction of impacted lower third molars
Background The surgical removal of an impacted third molar can cause patient anxiety. Such anxiety and the use of vasoconstrictor drugs and local anesthetics in turn can induce hemodynamic variations during the operation. A study is made of the variations in hemodynamic parameters (systolic and diastolic blood pressure and heart rate) and their correlation to patient gender and anxiety during surgical removal of an impacted lower third molar. Material and methods A prospective study was carried out in the Oral Surgery Unit of a university clinic, with the inclusion of 125 patients (mean age 24.9 years). Anesthesia was administered in the form of 4% articaine and adrenalin 1:200,000 for surg…
Immediate loading with fixed full-arch prostheses in the maxilla: review of the literature
Objectives: To critically review the evidence-based literature on immediate loading of implants with fixed full- arch prostheses in the maxilla to determine 1) currently recommended performance criteria and 2) the outcomes that can be expected with this procedure. Study Desing: Studies from 2001 to 2011 on immediate loading with fixed full-arch maxillary prostheses were reviewed. Clinical series with at least 5 patients and 12 months of follow-up were included. Case reports, studies with missing data and repeatedly published studies were excluded. In each study the following was assessed: type of study, implant type, number of patients, number of implants, number of implants per patient, us…
Efficacy of infiltrative local anesthesia and inferior alveolar nerve block in periapical surgery of lower premolars and molars : a preliminary report
Background The aims of this study were: 1) compare the amount of anesthesia used with the anesthetic technique; 2) relate the quantity of anesthesia needed with the level of anxiety of the patient; 3) study the relationship between the anesthetic technique and the level of hemostasis; 4) correlate the amount of anesthesia with patient and tooth dependent variables. Material and Methods A randomized controlled trial was designed with two parallel groups according to the anesthetic technique: infiltrative local anesthesia (infiltrative group) and inferior alveolar nerve block (block group). The following variables were collected: sex, age, smoking habits, plaque index, symptoms, signs, positi…
Radiological Outcomes of Bone-Level and Tissue-Level Dental Implants: Systematic Review
Purpose: to assess any differences on marginal bone loss between bone-level or tissue-level dental implants through a review of literature until September 2019. Materials and methods: MEDLINE, Embase and other database were searched by two independent authors. The search was limited to articles in English. Results: The search provided 1028 records and, after removing the duplicates through titles and abstracts screening, 45 full-text articles were assessed for eligibility. For qualitative analysis 20 articles were included, 17 articles of them for quantitative analysis. A total of 1161 patients (mean age 54,4 years) and 2933 implants were observed, 1427 (Tissue-level) and 1506 (Bone-level).…
Implant Abutment Cleaning by Plasma of Argon: 5-Year Follow-Up of a Randomized Controlled Trial.
Contamination of implant abutments could potentially influence the peri-implant tissue inflammatory response. The aim of the present study is to assess the radiographic bone changes around customized, platform-switched abutments placed according to the "one-abutment-one-time" protocol, with and without plasma of argon cleaning treatment.Thirty healthy patients with thin gingival biotype (1 mm) and history of periodontal disease received one maxillary implant each. Immediately before abutment connection, patients were randomly assigned to control group (cleaning protocol by steaming) or test group (plasma of argon treatment). Outcome measures were: 1) success rate of implants and prostheses;…
Impact of crestal and subcrestal implant placement in peri-implant bone: a prospective comparative study
Background To assess the influence of the crestal or subcrestal placement of implants upon peri-implant bone loss over 12 months of follow-up. Material and Methods Twenty-six patients with a single hopeless tooth were recruited in the Oral Surgery Unit (Valencia University, Valencia, Spain). The patients were randomized into two treatment groups: group A (implants placed at crestal level) or group B (implants placed at subcrestal level). Control visits were conducted by a trained clinician at the time of implant placement and 12 months after loading. A previously established standard protocol was used to compile general data on all patients (sex and age, implant length and diameter, and bru…
Additional file 6 of Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies
Additional file 6. Supplementary Table S1. Assessment of the certainty of evidence by GRADE tool for FAB thickness considering FBC as anatomical reference. Supplementary Table S2. Assessment of the certainty of evidence by GRADE tool for FAB thickness considering CEJ as anatomical reference. Supplementary Table S3. Assessment of the certainty of evidence by GRADE tool for CEJ-FBC distance.
Marsupialización modificada de ránula gigante intraoral: reporte de caso
ResumenLa ránula intraoral es una enfermedad benigna seudoquística de extravasación que tiene su origen en las glándulas salivales sublinguales. Es una entidad poco prevalente. Es más frecuente en niños y adolescentes, con características clínicas propias que la diferencian de otras entidades de la boca.Su tratamiento es quirúrgico y varias técnicas han sido descritas en la literatura: marsupialización simple y modificada, enucleación de la lesión, extirpación de la glándula junto con enucleación de la ránula.Si bien la extirpación de la glándula junto con la enucleación de la lesión es el tratamiento definitivo radical y más aceptado, la marsupialización modificada puede ser útil como alte…
Use of buccal fat pad to repair post-extraction peri-implant bone defects in the posterior maxilla: a preliminary prospective study
Background: Extensive literature exists about the use of the BFP in the treatment of oral defects but, to our knowledge, no article refers to the use of the BFP as a substitute of the membrane barriers for treatment of peri- implant bone defects. The aim was to evaluate the use of the buccal fat pad as a coating material for bone grafting in the peri-implant bone defect regeneration of immediate implants placed in the posterior maxilla. Material and Methods: A preliminary prospective study of patients involving immediate implants in which the buccal fat pad was used as a coating material to peri-implant bone defects was carried out. The outcome measures assessed were: postoperative pain and…
The funding sources of implantology research in the period 2008-2017: A bibliometric analysis
BACKGROUND Implant dentistry is subject to major economic pressures as a result of the growth in the manufacturing and commercialization of dental implants. PURPOSE To examine research funding in implant dentistry by means of a bibliometric analysis of articles indexed in Web of Science (WoS) published during the period 2008-2017. MATERIALS AND METHODS The search was conducted applying the truncated term "implant*" in the WoS dentistry area. Only items labeled as "article" or "review" were selected. Records were manually refined and normalized to unify terms and to remove typographical, transcription, and/or indexing errors. RESULTS A total of 14 255 records were identified for analysis. Ab…
Culturomic and quantitative real‐time ‐ polymerase chain reaction analyses for early contamination of abutments with different surfaces: A randomized clinical trial
Background Rough and/or plasma-activated abutments seem to be able to increase soft tissue adhesion and stability; however, limited evidence is available about bacterial contamination differences. Purpose The aim was to investigate the oral microbiota on four dental abutments with different surfaces by quantitative real-time polymerase chain reaction (qRT-PCR) and culturomic approach. Methods Forty patients needing a single implant rehabilitation were involved in the study. Forty healing abutments, especially designed for the study, were divided into four groups according to the surface topography (1. machined [MAC], 2. machined plasma of argon treated [plasmaMAC], 3. ultrathin threaded mic…
An up to 7-Year Retrospective Analysis of Biologic and Technical Complication With the All-on-4 Concept
The aim of this study was to evaluate retrospectively biologic and technical complications as well as clinical and radiographic outcomes of patients treated with 4 implants according to the All-on-4 protocol and followed up to 7 years of function. Data from 56 consecutive patients presenting complete edentulous jaw, aged 18 years or older, treated between January 2008 and December 2013, were evaluated. The outcomes were implant and prosthetic survival and success rates, any complications, and marginal bone loss (MBL). Two-hundred twenty-four implants were placed in 56 patients. During the entire follow-up, 1 maxillary implant but no prosthesis failed during the healing process. Fourteen pat…
Aluminum Chloride versus Electrocauterization in Periapical Surgery: A Randomized Controlled Trial
The aim of this study was to evaluate the efficacy of 2 hemostatic agents in periapical surgery and its relationship with patient- and tooth-dependent variables.A prospective study was designed with 2 randomized parallel groups established according to the hemostatic agent used: aluminum chloride or electrocauterization. The surgeon and 2 independent blinded observers examined the initial and final bleeding and recorded it as 0 (no hemorrhage control), 1 (slight but apparent intermittent bleeding), or 2 (complete hemorrhage control). The following patient- and tooth-dependent variables were collected: sex, age, smoking habit, plaque index, and position.Sixty patients with a periapical lesio…
Implant periapical lesion: diagnosis and treatment
The implant periapical lesion is the infectious-inflammatory process of the tissues surrounding the implant apex. It may be caused by different factors: contamination of the implant surface, overheating of bone during drilling, preparation of a longer implant bed than the implant itself, and pre-existing bone disease. Diagnosis is achieved by studying the presence of symptoms and signs such us pain, swelling, suppuration or fistula; in the radiograph an implant periapical radiolucency may appear. A diagnostic classification is proposed to establish the stage of the lesion, and determine the best treatment option accordingly. The following stages are distinguished: acute apical periimplantit…
Periapical Microsurgery with an Endoscope and Microscope of Two Upper Central Incisors Already Subjected to Periapical Surgery 25 Years Ago
Introduction. The present clinical case describes periapical microsurgery with an endoscope and microscope in a patient already treated 25 years ago due to persistent periapical disease of the two central upper incisors, restored with poorly adapted crowns. Clinical Case. The first periapical surgery had been performed with silver amalgam as a retrograde filler material, causing grayish staining of the buccal mucosa. Periapical surgery was performed raising a submarginal flap with ostectomy and apicoectomy, retrograde cavity preparation with ultrasound tips, and filling with mineral trioxide aggregate (MTA). After soft tissue healing and complete bone regeneration of the lesion, retreatment…
Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: a case report and 6-month follow-up
The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction. A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow…
Influence of supracrestal tissue attachment thickness on radiographic bone level around dental implants: A systematic review and meta-analysis.
The present systematic review and meta-analysis was carried out to determine the extent to which supracrestal tissue attachment (STA) thickness affects marginal bone loss (MBL) around dental implants. An electronic search was conducted in PubMed (MEDLINE), EMBASE, and complementary sources covering the period up to June 2018. The studies were meta-analyzed based on implant position with respect to the alveolar bone crest (crestal/supracrestal). The MBL values were categorized according to STA width (thick/thin). Of the 1062 eligible titles, nine articles were included in the review. The implants were positioned crestal or supracrestal with respect to the alveolar ridge. The difference betwe…
Additional file 5 of Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies
Additional file 5. Measurement of CEJ-FBC distance analyzed by meta-regression of study geographical setting CI, LI and C.
Dental implants with versus without peri-implant bone defects treated with guided bone regeneration
BACKGROUND: The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects. The aim was to determine whether or not implants associated with GBR due to peri-implant defects show the same survival and success rates as implants placed in native bone without defects. MATERIAL AND METHODS: Patients with a minimum of two submerged dental implants: one suffering a dehiscence or fenestration defect during placement and undergoing simultaneous guided bone regeneration (test group), versus the other entirely surrounded by bone (control group) were treated and monitored annually for three years. Complications with the healing procedure, implant surviv…
Single-blind randomized clinical trial to evaluate clinical and radiological outcomes after one year of immediate versus delayed implant placement supporting full-arch prostheses
Purpose: To evaluate and compare peri-implant health, marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses. Material and Methods: The present study was a prospective, randomized, single-blind, clinical preliminary trial. Patients were randomized into two treatment groups. In Group A implants were placed immediately post-extraction and in Group B six months after extraction. The following control time-points were established: one week, six months and twelve months after loading. Measurements were taken of peri-implant crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified …
Diagnosis and Planning in Immediate Loading: Prosthetic Diagnosis
Immediate loading provides functional and esthetic advantages, improving the quality of life of the patient during the osseointegration period. But, clinicians have to know that the three key parameters that should be evaluated for prosthetic planning of the totally edentulous patient are prosthetic space, lip support, and smile line. This is a crucial part of the planning because the prosthetic space, lip support, and smile line determine the type of prosthetic restoration.
The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: A systematic review
Aim: The purpose of this study was to systematically review clinical studies examining the survival and success rates of implants placed with intraoral onlay autogenous bone grafts to answer the following question: do ridge augmentations procedures with intraoral onlay block bone grafts in conjunction with or prior to implant placement influence implant outcome when compared with a control group (guided bone regeneration, alveolar distraction, native bone or short dental implants.)? Material and Method: An electronic data banks and hand searching were used to find relevant articles on vertical and lateral augmentation procedures performed with intraoral onlay block bone grafts for dental im…
Patient morbidity after impacted third molar extraction with different flap designs. A systematic review and meta-analysis
Background To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction. Material and Methods An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized clinical trials. The Cochrane risk of bias assessment tool was used for methodological appraisal. A random-effects meta-analysis was conducted of pain perception and trismus. Results From the initially 1314 screened studies, only 11 were included in the qualitative synthesis, and 5 in the meta-analysis. There were no statistically significant difference…
Indirect sinus lift without bone graft material: systematic review and meta-analysis
A systematic literature review and a meta-analysis of indirect sinus lift without the use of bone graft material was performed. A PubMed search was made from January 2005 to January 2012 with keywords: “sinus lift” , “osteo-tome” , “graft” and “maxillary sinus elevation” . The inclusion criteria were: maxillary sinus lift technique with osteotomes with a minimum follow-up period of 5 months after surgery without bone graft material. 11 articles were included. The mean gain in residual crestal bone height after maxillary sinus lift without bone graft material was 3,43 mm ± 0,09 (2,5 mm – 4,4 mm). The survival rate ranged from 94% to 100%. Placement of implants with sinus lift without bone gr…
Radiological implications of crestal and subcrestal implant placement in posterior areas. A cone-beam computed tomography study
Background Subcrestal implant placement has been suggested as a method that could contribute to maintain the periimplant soft and hard tissues in comparison with crestal placement. The objective of this study was to investigate the relationship between implant placement at different depths in the alveolar bone and (a) the thickness of the buccal bone plate (BBP); and (b) crestal cortical bone thickness, based on the use of cone-beam computed tomography (CBCT). Material and Methods A cross-sectional study was performed, analyzing CBCT scans from the database of the Oral Surgery Unit of the University of Valencia. Individuals with single missing teeth in posterior sectors were included. Two t…
Immediate Loading with Fixed Full-Arch Prosthesis in the Edentulous Patient: Treatment Protocol
Immediate loading is basically a prosthetic concept. However, the surgical implantological planning is very important to ensure a primary stability in the total edentulous patient. This characteristic is crucial to allow immediate loading in this type of patients. For the first time, the incisional design has allowed the clinician to overview about the surgical side. Later, maybe, the bone will need an osteoplasty to regularize possible bone defects. To ensure primary stability, it can use methods to enhance primary stability as undersized drilling technique and use of osteotomes and bi-cortical anchorage implants. There are two main protocols to obtain temporary immediate loading full-arch…
Modified marsupialisation of a giant intraoral ranula: Case report
La ránula intraoral es una enfermedad benigna seudoquística de extravasación que tiene su origen en las glándulas salivales sublinguales. Es una entidad poco prevalente. Es más frecuente en niños y adolescentes, con características clínicas propias que la diferencian de otras entidades de la boca. Su tratamiento es quirúrgico y varias técnicas han sido descritas en la literatura: marsupialización simple y modificada, enucleación de la lesión, extirpación de la glándula junto con enucleación de la ránula. Si bien la extirpación de la glándula junto con la enucleación de la lesión es el tratamiento definitivo radical y más aceptado, la marsupialización modificada puede ser útil como alternati…
Biomechanics and Occlusion in Immediate Loading
In this chapter, biomechanical concepts as tension, types of forces, and static and dynamic loads in oral implantology are explained. Also, biomechanical factors as type of bone, implant design, switching platform, connection type, crown-implant ratio, and passive fit are exposed. So, it is important to know keys for biomechanical control and occlusal pattern. The lowering of tensions is one of our aims when planning cases for immediate loading, since we know the complications they can cause. It is therefore necessary to reduce the incident forces or increase the surface upon which they fall. Increasing the number of implants is the most effective method for improving surface area and reduc…
Pain and swelling after periapical surgery related to the hemostatic agent used: anesthetic solution with vasoconstrictor or aluminum chloride.
Objective: To assess pain and swelling in the first 7 days after periapical surgery and their relationship with the agent used for bleeding control. Study Design: A prospective study was conducted between October 2006 and March 2009. Patients subjected to root surgery, who completed the questionnaire and who consented to the postoperative instructions were included in the study. The subjects were divided into two groups according to the hemostatic agent used: A) gauze impregnated with anesthetic solution with vasoconstrictor; or B) aluminum chloride. The patients were administered a questionnaire, and were asked to record the severity of their pain and swelling on a plain horizontal visual …
Microbial Colonization of the Peri-Implant Sulcus and Implant Connection of Implants Restored With Cemented Versus Screw-Retained Superstructures: A Cross-Sectional Study.
The aim of this study is to investigate peri-implant and intraconnection microflora of healthy implants restored with cemented and screwed superstructures.Patients with two to three implants restored with cemented or screwed restorations and 5 years of follow-up were recruited. Samples were taken from peri-implant sulci, adjacent teeth, and the inner portion of connections. Prevalence of positive sites and bacterial loads for 10 microorganisms were obtained with quantitative real-time polymerase chain reaction. Implant connection permeability to the studied microorganisms was estimated using a standardized bacterial contamination index. Statistical analysis was performed using a generalized…
Relationship between indication for tooth extraction and outcome of immediate implants: a retrospective study with 5 years of follow-up
Objectives: The aims of this retrospective study were to evaluate the survival rate of a series of immediate implants after 3 years of follow-up and to study the relationship between survival and indication for tooth extraction. Study design: A retrospective study of patients treated with immediate implants between January 2003 and Dec - ember 2008 was carried out. All patients receiving at least one post-extraction implant and a minimum follow-up of 5 years were included. Results: After 60 months, 30 immediate implants had been lost in 17 patients, yielding a total implant success rate of 93.8%. None of the implants placed failed after the extraction of included canines (100% success rate)…
Soft tissue cell adhesion to titanium abutments after different cleaning procedures: preliminary results of a randomized clinical trial
Objectives: A randomized controlled trial was performed to assess soft tissue cell adhesion to implant titanium abutments subjected to different cleaning procedures and test if plasma cleaning can enhance cell adhesion at an early healing time. Study Design: Eighteen patients with osseointegrated and submerged implants were included. Before re-opening, 18 abutments were divided in 3 groups corresponding to different clinical conditions with different cleaning processes: no treatment (G1), laboratory customization and cleaning by steam (G2), cleaning by plasma of Argon (G3). Abutments were removed after 1 week and scanning electron microscopy was used to analyze cell adhesion to the abutment…
Basic Bone Biology Healing During Osseointegration of Titanium Dental Implants
Dental implants can be integrated at both hard and soft tissue levels. Osseointegration is a dynamic process during its establishment and maintenance, characterized by resorption and apposition events, and the extent and degree of osseointegration is in part affected by implant surface configuration. It is marked by three distinct healing stages during endosseous implant integration: osteoconduction, “de novo” bone formation, and bone remodeling, which occur by the interaction of different bone cells: osteocytes, osteoblasts, and osteoclasts. One of the most important aspects for reaching clinical osseointegration is the primary stability during implant placement. The extent of primary anch…
Maxillary sinus septa : A systematic review
This review analyzes articles published on the presence of septa in maxillary sinuses. An automated search was conducted on PubMed using different key words. This search resulted in 11 papers in which the presence of antral septa was assessed. These septa are barriers of cortical bone that arise from the floor or from the walls of the sinus and may even divide the sinus into two or more cavities. They may originate during maxillary development and tooth growth, in which case they are known as primary septa; or they may be acquired structures resulting from the pneumatization of maxillary sinus after tooth loss, in which case they are called secondary septa. Several methods have been used in…
Peri-implantitis : associated microbiota and treatment
Introduction: Peri-implantitis is a late complication of dental implant treatment, induced by microbiological changes. Since the disorder is frequent, a review is indicated of the microorganisms that influence it and of the existing treatment options. Objective: To conduct a literature review of the microbiota associated to peri-implantitis and the existing treatment options. Material and Method: A PubMed literature search was made of the studies on the microbiota associated to dental implants in healthy patients and patients with peri-implantitis, as well as of the latest treatment developments, using the following key words: "peri-implantitis AND microbiota", "periimplantitis AND microbio…
Preoperative Anxiety and Its Influence on Patient and Surgeon Satisfaction in Patients Receiving Dental Implant Surgeries Performed Under Intravenous Conscious Sedation
Purpose: The aims of this study were to evaluate the relationship of age, sex, and type and duration of the surgery with preoperative anxiety in patients undergoing dental implant surgeries under intravenous conscious sedation, and to assess preoperative anxiety association with the postoperative satisfaction of both the patient and surgeon. Materials and Methods: This prospective study included 180 patients receiving dental implant surgeries under intravenous conscious sedation by means of midazolam, fentanyl, and propofol. Preoperative anxiety (Corah Dental Anxiety Scale), number of implants, duration of surgery, surgeon satisfaction (evaluated as three categories: patient too awake and n…
Comparison of digital protocols for the measurement of peri-implant marginal bone loss
Background The measurement of peri-implant marginal bone loss is currently carried out using digital methods of radiographic analysis assisted by various types of software. The purpose of this study was to compare the characteristics of three different softwares: specific radiology software for the development and visualization of radiological images in DICOM format (3Dicom Viewer®), advanced level software for professional editing of bitmap images (or raster graphics) (Adobe Photoshop®), and mid-level software for processing bitmap-type images, programmed in Java and in the public domain (ImageJ®). Material and Methods It was verified that the three softwares used are valid for the measure…
Relationship between preoperative anxiety and postoperative satisfaction in dental implant surgery with intravenous conscious sedation
Purpose: To study if patient preoperative anxiety is related to age and gender and to compare preoperative anxiety with postoperative patient and surgeon satisfaction in dental implant surgery under intravenous conscious sedation. Materials and Methods: Dental implants were placed in 102 patients under local anesthesia and intravenous conscious sedation. The procedures were performed with or without dental extractions, and with or without bone regeneration. Anxiety was evaluated using Corah?s Dental Anxiety Scale and levels of surgeon and patient satisfaction were evaluated on an adapted scale. Results: Low preoperative anxiety was observed in 27.8% of patients, moderate in 50%, and high in…
Severe odontogenic infection: An emergency. Case report
Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. However, some OI can spread to vital and deep structures, overcome the host immune system - especially in diabetic, immunocompromised or weakened patients - and even prove fatal. Ludwig's angina is a severe form of diffuse cellulitis that can have an acute onset and spread very rapidly, bilaterally affecting areas of the head and neck, and may prove life threatening. A case of severe dental infection is presented in which emphasis is placed on the importance of airway maintenance, followed by surgical de…
Prognostic Factors after Endodontic Microsurgery: A Retrospective Study of 111 Cases with 5 to 9 Years of Follow-up
A study was performed of the healing rate of teeth subjected to endodontic microsurgery after a minimum follow-up of 5 years with an analysis of the influence of different pre- and postoperative factors on the outcome.This was a retrospective study of patients subjected to endodontic microsurgery with the use of mineral trioxide aggregate (MTA) for retrograde filling between January 2011 and December 2015. In patients with multiple treated teeth, only 1 random tooth was selected for the statistical analysis. Clinical and radiographic parameters were used to assess healing. Simple binary logistic regression models were used to analyze the influence of patient age and sex, the type of tooth, …
Regeneration of lingual musculature in rats using myoblasts over porcine bladder acellular matrix
To use tissue engineering muscle repair (TEMR) for regenerating the lingual musculature of hemiglossectomized rats using neonatal myoblasts (NM) on porcine acellular urinary bladder matrix (AUBM).The study used 80 male rats. A volumetric muscle loss (VML) injury was created on the left side of the tongue. The rats were randomized into four groups: Group 1 (AUBM + myoblasts); Group 2 (AUBM); Group 3 (myoblasts); and Group 4 (control). NM were obtained from neonatal rats. The animals were weighed on day 0 and just before euthanasia. Five rats in each group were euthanized at days 2, 14, 28, and 42; the tongues were prepared for morphometric analysis, postoperative left hemitongue weight, and …
Bone regeneration using particulate grafts : an update
Objective: A review is made of the publications on bone regeneration using particulate grafts, with an evaluation of the success of implants placed in such regenerated areas. Material and Method: A Medline search using different key words was made of the articles published between 1999-2009 involving at least two patients subjected to grafting with autologous, homologous or xenogenic bone, non-bony substitutes, or a combination of these grafts for the placement of dental implants. Studies involving block grafting were excluded. A total of 11 studies were evaluated. Results: These grafts are indicated in cases of small or peri-implant bone defects such as dehiscences and fenestrations, with …
Anxiety before extraction of impacted lower third molars.
Objetives: Assess levels of trait anxiety, state anxiety and dental anxiety before extraction of lower third molars and check the correlation and reliability of the scales used for the measurement of preoperative anxiety. Study D esign: A prospective study of patients treated with extraction of a lower third molar between September 2010 to December 2010 was carried out. A total of 125 patients were included in the study. All of them were patients of the Oral Surgery and Implantology Department (Valencia University Medical and Dental School, Valencia, Spain). Before surgery, patients had to complete a preoperative protocol with 4 scales: the STAI-T (State-Trait Anxiety Inventory-Trait) for m…
Local Formula with Mucoadhesive Property: A Randomized Clinical Trial of a Therapeutic Agent for the Treatment of Oral Aphthous Ulcers
Background Recurrent or occasional aphthous lesions represent a painful oral condition with high prevalence. Since the etiology is still unclear and most likely related to a dysfunction in the local immune system, several treatment strategies have been proposed, including systemic agents, local agents, and laser therapy, to reduce the pain and discomfort for the patient without acting on the causes. Materials and methods The purpose of the present randomized study was to assess the clinical efficacy of a new topical gel with mucoadhesive property to reduce the pain and the dimension of the aphthosis lesions. Fifty patients presenting at least one minor ulcer were randomized to a control gro…
Osteotomy in direct sinus lift. A comparative study of the rotary technique and ultrasound
Purpose: The present study investigates sinus membrane rupture in direct maxillary sinus lift with the rotary technique and with ultrasound, examining the survival of implants placed after sinus augmentation, and analyzing the bone gain obtained after the operation and 12 months after placement of the prosthetic restoration. Material and Methods: A retrospective study was made of 45 patients requiring maxillary sinus lift or augmentaMethods: A retrospective study was made of 45 patients requiring maxillary sinus lift or augmentaethods: A retrospective study was made of 45 patients requiring maxillary sinus lift or augmentation for implant-prosthetic rehabilitation. Use was made of the handp…
Prescription of Antibiotic Prophylaxis for Dental Implant Surgery in Healthy Patients: A Systematic Review of Survey-Based Studies
Background: Systemic antibiotic prophylaxis is frequently prescribed by dentists performing dental implant surgery to avoid premature implant failure and postoperative infections. The scientific literature suggests that a single preoperative dose suffices to reduce the risk of early dental implant failure in healthy patients.Material and Methods: A systematic review was made based on an electronic literature search in the PubMed-Medline, Embase, Web of Science, Scopus and Open Gray databases. The review addressed the question: “which antibiotic prophylaxis regimens are being used in dental implant surgery in healthy patients according to survey-based studies?” The identification, screening,…
Effect on osseointegration of two implant macro-designs:A histomorphometric analysis of bicortically installed implants in different topographic sites of rabbit’s tibiae
Background To evaluate the effect of two different implant macro-designs on the sequential osseointegration at bicortically installed implants in the rabbit tibia. A further aim is to compare the osseointegration at different topographic zones. Material and Methods 27 New Zealand rabbits were implemented. Two implants, one for each macro-design (Ticare Inhex® or Ticare Quattro®, Mozo-Grau, Valladolid, Spain), were randomly implanted in the diaphysis or metaphysis of each tibia. The flaps were sutured to allow a submerged healing. The animals were sacrificed after 2, 4 or 8 weeks. Ground sections were prepared and analyzed. Results No statistically significant differences were found between …
Side effects and complications of intraosseous anesthesia and conventional oral anesthesia
Objective: To analyze the side effects and complications following intraosseous anesthesia (IA), comparing them with those of the conventional oral anesthesia techniques. Material and method: A simple-blind, prospective clinical study was carried out. Each patient underwent two anesthetic techniques: conventional (local infiltration and locoregional anesthetic block) and intraosseous, for respective dental operations. In order to allow comparison of IA versus conventional anesthesia, the two operations were similar and affected the same two teeth in opposite quadrants. Heart rate was recorded in all cases before injection of the anesthetic solution and again 30 seconds after injection. The …
Relation between the distance from the cementoenamel junction to the bone crest and the thickness of the facial bone in anterior maxillary teeth: A cross-sectional tomographic study
Background The purpose of this cross-sectional study was to evaluate radiologically, the relation between the distance from the cementoenamel junction (CEJ) to the facial bone crest (FBC), and the facial alveolar bone (FAB) width at maxillary anterior teeth. A further aim was to assess if the CEJ-FBC distance had an impact in the prevalence to find a FAB thickness greater than one mm. Material and Methods CBCT images were retrospectively obtained from the database of the Oral Surgery Unit of the University of Valencia. The teeth were divided in 3 groups according to the CEJ-FBC distance: Shorter (≤3mm), Middle (>3 ≤4.5 mm) and Larger (>4.5 mm). FAB thickness was measured by two different ex…
Association between maxillary sinus pathology and odontogenic lesions in patients evaluated by cone beam computed tomography. A systematic review and meta-analysis
Background A study is made of the association between maxillary sinus pathology and odontogenic lesions in patients evaluated with cone beam computed tomography. Material and Methods A literature search was made in five databases and OpenGrey. Methodological assessment was carried out using the Newcastle-Ottawa tool for observational studies. The random-effects model was used for the meta-analysis. Results Twenty-one studies were included in the qualitative review and 6 in the meta-analysis. Most presented moderate or low risk of bias. The periodontal disease showed to be associated with the thickening of the sinus membrane (TSM). Mucous retention cysts and opacities were reported in few st…
Measurement of gap between abutment and fixture in dental conical connection implants. A focused ion beam SEM observation
Background The aim of the authors was to examine the abutment-fixture interface in Morse-type conical implants in order to verify gaps at this level using a new microscopical approach. Material and Methods In this in vitro study, 20 abutment-fixture complexes were prepared by sectioning (longitudinal and cross-sectional to the long axis) with a microtome and then with a focused ion beam (FIB). This is a micrometric machine tool that uses gallium ions to abrade circumscribed areas to dig deeper into the cuts obtained with the microtome in order to eliminate cut-induced artifacts. This is because the FIB abrasion is practically free from artifacts, which are normally generated by the action o…
Immediate bleeding complications in dental implants: A systematic review
Objective: A review is made of the immediate or immediate postoperative bleeding complications in dental implants, with a view to identifying the areas of greatest bleeding risk, the causes of bleeding, the length of the implants associated with bleeding, the most frequently implicated blood vessels, and the treatments used to resolve these complications. Material and Methods: A Medline (PubMed) and Embase search was made of articles on immediate bleeding complications in dental implants published in English up until May 2014. Inclusion criteria: studies in humans subjects with severe bleeding immediately secondary to implant placement, which reported the time until the hemorrhage, the impl…
Simultaneous and delayed direct sinus lift versus conventional implants : retrospective study with 5-years minimum follow-up
Background To compare the radiological parameters and success of posterior maxillary direct sinus lift with simultaneous or delayed implant placement, or implant placement in native bone, after a minimum follow-up period of 5 years. Material and Methods A retrospective cohort study was carried out in a university clinic, selecting patients subjected to implant treatment in the posterior maxilla between the years 2005 and 2011. The patients were divided into three groups: 1) implants placed in native bone; 2) direct sinus lift with simultaneous implant placement; and 3) direct sinus lift with delayed implant placement. Bone crest level, bone loss, vertical bone gain, and implant success and …
Closure of oroantral communications with Bichat´s buccal fat pad. Level of patient satisfaction
Purpose: To report the closure of oroantral communications with the pedicled buccal fat pad in a series of patients, and to determine the level of patient satisfaction after the surgery. Study Design: A prospective study of patients diagnosed of unilateral or bilateral oroantral communication (OAC) closed using the buccal fat pad between May 2012 and January 2013 was performed. Data analysis extended to: age, sex, and cause, location and size of oroantral communication. Complications and success related to buccal fat pad surgery were evaluated. Also, patient satisfaction was assessed after six months of surgery. Results: Nine patients (3 men and 6 women) with a mean age of 50.5 years and 11…
Implant-supported overdenture manufactured using CAD/CAM techniques to achieve horizontal path insertion between the primary and secondary structure: A clinical case report
This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The techn…
Bone Regeneration and Soft Tissue Enhancement Around Zygomatic Implants: Retrospective Case Series
Purpose: To present a case series of zygomatic implants combined with bone regeneration and soft tissue enhancement techniques to reduce the risk of biological delayed complications such as maxillary sinusitis and soft tissue recession. Materials and methods: Zygomatic implants placed simultaneously with different bone regeneration techniques (buccal, palatal and buccal-palatal bone regeneration) and soft tissue enhancement techniques (pediculate and free connective tissue graft) were followed for at least 12 months. The following information was collected: patient age and sex, number of zygomatic implants, zygomatic implant success rate, zygomatic implant position according to classificati…
Comparison of peri-implant bone loss between conventional drilling with irrigation versus low-speed drilling without irrigation
Background To compare the technique of high speed drilling with irrigation and low speed drilling without irrigation in order to evaluate the success rate and peri-implant bone loss at 12 months of follow-up. Material and Methods A randomized, controlled, parallel-group clinical trial was carried out in patients requiring dental implants to rehabilitate their unitary edentulism. Patients were recruited from the Oral Surgery Unit of the University of Valencia (Spain) between September 2014 and August 2015. Patients who met the inclusion criteria were randomized to two groups: group A (high-speed drilling with irrigation) and group B (low-speed drilling without irrigation). The success rate a…
Clinical and microbiological findings in patients with peri-implantitis: a cross-sectional study
Objective The aim of this study was to analyze clinical and microbiological characters in subjects and implants affected and not affected by peri-implantitis. Additionally, same features were analyzed also intra-individually, comparing healthy and diseased implants within the same subject. Materials and methods A total of 534 patients who received at least 1 implant and coming to routine check-up or spontaneous visits at the University of Valencia were recruited. Clinical parameters including Bleeding on probing (BoP), Probing pocket depth (PPD), and Pi were screened. Samples for microbiological analysis were obtained from three locations: peri-implant sulci (PIS), inner parts of the implan…
Comparative study between manual injection intraosseous anesthesia and conventional oral anesthesia.
Objective: To compare intraosseous anesthesia (IA) with the conventional oral anesthesia techniques. Materials and methods: A simple-blind, prospective clinical study was carried out. Each patient underwent two anesthetic techniques: conventional (local infiltration and locoregional anesthetic block) and intraosseous, for res-pective dental operations. In order to allow comparison of IA versus conventional anesthesia, the two operations were similar and affected the same two teeth in opposite quadrants. Results: A total of 200 oral anesthetic procedures were carried out in 100 patients. The mean patient age was 28.6±9.92 years. Fifty-five vestibular infiltrations and 45 mandibular blocks we…
Comparative study of mandibular linear measurements obtained by cone beam computed tomography and digital calipers
Objectives: Cone beam computed tomography (CBCT) is an innovative dental of imaging system characterized by rapid volumetric imaging with patient exposure to a single dose of radiation. The present study was carried out to compare the linear measurements obtained with CBCT and digital caliper in 20 mandibles from human cadavers. Study design: A total of 4800 linear measurements were measured between different mandibular anatomical points with CBCT and digital caliper. The real measurements were defined as those obtained with the digital caliper. Posteriorly, the mandibles were scanned to obtain the CBCT images, with software-based measurements of the distances. Results: The measurements obt…
Additional file 1 of Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies
Additional file 1. Studies excluded by full-text assessment.
Hemostatic Agents in Periapical Surgery: A Randomized Study of Gauze Impregnated in Epinephrine versus Aluminum Chloride
Abstract Introduction Adequate bleeding control is essential for the success of periapical surgery. The aim of this study was to evaluate the effects of 2 hemostatic agents on the outcome of periapical surgery and their relationship with patient and teeth parameters. Methods A prospective study was designed with 2 randomized parallel groups, depending on the hemostatic agent used: gauze impregnated in epinephrine (epinephrine group) and aluminum chloride (aluminum chloride group). The analysis of the hemorrhage control was judged before and after the application of the hemostatic agents by the surgeon, and 2 examiners independently recorded it as adequate (complete hemorrhage control) or in…
Comparison of the diagnostic efficacy of 2D radiography and cone beam computed tomography in persistent apical periodontal disease: A PRISMA-DTA systematic review and meta-analysis.
Objective The objective of this study was to answer the question: Do conventional radiographs (periapical/panoramic) afford better diagnostic outcomes than cone beam computed tomography (CBCT) as a complement for clinical diagnosis of apical lesions with persistent apical periodontitis or disease after root canal treatment? Study Design Five electronic databases were searched and provided information to enable construction of a table to determine primary diagnostic measures and secondary parameters. The evidence was appraised with the Quality Assessment of Diagnostic Accuracy Studies tool and GRADEpro software. Results Twenty-seven articles (9903 diagnostic images) were included. The pooled…
Immediate prosthesis over implants retained using abutments with flexible screws: A preliminary study
Background Immediate loading protocols for the rehabilitation of edentulous or partially edentulous patients have become very popular, due to the conveniences they afford in comparison with conventional loading techniques. Material and Methods A preliminary study was carried out with 8 patients subjected to dental implant treatment with an immediate loading protocol involving a novel system of abutments with flexible screws. Implant survival was analyzed, together with marginal bone loss and patient and dentist satisfaction. Results A total of 35 implants were subjected to immediate loading using the abutments with flexible screws. The mean patient and dentist satisfaction score was 9.1 and…
Treatment of orofacial pain in patients with stylomandibular ligament syndrome (Ernest Syndrome).
Introduction: Ernest syndrome involves the stylomandibular ligament. It is characterised by pain in the preauricular area and mandibular angle, radiating to the neck, shoulder, and eye on the same side, and associated with pain during palpation of that ligament. The purpose of this study is to describe the clinical characteristics, treatment, and course of the disease in a series of patients with Ernest syndrome. Methods: Retrospective observational study covering the period from 1998 to 2008. We recorded patients’ age, sex, duration of the disorder, and pain characteristics. All patients were injected with 40 mg triamcinolone acetonide at the mandibular insertion of the stylomandibular lig…
Single- and Partial Multiple-Unit Provisional Restorations in the Esthetic Area
The immediate implant-supported provisional restoration in the partially or totally edentulous patients is a predictable and well-accepted procedure in dentistry. The Glossary of Prosthodontic Terms defines a provisional prosthesis as a prosthesis designed to improve or evaluate esthetics, speech, and occlusal function in a period of time between implant placement and final restoration with a definitive prosthesis. Planning and design should always take place during the pre-surgical phase of treatment and constitute a tool for communication among the members of the team, which in most cases is of a multidisciplinary nature (prosthodontist, surgeon, dental technician, and patient).
Impression of multiple implants using photogrammetry: Description of technique and case presentation
Aim: To describe a technique for registering the positions of multiple dental implants using a system based on photogrammetry. A case is presented in which a prosthetic treatment was performed using this technique. Study Design: Three Euroteknika® dental implants were placed to rehabilitate a 55-year-old male patient with right posterior maxillary edentulism. Three months later, the positions of the implants were registered using a photogrammetry-based stereo-camera (PICcamera®). After processing patient and implant data, special abut - ments (PICabutment®) were screwed onto each implant. The PICcamera® was then used to capture images of the implant positions, automatically taking 150 image…
Dental implants in patients with oral mucosal alterations : an update
Objective: To determine whether a series of diseases of the oral mucosa - Sjogren syndrome, ectodermal dysplasia, epidermolysis bullosa and lichen planus - reduce the survival rate of dental implants. Material and Method: A Medline search was carried out using the key words: "Sjogren syndrome", "ectodermal dysplasia", "epidermolysis bullosa", "lichen planus" and "dental implants", including those publications involving clinical series comprising more than one patient with the mentioned disorders and treated with dental implants, in the last 10 years. Results: The study included three articles involving patients with Sjogren syndrome subjected to dental implant treatment, representing a tota…
Microbial Leakage at the Implant-Abutment Connection Due to Implant Insertion Maneuvers: Cross-Sectional Study 5 Years Postloading in Healthy Patients.
The aim of this study was to test if stress on the prosthetic connection during insertion maneuvers can induce micro-warping at the implant connection. From September 2011 to July 2013, patients with implants loaded for at least 5 years that were placed with 2 different insertion implant mounters—MP (conventional) and ME (mountless)—were selected from all of those who had received dental implant therapy in the past and were attending routine check-up or spontaneous visits during the study period. Samples were obtained from inside the connection and the abutment surface using absorbent sterile paper tips. Quantitative real-time polymerase chain reaction was performed for total bacterial coun…
In-Vitro Investigation of Fatigue and Fracture Behavior of Transmucosal versus Submerged Bone Level Implants Used in Fixed Prosthesis
Background: The present in vitro study aimed to investigate the fatigue performance of different dental fixtures in two different emergence profiles. Biological failures are frequently reported because the problem canonly be solved by replacing a failing implant with a new one. Clinicians addressed minor mechanical failures, such as bending, loosening or the fracture of screws, abutment, or the entire prosthesis, by simply replacing or fixing them. Methods: Transmucosal and submerged bone-level dental implants underwent fatigue strength tests (statical and dynamical performance) by a standardized test: UNI EN ISO 14801:2016. Two types of emergence profiles (Premium sub-crestal straight impl…
Effect of a single initial phase of non-surgical treatment of peri-implantitis: Abrasive air polishing versus ultrasounds. A prospective randomized controlled clinical study
Background Non-surgical treatment of peri-implantitis includes a correct mechanical debridement of the implant surface to reduce the inflammation and recondition the soft tissues. The aim of the study was to evaluate the results of a single phase of non-surgical therapy by comparing the effect of curettes and ultrasounds versus curettes and abrasive air polisher (Air-Flow) in the peri-implant tissue conditions, and patient satisfaction. Material and Methods A double-blind randomized and controlled prospective clinical study was conducted on patients in peri-implant maintenance phase diagnosed of peri-implantitis treated in the Oral Surgery Unit of the Stomatology Department of the Faculty o…
Salivary myeloperoxidase and malondialdehyde are increased in patients exhibiting an asymptomatic mandibular impacted third molar
Background To determine whether saliva is a good means of evaluating concentrations of oxidative stress biomarkers, analyzing the correlation between concentrations in saliva and in follicular tissue, and to compare biomarker concentrations in patients with one asymptomatic mandibular impacted third molar (MITM) (before extraction) with a healthy control, and to determine how biomarkers are modified by extraction. Material and Methods 80 patients with one asymptomatic MITM and 80 healthy controls were included. Saliva samples were collected from all subjects (before extraction in the study group) to evaluate Myeloperoxidase (MPO) and Malondialdehyde (MDA) concentrations. Follicular tissues …
<p>Floor of the mouth hemorrhage subsequent to dental implant placement in the anterior mandible</p>
Complications in dental implant surgery are possible. Bleeding complications have been described that may be serious, particularly in the floor of the mouth. We present two cases of sublingual hematomas during dental implant osteotomies that impeded but did not close the airway. The clinical courses of these patient's complications are reviewed. One patient had immediate hematoma formation while the other developed a hematoma overnight, presenting the next day. The treatment rendered was a precautionary in-hospital tracheotomy for the first patient and only compression control for the second. Bleeding complications during dental implant placement in the anterior mandible can be serious issu…
Probiotic treatment in the oral cavity: An update
Probiotics have been found to be beneficial to host health. Their primary use in medicine has been for the management of intestinal tract problems. In recent years, probiotics have been used as a treatment to promote oral health. The aim of the present study was to review published studies regarding probiotics and their effects on the oral cavity. Studies reporting the anticariogenic effects of probiotics, their use in the treatment of periodontal disease, a reduced crevicular fluid volume and cytokine content, as well as their use in the treatment of halitosis and Candida albicans were identified. Studies assessing residence time of probiotics in the oral cavity were also selected for retr…
Influence of Hemostatic Agents in the Prognosis of Periapical Surgery: A Randomized Study of Epinephrine versus Aluminum Chloride
Abstract Introduction Several variables have been associated with a better prognosis of periapical surgery. The aim of this study was to evaluate the influence of 2 hemostatic agents on the prognosis of periapical surgery at 12 months. Methods A prospective study was designed with 2 randomized parallel groups established depending on the hemostatic agent used: epinephrine or aluminum chloride. The analysis of the hemorrhage control was recorded as 0 (no hemorrhage control), 1 (slight but apparent intermittent bleeding persisted after application of the material), or 2 (complete hemorrhage control). At 12 months, periapical lesion healing was determined clinically and radiologically as succe…
Replantation of a maxillary second molar after removal of a third molar with a dentigerous cyst: Case report and 12-month follow-up
The aim of this study was to describe the replantation of a maxillary second right molar, which had been removed for surgical reasons in order to remove a dentigerous cyst associated with the adjacent third molar, and the case’s 12-month follow-up. A 51-year-old man presented swelling in the right maxillary area. Radiographic examination showed a large radiolucency in close proximity to the third molar, suggesting a follicular cyst. The third molar was extracted and the cyst underwent curettage. The second molar had to be extracted to enable complete removal of the cyst and to achieve primary closure of the wound, which would have been impossible without repositioning the molar. With this o…
Comparison of diagnostic accuracy between periapical and panoramic radiographs and cone beam computed tomography in measuring the periapical area of teeth scheduled for periapical surgery. A cross-sectional study
Background The aim of the study was compare the sensitivity and measurements obtained from teeth with apical lesions scheduled for periapical surgery using three different diagnostic methods: periapical radiography (Gendex Expert DC), panoramic radiography (Planmeca® Promax 3D Classic) and cone beam computed tomography (CBCT) (Planmeca® Promax 3D Classic). Material and methods This cross-sectional study involved 35 patients (45 teeth) scheduled for periapical surgery in which periapical radiographs, panoramic radiographs and CBCT scans had been obtained. The images were used to analyze the maximum vertical and horizontal dimension and the resulting areas of the periapical lesions based on t…
Impact of crestal and subcrestal implant placement upon changes in marginal peri-implant bone level. A systematic review.
Background To systematically assess studies analyzing peri-implant bone loss in implants placed in crestal and subcrestal position. Material and Methods Following the recommended methods for systematic reviews and meta-analyses (PRISMA), an electronic search was conducted in the PubMed (MEDLINE), EMBASE and LILACS databases to identify all relevant articles published up until April 2017. The search included human studies comparing marginal bone loss (MBL) between a control group and a study group with a minimum of 10 patients and a minimum follow-up of 6 months after prosthetic loading with rough neck implants. Two independent reviewers assessed the risk of bias in the selected studies base…
Influence of hemostatic agents upon the outcome of periapical surgery: dressings with anesthetic and vasoconstrictor or aluminum chloride
Objective: To evaluate the effects of different hemostatic agents upon the outcome of periapical surgery. Design: A retrospective study was made of patients subjected to periapical surgery between 2006-2009 with the ultrasound technique and using MTA as retrograde filler material. We included patients with a minimum follow-up of 12 months, divided into two groups according to the hemostatic agent used: A) dressings impregnated in anesthetic solution with adrenalin; or B) aluminum chloride paste (Expasyl™). Radiological controls were made after 6 and 12 months, and on the last visit. The global evolution scale proposed by von Arx and Kurt (1999) was used to establish the outcome of periapica…
Treatment of apicomarginal defect with periapical surgery: A case report
An apicomarginal defect can be explained as a total loss of buccal alveolus extending from the original crestal bone to the apex of the tooth. This study presents a case of an apicomarginal defect in a first left molar subjected to periapical surgery with vestibular cortex block replacement and A-PRF + membrane coating approximately one year ago. One-year clinical follow-up was performed, with no evidence of recurrence. This case report discusses periapical surgical treatment and the importance of an interdisciplinary approach to the management of teeth with apicomarginal defects. Key words:Periapical surgery, apicomarginal defect, A-PRF+, bone graft.
Volumetric variation of peri-implant soft tissues in convergent collar implants and crowns using the biologically oriented preparation technique (BOPT)
Background To evaluate the changes in the peri-implant soft tissues of convergent collar implants with biologically oriented preparation technique (BOPT) crowns, 10 months after loading. Material and Methods A pilot study was carried out from January 2016 to October 2017 involving 14 patients with one or two implants in the posterior mandibular sector. A total of 32 convergent collar implants were placed using a non-submerged protocol. Three months later the provisional cemented crowns were fitted using the BOPT approach with the finish line 1-1.5 mm below the gingival margin, simulating coronal emergence of a natural tooth. The soft tissue changes were measured with an intraoral scanner at…
Immediate Loading in Atrophic Jaws: Zygomatic Implants
The zygomatic fixture is an extended length (35–55 mm) titanium implant, placed into the zygomatic and maxillary alveolar bone. It was designed for situations where atrophy of the posterior maxilla complicates or prevents the placing of conventional implants. The use of zygomatic implants avoids the need for bone grafting, shortens treatment times, and reduces morbidity. They have also been used in patients with maxillectomies resulting from tumors or diseases associated with atrophic conditions of the maxilla.
Palatal positioned implants in severely atrophic maxillae versus conventional implants to support fixed full-arch prostheses: Controlled retrospective study with 5 years of follow-up.
Background: To evaluate soft tissue conditions and bone loss around palatal positioned implants supporting fixed full-arch prostheses to rehabilitate edentulous maxillae with horizontal atrophy and compare them with conventional well-centered implants placed in non-atrophic maxillae after a minimum follow-up of 5 years. Material and M ethods: A clinical retrospective study was performed of patients that were rehabilitated with full-arch fixed implant-supported maxillary prostheses and had a minimum follow-up of 5 years after implant loading. Patients were divided into 2 groups: patients with class IV maxilla according to Cawood and Howell and treated with palatal positioned implants (test) …
In Vitro Study on Bone Heating during Drilling of the Implant Site: Material, Design and Wear of the Surgical Drill
Objective: An in vitro study was made to compare mean thermal variation according to the material, design and wear of the surgical drills used during dental implant site preparation. Material and methods: Three study groups (stainless steel drills with straight blades
Survival Rate and Prosthetic and Sinus Complications of Zygomatic Dental Implants for the Rehabilitation of the Atrophic Edentulous Maxilla: A Systematic Review and Meta-Analysis
Simple Summary Zygomatic dental implants have been proposed as an alternative to atrophic total edentulous maxillae rehabilitation with the necessity of bone grafting procedures. However, surgical, prosthetic, and maxillary sinus complications have been associated with this surgical procedure. Therefore, it is necessary to produce a systematic review and meta-analysis that provides evidence associated with the prognosis when using zygomatic dental implants as an alternative to atrophic total edentulous maxillae rehabilitation. Abstract The aim of this systematic review and meta-analysis was to analyze and compare the survival rate and prosthetic and sinus complications of zygomatic dental i…
Influence of occlusal loading on peri-implant clinical parameters. A pilot study
Objectives: To investigate the relation between occlusal loading and peri-implant clinical parameters (probing depth, bleeding on probing, gingival retraction, width of keratinized mucosa, and crevicular fluid volume) in pa - tients with implant-supported complete fixed prostheses in both arches. Material and Methods: This clinical study took place at the University of Valencia (Spain) dental clinic. It included patients attending the clinic for regular check-ups during at least 12 months after rehabilitation of both arches with implant-supported complete fixed ceramo-metallic prostheses. One study implant and one control implant were established for each patient using the T-Scan®III comput…
A prospective clinical study of polycarboxylate cement in periapical surgery
Objective: To evaluate the clinical efficacy of polycarboxylate cement as retrograde filling material. Design: A prospective clinical study was made of 25 patients subjected to periapical surgery with ultrasound and magnifying loupes, in which polycarboxylate cement was used as retrograde filling material. Measurements were made of the area and diameter of the lesions pre- and postoperatively, and 6 and 12 months after the operation. The apical resection and retrograde filling areas were also measured, and the prognosis following surgery was recorded. Results: A total of 23 patients with 31 apicoectomized teeth were studied (2 patients being lost to follow-up). The mean area of the periapic…
Tratamiento del dolor orofacial en pacientes con síndrome del ligamento estilomandibular (síndrome de Ernest)
Resumen: Introducción: El síndrome de Ernest se define como una alteración del ligamento estilomandibular, caracterizado por la presencia de dolor en la región preauricular y en el ángulo mandibular, irradiado al cuello, el hombro y el ojo del mismo lado, asociado a dolor durante la palpación del ligamento estilomandibular. El objetivo es presentar las características clínicas, el tratamiento y la evolución de una serie de pacientes con el síndrome de Ernest. Métodos: Se realizó un estudio clínico, observacional, retrospectivo, entre los años 1998 y 2008. Se recogieron todos los datos con respecto a la edad, el sexo, el tiempo de evolución y las características del dolor. A todos los pacien…
Oral rehabilitation with tilted dental implants: A metaanalysis
Objective: To compare the course of patients treated with tilted implants versus those treated conventionally with axial implants, analyzing the success rate and marginal bone loss. Material and M ethods: A PubMed search was made using the key words ?tilted implants?, ?angled implants?, ?angulated implants?, ?inclined implants? and ?maxillary atrophy.? A review was made of the articles published between 1999-2010. The inclusion criteria were the use of tilted implants, clinical series involving at least 10 patients, and a minimum follow-up of 12 months after prosthetic loading. The exclusion criteria were isolated clinical cases, studies with missing data, and publications in languages othe…
Additional file 3 of Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies
Additional file 3. Influence of age and sex subgroups on FAB thickness at different points from FBC and influence of the gingival phenotype on FAB thickness at different points.
Marginal bone loss in relation to the implant neck surface: An update
A review is made of the publications on the marginal bone loss of implants with a polished neck, rough neck with microthreading, and rough neck without microthreading. A PubMed search was carried out with the following key words: machined neck implant, polished neck implant, marginal bone loss, covering the period between January 1998 and March 2009. Inclusion was limited to those human clinical studies involving a minimum follow-up of 12 months, and registering the level of bone loss from the time of placement of the implant or prosthetic restoration to the end of follow-up. For most of the authors there were no significant differences in marginal bone loss between polished neck and rough …
Effect of incision design on interproximal bone loss of teeth adjacent to single implants. A randomized controlled clinical trial comparing intrasulcular vs paramarginal incision
PURPOSE To evaluate the effect of incision design in implant surgery on interproximal bone loss of posterior teeth adjacent to interdental single implants, comparing intrasulcular and paramarginal incision. A further aim was to assess the influence of the incision technique on peri-implant bone remodeling. MATERIALS AND METHODS A controlled randomized clinical trial was carried out in a University Clinic. All the patients received an interdental posterior single implant. The incision type was randomly divided into two groups: (a) intrasulcular or (b) paramarginal. Standardized periapical digital radiographs were made with the parallel technique and a silicone index individualized in each pa…
Additional file 2 of Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies
Additional file 2. Characteristics and major inferences of the selected studies.
Intraosseous anesthesia with solution injection controlled by a computerized system versus conventional oral anesthesia : a preliminary study
Objective: To compare a computerized intraosseous anesthesia system with the conventional oral anesthesia techniques, and analyze the latency and duration of the anesthetic effect and patient preference. Design: A simple-blind prospective study was made between March 2007 and May 2008. Each patient was subjected to two anesthetic techniques: conventional and intraosseous using the Quicksleeper® system (DHT, Cholet, France). A split-mouth design was adopted in which each patient underwent treatment of a tooth with one of the techniques, and treatment of the homologous contralateral tooth with the other technique. The treatments consisted of restorations, endodontic procedures and simple extr…
Irritative and sensory disturbances in oral implantology. Literature review.
The aim of this study was to review irritative and sensory disturbances following placement of dental implants. A literature search was made of PubMed for articles published between 2000 and 2010. Studies that reported sensory disturbances directly caused by the placement of dental implants were included. Sensory deficits or trigeminal neuropathy are caused by damage to the third branch of the trigeminal nerve du-ring surgery. This manifests in the immediate postoperative period as a sensory deficit not usually associated with pain and generally transient. The literature reviewed reported irritative and sensory disturbances caused during surgery, after surgery, and as a result of complicati…
Immediate Loading in All-on-Four
Severe bone atrophy of the upper maxilla (Cawood and Howell class V and VI) is associated with certain problems such as reduced perioral tissue support, the impossibility of wearing complete dentures, chewing and speech alterations, and difficulties in placing dental implants due to the limited amount of available bone.
Does Apico-Coronal Implant Position Influence Peri-Implant Marginal Bone Loss? A 36-Month Follow-Up Randomized Clinical Trial
Purpose Preserving peri-implant bone and reducing exposure of the rough implant surface might influence long-term outcomes of implant therapy. The aim of this study was to compare peri-implant clinical and radiologic parameters after crestal and subcrestal dental implant placement at 36 months' follow-up. Materials and Methods We carried out a randomized clinical trial involving partially edentulous patients in need of an implant-supported, partial fixed dental prosthesis or a single crown. Patients were randomized according to the implant insertion depth: implants placed approximately 2 mm below the bone crest (test group) or implants placed at bone crest level (control group). They were e…
The use of the endoscope in endodontic surgery : a systematic review
Background A systematic review of clinical studies with at least one year of follow-up was done to assess the success rate of endodontic surgery including endoscopy for magnification and illumination. Material and Methods Five electronic databases were searched, including MEDLINE (via PubMed), Embase, Web of Science, Scopus and the Cochrane Library of the Cochrane Collabora-tion (CENTRAL). There were no language restrictions, and the search covered the period up to October 2019. The risk of bias was evaluated with the Cochrane Collaboration tool for randomized clinical trials and the ROBINS-I tool for non-randomized studies of inter-ventions. Results From the 278 initially identified titles…