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To evaluate implant loss (IL) and marginal bone loss (MBL); follow-up period of up to 10 years after prosthetic loading. Retrospective multi-centre cross-sectional cohort study. Double analysis: (1) all the implants (n = 456) were analysed; (2) to allow for possible cluster error, one implant per patient (n = 143) was selected randomly. Statistical analysis: Spearman's correlation coefficient; Kruskal-Wallis (post-hoc U-Mann-Whitney); Chi-square (post-hoc Haberman). (1) Analysing all the implants (456): IL was observed in patients with past periodontitis (6 vs. 2.2%, p < 0.05), short implants (12 vs. 2.8%, p < 0.001) and when using regenerative surgery (11.3 vs. 2.9%, p < 0.001); greater MBL was observed among smokers (0.39 +/- 0.52 vs. 0.2 +/- 0.29, p < 0.01), maxillary implants (0.28 +/- 0.37 vs. 0.1 +/- 0.17, p < 0.0001), anterior region implants (0.32 +/- 0.36 vs. 0.21 +/- 0.33, p < 0.001), external connection implants (0.2 +/- 0.29 vs. 0.63 +/- 0.59, p < 0.0001), and 2-3 years after loading (p < 0.0001). (2) analysing the cluster (143): IL was observed in smokers (18.8 vs. 3.5%, p < 0.05), splinted fixed crowns (12.9%, p < 0.01), short implants (22.2 vs. 4.0%, p < 0.01) and when using regenerative surgery (19.2 vs. 3.4%, p < 0.01); greater MBL was observed in maxillary implants (0.25 +/- 0.35 vs. 0.11 +/- 0.18, p < 0.05), in the anterior region (p < 0.05), in the first 3 years (p < 0.01), in external connection implants (0.72 +/- 0.71 vs. 0.19 +/- 0.26, p < 0.01) and in short implants (0.38 +/- 0.31 vs. 0.2 +/- 0.32, p < 0.05). There is greater risk in smokers, patients with past periodontal disease, external connection implants, the use of short implants and when regenerative techniques are used. To prevent MBL and IL, implantologists should be very meticulous in indicating implants in patients affected by these host factors.

Aim: The aim of this prospective clinical study was to evaluate the changes in resonance frequency analysis (RFA), assessed by Osstell Mentor, obtaining information on the implant stability quotient (ISQ) during implants tissue integration for immediately loaded and non-loaded control implants. Materials and methods: A total of 40 implants, 20 implants with no immediate loading (control) and 20 immediately loaded implants (test), were placed in 15 patients. ISQ implants was evaluated at baseline and at 6 and 8 weeks. Provisional crowns were removed at 8 weeks, when the definitive restoration was placed. Data of control and test implants and maxillary and mandibular areas were statistically compared. Results: At 8 weeks, all implants were integrated and there were no major postoperative complications. A statistically significant difference was found only at baseline between test and control maxillary implants (p=0.009) but not at 6 or 8 weeks (p>0.05). Conclusion: Immediate loading procedures may be applied with primary stability ISQ values >60 and inserted with a force of ≥30 N. The Osstell Mentor RFA may offer an objective method to determine when implant stability is adequate for immediate loading.

La osteoporosis es una enfermedad sistémica del esqueleto, con amplia prevalencia sobre todo en mujeres postmenopáusicas. La ortopantomografía (OPMG) es una técnica radiológica de uso generalizado en las consultas de los odontólogos. En el presente estudio se hace una revisión de trabajos en los que, utilizando una serie de índices como: Mandibular Cortical Index (MCI), Mental Index (MI), Panoramic Mandibular Index (PMI), Antegonial Index (AI), Gonial Index (GI), medidos sobre OMPG se plantea la hipótesis de poder detectar precozmente la osteoporosis por este medio. Los resultados expuestos en los diferentes estudios avalan esta hipótesis y así se podrá remitir a los pacientes al especialista para que se les haga un estudio más exhaustivo sobre dicha patología. Osteoporosis is a systemic skeletal disease, with widespread prevalence especially in postmenopausal women. Orthopantomography (OPMG) is a widely used diagnosis technique in dental practice. The objective of this study is to make a systematic review of studies in which, using a series of indices as Mandibular Cortical Index (MCI), Mental Index (MI), Panoramic Mandibular Index (PMI), Antegonial Index (AI), Gonial Index (GI) measured on panoramic radiographs are useful for detecting early osteoporosis. The results reported in different studies support the possibility that OPMG could be an effective tool to detect early Osteoporosis and refer patients to a specialist to treat their disease.

Introducción. El implante inmediato postextracción es aquel que está indicado para sustituir al diente con patología sin posibilidad alguna de tratamiento o en casos tras exodoncia de inclusiones, retenciones y dientes temporales. Teniendo en cuenta que tras la extracción tiene lugar un período de recambio óseo en forma de reabsorción fisiológica reduciendo las dimensiones del reborde alveolar, optamos por la terapia regenerativa con el fin de disminuir las secuelas. En este artículo se revisa la técnica quirúrgica y el manejo de los tejidos blandos mediante el procedimiento protésico de los implantes inmediatos postextracción, ilustrado en un caso clínico con una nueva superficie de implante dental. Caso clínico. Mujer de 24 años de edad, no fumadora sin antecedentes médicos de interés, que acude a consulta con dolor agudo de 4 días de evolución en la zona del primer molar inferior derecho que se ha incrementado en el tiempo, con diagnóstico de fractura coronorradicular. El plan de tratamiento comprende: exodoncia de la pieza con el menor trauma posible respetando las paredes alveolares y legrado del alvéolo para la inserción de forma sumergida de un implante SPI® de titanio autorroscable con superficie rugosa pulida producida por chorreado de arena y grabada térmicamente al ácido de Thommen Medical y regeneración ósea guiada mediante injerto óseo particulado de origen bovino Bio-Oss®. Después de 6 meses cargamos funcionalmente el implante con corona unitaria atornillada observando su evolución a los 12 y 24 meses tras la intervención. Conclusión. Gracias a los avances en el campo de las superficies, el tratamiento con este nuevo tipo de implante dental ha constituido en este caso una terapéutica de éxito. Introduction.The immediate implant placement in fresh extraction socket is intended to replace the tooth with no possibility of disease treatment or post-extraction of inclusions, deductions and immediate dentures. Bearing in mind that after the extraction takes place a period of bone turnover in the form of reduced physiological reabsorption of alveolar ridge dimensions, opted for regenerative therapy to reduce the after-effects. In this article the surgical technique and the handling of the soft tissue are reviewed by means of the prosthetic procedure of the immediate implant placement informed in a clinical case with a new dental implant surface. Clinical case. We present the case of a 24-year-old nonsmoker with no relevant medical history, who attends our clinic with a sharp pain of 4 days duration in the lower right first molar that has increased over time with a diagnosis of crown-root fracture. The treatment plan includes extraction of the tooth with as little trauma as possible, respecting the alveolar walls and curettage of alveolo removing all pathological tissue for insertion by submersion of a single self tapping titanium polished implant with a rough surface produced by sandblasting and Thommen Medical acid-etched heat and guided bone regeneration with particulate bovine bone Bio-Oss®. After 6 months we place a healing screw much higher so that we can load the implant functionally with a single screwed crown whose evolution should be monitored at 12 and 24 months after surgery. Conclusion. Thanks to the advances in the field of surface treatment with this new type of self-tapping dental implant is an overall success in the field of implant treatment.

Introducción. El implante inmediato postextracción es aquel que está indicado para sustituir al diente con patología sin posibilidad alguna de tratamiento o en casos tras exodoncia de inclusiones, retenciones y dientes temporales. Teniendo en cuenta que tras la extracción tiene lugar un período de recambio óseo en forma de reabsorción fisiológica reduciendo las dimensiones del reborde alveolar, optamos por la terapia regenerativa con el fin de disminuir las secuelas. En este artículo se revisa la técnica quirúrgica y el manejo de los tejidos blandos mediante el procedimiento protésico de los implantes inmediatos postextracción, ilustrado en un caso clínico con una nueva superficie de implante dental. Caso clínico. Mujer de 24 años de edad, no fumadora sin antecedentes médicos de interés, que acude a consulta con dolor agudo de 4 días de evolución en la zona del primer molar inferior derecho que se ha incrementado en el tiempo, con diagnóstico de fractura coronorradicular. El plan de tratamiento comprende: exodoncia de la pieza con el menor trauma posible respetando las paredes alveolares y legrado del alvéolo para la inserción de forma sumergida de un implante SPI® de titanio autorroscable con superficie rugosa pulida producida por chorreado de arena y grabada térmicamente al ácido de Thommen Medical y regeneración ósea guiada mediante injerto óseo particulado de origen bovino Bio-Oss®. Después de 6 meses cargamos funcionalmente el implante con corona unitaria atornillada observando su evolución a los 12 y 24 meses tras la intervención. Conclusión. Gracias a los avances en el campo de las superficies, el tratamiento con este nuevo tipo de implante dental ha constituido en este caso una terapéutica de éxito.

Objetive. The purpose of this study was to determine the type and characteristics of the interventions, indications of dental treatment and procedures performed to patients treated under general anesthesia (GA) by pediatric dentistry residents, during the 1997-1999 period. Method. a sample of 57 hospital records of patientes treated as part of the Special Pediatric course at the Puerto rico Pediatric hostpial were reviewed. statistical analysis was done using the chi-square test for inferenes on proportions. Results. MR patients made up 59.7% and BNR patients made up 40.3% of the sample studied. Ages ranged from 2 to 35 years with a mean age of 11 years (SD=8.54). MR patients were classified into 7 categories: mental retardation (38.2%), recerbral palsy (14.7%), epileptic (5.9%), mental syndromes (26.9%), hydrocephalic (5.9%), autism (5.95) and others (2.9%). The NMR were classified into 5 categories: early childhood caries (65.2%), cardiac patients (8.7%), maxilofacial anomalies (4.3%), organic syndromes(13.1%) and others (8.7%). The dental procedures performed were: dental extractions 84% (MR) and 68% (NMR), restorative procedures 87.3% (MR) and 12.7% (NMR). Oral prophylaxis was performed in 76.8%, fissure sealants in 10.7% and topical fluoride applications in 21.8%. Conclusion. Dental extraction was a frequently performed procedure in both groups. The prevalence of exodontia and restorative procedures indicates the need to desing and implement prevention programs for special pediatric patients.