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Background This study investigated the association between xerostomia and health risk behaviours, general and oral health and quality of life. Methods A cross-sectional study involving 800 adults over 65 years of age residing in Spain using a computer-assisted telephone questionnaire. The severity of xerostomia was assessed through the Xerostomia Inventory (XI). Both univariate and adjusted multinomial logistic regression were used to determine the risk (OR) of xerostomia. Results The sample comprised of 492 females (61.5%) and 308 males, with a mean age of 73.7 ± 5.8 years. Some, 30.7% had xerostomia: 25.6% mild, 4.8% moderate and 0.3% severe, the majority being female (34.8% vs 24%; p = 0.003). The mean XI was 24.6 ± 6.3 (95% CI 19.2–24.8) for those with poor health, whereas it was 17.4 ± 6.3 (95%CI 16.1–18.6) in those reporting very good health (p p = 0.002). Logistic regression showed that the highest OR for xerostomia was observed among adults with poor general health (2.81; 95%CI 1.8–4.3; p p = 0.001). Those who needed help with household chores had 2.16 higher OR (95%CI 1.4–3.4; p = 0.001) and 1.69 (95%CI 1.1–2.7; p = 0.03) in the adjusted model. Females had a higher risk of suffering from xerostomia than males. Conclusion The strong association between xerostomia and the general and oral health status of older adults justifies the need for early assessment and regular follow-up.

Purpose This study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity. Methods 212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P Results PSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males. Conclusions The use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery. Graphical Abstract

Purpose This review aimed to investigate the clinical outcomes of autogenous particulated dentin (APD) used for alveolar ridge preservation (ARP), evaluating volume gain, histologic/histomorphometric data, and associated complications. Material and methods The review followed PRISMA guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An automated search was made in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library) supplemented by a manual search for relevant clinical articles published before March 10th, 2022. The review included human studies of at least four patients in which extraction and subsequent ARP were performed in a single surgery. Both comparative studies and studies that assessed ARP with APD exclusively were admitted. The quality of evidence was assessed with the Cochrane bias assessment tool, the Newcastle-Ottawa Quality Assessment Scale, and the Joanna Briggs Institute Critical Appraisal tool. Results Eleven studies fulfilled the inclusion criteria and were included for descriptive analysis, with a total of 215 patients, and 337 alveoli preserved by APD, spontaneous healing (blood clot), or other bone substitutes, obtaining comparatively less vertical and horizontal resorption when APD was used. Conclusions After dental extraction, autogenous dentin was effective in terms of volume maintenance, showing promising results in histologic/histomorphometric analysis, and a low complication rate. Nevertheless, few comparative studies with comparable parameters have been published and so more research providing long-term data is needed to confirm these findings.

Multiple dental impactions not associated with craniofacial syndromes are a rare condition and present the dentist with a therapeutic challenge when it comes to performing surgical/restorative treatments in adult patients. This case report describes a geriatric patient with multiple impacted teeth restored by means of two different protocols. In the second quadrant, an impacted tooth was extracted followed by regeneration and placement of an implant. In the third quadrant, implants were placed though impacted teeth for restoration with a fixed partial prosthesis. Placing dental implants through impacted teeth may offer a possible therapeutic option for implant-supported restorations in middle-aged or elderly patients, for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery.

Background A number of reference patterns such as the interincisal line, curve of the upper lip, width of the smile or shape of the teeth have been studied in different populations. Determining the frequency of different smile aesthetic parameters in a European Caucasian population and exploring possible gender differences is important in order to obtain predictable treatment outcomes. Methods Photographs were obtained under resting and forced smiling conditions in 140 individuals (70 males and 70 females) with a mean age of 20.1 ± 4.3 years. Different variables were recorded, including the position of the maxillary interincisal midline in relation to the facial midline, the arc and width of the smile, and the shape of the teeth. The data were processed using the SPSS version 15.0 statistical package, with application of the chi-squared test and a confidence level of 95%. The statistical power was 80%, and the level of significance 5% (α = 0.05). Results A total of 94.3% of the sample presented a maxillary interincisal midline coinciding with the facial midline, and 80% had a consonant smile line. The curve of the upper lip was upwards in 47.1% of the cases, followed by a straight curve in 41.4%. Most of the subjects (84.3%) presented a medium smile line with tooth exposure to the second premolar (61.4%). There were no significant differences between males and females. Conclusions The integration of aesthetic criteria is needed in order to guarantee satisfactory and predictable dental treatment outcomes. There were no statistically significant differences between males and females. The maxillary interincisal midline coincided with the facial midline, with a consonant smile arc and a medium smile line, upward lip curve and oval tooth shape.

BACKGROUND Nonsurgical treatment, resective surgery, reconstructive surgery, or combined approaches have been proposed for the treatment of peri-implantitis, with variable results. PURPOSE To evaluate the 1-year clinical and radiographic outcomes following combined resective and reconstructive surgical treatment with topical piperacillin/tazobactam antibiotic in the management of peri-implantitis. MATERIAL AND METHODS Forty-three patients diagnosed with peri-implantitis were included. Surgical treatment consisted of implantoplasty of the supra-crestal component of the defect, the application of a topical antibiotic solution over the implant surface, and subsequent reconstruction of the intra-osseous component of the peri-implant defect. The primary outcome was disease resolution, defined as the absence of bleeding on probing (BoP) and/or suppuration on probing (SoP), a peri-implant pocket probing depth (PPD) ≤5 mm, and no bone loss >0.5 mm 1 year after surgery. Secondary outcomes included changes in BoP, PPD, SoP, and peri-implant marginal bone levels. One implant per patient was included in the analysis. RESULTS The treatment success rate of the 43 dental implants included in the study was 86% at 1 year after surgery. Mean PPD and BoP decreased from 6.41 ± 2.11 mm and 100% at baseline to 3.19 ± 0.99 mm (p

The clinical application of phentolamine mesylate (PM) as an anaesthetic reversal agent has been documented in the paediatric population and in conservative dentistry, but no studies have been conducted regarding dental implant surgery. A prospective randomised study was conducted on 60 patients eligible for mandibular implant treatment, randomly divided between a control group (CG) and an experimental group (EG), to whom PM was administered. Haemodynamic changes, adverse effects and patient satisfaction were assessed. No statistically significant differences in haemodynamic changes and postoperative pain were found between CG and EG (p &lt, 0.05), except for systolic blood pressure (SBP), which increased slightly in EG, without posing a risk to patients. There were no differences in the occurrence of adverse effects between the two groups, except for greater difficulty in chewing and biting (p &lt, 0.05) in CG and greater pain in the injection area (p = 0.043) in EG. Among EG patients, 83.3% reported that they would request PM again for future dental treatment. The use of PM offers an alternative to implant surgery, thereby increasing patients’ quality of life without increasing the risks.

Background This systematic review aimed to propose a treatment protocol for repairing intraoperative perforation of the Schneiderian membrane during maxillary sinus floor augmentation (MSFA) procedures with lateral window technique. In turn, to assess subsequent implant survival rates placed below repaired membranes compared with intact membranes and therefore determine whether membrane perforation constitutes a risk factor for implant survival. Material and methods This review was conducted according to PRISMA guidelines. Two independent reviewers conducted an electronic search for articles published between 2008 and April 30, 2020, in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL); also, a complementary handsearch was carried out. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of evidence in the studies reviewed. Results Seven articles fulfilled the inclusion criteria and were analyzed. A total of 1598 sinus lift surgeries were included, allowing the placement of 3604 implants. A total of 1115 implants were placed under previously perforated and repaired membranes, obtaining a survival rate of 97.68%, while 2495 implants were placed below sinus membranes that were not damaged during surgery, obtaining a survival rate of 98.88%. The rate of Schneiderian membrane perforation shown in the systematic review was 30.6%. In the articles reviewed, the most widely used technique for repairing perforated membranes was collagen membrane repair. Conclusions Schneiderian membrane perforation during MFSA procedures with lateral approach is not a risk factor for dental implant survival (p=0.229; RR 0.977; 95% CI 0.941-1.015). The knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.

Simple Summary With the emergence of novelty regeneration techniques in the implant dentistry field, the professional may have some queries about which one to use in their daily practice. No systematic review, to date, analyzes the horizontal gains achievable with the two main procedures for bone regeneration: the Khoury technique, which uses split blocks obtained from the patient himself, or the Urban technique, which employs membranes to contain the biomaterials. Regarding this paper, the reader will be able to decide if any of these options is adequate for the indication required. Abstract Purpose. The objective of this systematic review was to evaluate and compare the clinical efficacy of horizontal alveolar ridge augmentation techniques described by Khoury and Urban. Methods. A systematic electronic search in the MEDLINE databases, SCOPUS, WOS, and the Cochrane Central Register of Controlled Trials (CENTRAL) as well as a manual search, were conducted independently by two reviewers up to July 2021. Results. Six studies met the pre-established inclusion criteria and were included in the descriptive analysis. Due to the heterogeneity found across the included studies, meta-analysis could not be performed. Horizontal bone gain was between 3.93 ± 0.9 mm and 5.02 ± 0.8 mm with the Khoury technique and between 3.9 ± 0.9 mm and 5.68 ± 1.42 mm with the Urban technique. Similar complication rates were reported in both groups: infection (7%), in the Khoury technique, and membrane exposure (3.2–13.6%), in the Urban technique, being the most frequent events. Conclusions. Both techniques were found to be effective, in terms of clinical bone gain, for horizontal alveolar ridge gain. Nevertheless, available literature is limited, and there is a lack of comparative studies to better evaluate the results.

Microorganisms involved in ovine mandibular osteomyelitis (OMO) have not yet been deeply studied. The aim of the present study is to elucidate the microorganisms involved in OMO, comparing them with the microorganisms found in the healthy oral cavity of sheep. Two hundred and five samples were taken from mandibular osteomyelitis lesions, and they were compared with the microbiological results of samples obtained from twelve periodontally healthy sheep. Sixty-four samples (32.98%) of OMO lesions showed pure growths, while 130 (67.01%) were mixed cultures. Microorganisms of the genus Streptococcus were the most frequently isolated (20.95%), followed by bacteria of the genus Pseudomonas (8.50%), Trueperella pyogenes (7.26%), Staphylococcus (6.63%) and Escherichia coli (6.22%). Ninety-one different isolates were obtained from healthy mouths, and again, microorganisms of the genus Streptococcus were the most frequent (16.48%), followed by bacteria of the genus Staphylococcus (13.18%), Pseudomonas (9.89%) and Moraxella (6.59%). Based on these and previous results, it could be concluded that the normal microbiota of the oral cavity could be involved in the development of OMO lesions when there is an injury of the gingiva that enables the entry of bacteria to the oral mucosa that eventually settle locally in bony tissues, causing mandibular osteomyelitis.

Simple Summary Traditionally, 4–6 implants have been regarded as the optimal number of implants for supporting mandibular implant-supported fixed complete dental prostheses (ISFCDP). However, several studies have evaluated the clinical behavior and complications of ISFCDPs on three implants considering this option as a potentially valid alternative treatment. Fewer implants will not only reduce the economic cost but can also shorten surgical treatment time and minimize trauma, which will encourage more patients to receive this type of treatment. Abstract This systematic review and meta-analysis set out to assess the clinical behavior of mandibular implant-supported fixed complete dental prostheses (ISFCDP) on three dental implants by analyzing implant and prosthetic survival rates, marginal bone loss, biological/technical complications, and patient-reported outcomes. The review was conducted according to PRISMA guidelines. Electronic searches were conducted in the Medline (PubMed), Web of Science, and Cochrane databases, complimented by a manual search in specialist journals for relevant articles published up to February 2021. The Newcastle-Ottawa Quality Assessment Scale tool was used to assess the quality of evidence in the studies reviewed. The study included 13 articles with 728 patients treated with 2184 implants. A mean implant survival rate of 95.9% (95% CI: 94.6–97.3%) and a prosthetic survival rate of 97.0% (95% CI: 95.7–98.3%) were obtained over 1–6-year follow-up periods. Mandibular implant-supported fixed complete dental prostheses on three dental implants would appear to be a viable option for restoring the edentulous mandible in comparison with mandibular ISFCDP on more than three implants. Further comparative studies are needed, with adequate protocols, as well as sufficient sample sizes and follow-up periods to confirm these findings.

After tooth extraction, the alveolar bone undergoes a physiological resorption that may compromise the future placement of the implant in its ideal position. This study evaluated bone density, morphological changes, and histomorphometric results undergone by alveolar bone after applying a new biomaterial composed of calcium phosphate modified with silicon (CAPO-Si) compared with hydroxyapatite of bovine origin (BHA). Alveolar ridge preservation (ARP) was performed in 24 alveoli, divided into a test group filled with CAPO-Si and a control group filled with BHA. Three months later, the mineral bone density obtained by the biomaterials, horizontal and vertical bone loss, the degree of alveolar corticalization, and histomorphometric results were evaluated. Both biomaterials presented similar behavior in terms of densitometric results, vertical bone loss, and degree of alveolar corticalization. Alveoli treated with CAPO-Si showed less horizontal bone loss in comparison with alveoli treated with BHA (0.99 ± 0.2 mm vs. 1.3 ± 0.3 mm), with statistically significant difference (p = 0.017). Histomorphometric results showed greater bone neoformation in the test group than the control group (23 ± 15% vs. 11 ± 7%) (p = 0.039) and less residual biomaterial (5 ± 10% vs. 17 ± 13%) (p = 0.043) with statistically significant differences. In conclusion, the ARP technique obtains better results with CAPO-Si than with BHA.

Simple Summary The scientific literature repeatedly insists on the success of titanium implants. Nevertheless, the so-called tribocorrosion process releases titanium ions into the surrounding tissues, which can trigger a cascade of reactions, localized or at a distance, or even systemic reactions. Consequently, guidelines should be drawn up before starting treatment; when a hypersensitivity reaction following titanium dental implant placement occurs, a range of treatment alternatives should be clearly established and made available. Abstract The purpose of this scoping review was to describe the current state of knowledge and understanding of allergies to titanium dental implants. A scoping review was conducted following the Prisma Extension for Scoping Reviews checklist. An electronic search was performed in five databases complemented by manual and grey literature searches. Fifty-two relevant papers were included for final review. Titanium particles can be released from the surfaces of dental implants in a process called tribocorrosion, which may contribute to bone loss due to inflammatory reaction. Diverse mechanisms have been described that may trigger allergy to titanium, as well as the clinical signs that manifest as the allergy develops. Allergies to titanium are uncommon but represent a real possibility that should not be overlooked in patients requiring prosthodontic rehabilitation with dental implants. Allergy can trigger a range of symptoms. Patients who have already been diagnosed with allergies to other metals will be more predisposed to suffering an allergy to titanium. Further investigation is needed in order to measure the true scope of these allergies.

Various biomaterials are currently used for bone regeneration, with autogenous bone being considered the gold standard material because of its osteogenic, osteoconductive, and osteoinductive properties. In recent years, the use of autogenous dentin as a graft material has been described. This split-mouth clinical trial assesses the efficacy of autogenous dentin for the regeneration of periodontal defects caused by bone loss associated with impacted lower third molar extraction. Fifteen patients underwent bilateral extraction surgery (30 third molars) using dentin as a graft material on the test side, and leaving the control side to heal spontaneously, comparing the evolution of the defects by evaluating probing depth at three and six months post-operatively. Bone density and alveolar bone crest maintenance were also evaluated six months after surgery, and pain, inflammation, mouth opening capacity on the second and seventh days after surgery. Probing depth, radiographic bone density, and alveolar bone crest maintenance showed significant differences between the test and control sides. Autogenous dentin was found to be an effective biomaterial for bone regeneration after impacted lower third molar extraction.

Objectives The aim of this study was to establish the prevalence of supernumerary teeth (ST) in a sector of the population of Madrid, as well as possible complications associated with the presence of these teeth.Materials and Methods The study investigated patients (n = 28,114) who sought dental care at the Oral Surgery Service of three different centers between May 2005 and April 2018. Cases that did not present this numeric dental developmental variation were discarded, registering only those presenting ST.Statistical Analysis Statistical analysis consisted of univariate analysis (mean, standard deviation, median, etc.), bivariate analysis applying the chi-squared test, whereby statistical significance was established with a confidence interval (CI) of 95% (p < 0.05), and multivariate analysis by means of classification and decision trees.Results The study found ST in 518 patients, representing a prevalence of 1.84%. The 518 patients presented a total of 726 ST. Distomolars were the most common, representing 37.7% of the sample, followed by premolars (20.1%). About 70.5% of the sample were located in the maxilla and 78% of ST were impacted. Radiographs revealed that 39.7% of STs were associated with disorders. Supplementary morphology appeared in 52.1% of the sample.Conclusions Although mesiodens is considered the most common ST, the present study found distomolars and supernumerary premolars to be the most frequently occurring. Pathology was associated with 39.7% of the ST sample. Early diagnosis allows optimal patient management and treatment planning, with intervention at an appropriate time to prevent complications in development and so reduce later treatment need.

For a long time, Chlorhexidine digluconate (CHX) has been considered the most used mouth-rinse for reducing plaque and gingivitis. Sea4&reg, Encias is a new seawater-based mouth rinse with a similar action to CHX. Its prolonged use produces fewer side effects. This study compared the effects of two oral rinses: Chlorhexidine 0.20% and Sea 4&reg, Encias (seawater) for reducing plaque and gingivitis indices. This double-blind crossover study recruited and monitored 93 volunteer dental students, hygienists and doctors from the Universidad Cat&oacute, lica de Murcia (UCAM), for 1 month, and compared the efficacy of Chlorhexidine 0.20% (Group A), Sea4&reg, Enc&iacute, as (Group B), and a placebo saline solution (Group C) mouth-rinses for reducing plaque and gingivitis indices. Plaque and gingival inflammation (L&ouml, e and Silness test) were evaluated at baseline and after each study stage. Group A reduced plaque growth and gingivitis significantly compared with Groups B and C, Group B was more effective than Group C. The mean P.I. decreased similarly in groups A and B. However, Group A showed the statistically significant value compared with other groups. Group A and group B, showed greater reduction in Gingival Indexes compared with group C. The Sea4 mouthwash showed better inhibitory activity on plaque (1.32 &plusmn, 0.22) compared with CHX (1.97 &plusmn, 0.34) and saline (2.78 &plusmn, 0.11). Sea4 Encias and Chlorhexidine 0.20% mouth-rinses significantly reduce plaque growth and G.I. compared with saline mouth-rinse, Sea4 Enc&iacute, as mouth-rinse is more effective against plaque regrowth than Chlorhexidine in this pilot study.

[Capsule]: We document previously undescribed nocturnal flight behaviour by Bearded Vultures Gypaetus barbatus using a combination of accelerometer and global positioning system (GPS) information., [Aims]: To study the nocturnal flight activity of the Bearded Vulture and determine whether nocturnal flights could be linked to foraging behaviour., [Methods]: We used both accelerometer and GPS location data of 11 Bearded Vultures in the Spanish Pyrenees along with 88 carcasses monitored with camera traps., [Results]: Over half (55%, n = 11) of the individuals tracked were recorded flying between 0.7 and 6.1 km on at least 19 different nights, including 37% that occurred when less than 20% of the moon was illuminated. Bearded Vultures displayed feeding activity in only 8.2% of the 146 feeding events existing during the hour after dawn and the hour before dusk., [Conclusions]: Our findings suggest that foraging benefits do not explain the nocturnal flights. Disturbances or adverse weather conditions may result in the abandonment of an overnight roosting site. This could also explain why individuals recovered in the field showed impact injuries., This project was supported by Ministerio para la Transición Ecológica y el Reto Demográfico, Ministerio de Economía y Competitividad, Ministerio de Ciencia e Innovación, Gobierno de Aragón, Generalitat de Catalunya and the projects CGL2015-66966-C2-1-R2 and RTI2018-099609-B-C22. R.G.J. was supported by a pre-doctoral grant (FPI-2016-077510).

The aerospace sector is one of the main economic drivers that strengthens our present, constitutes our future and is a source of competitiveness and innovation with great technological development capacity. In particular, the objective of manufacturers on assembly lines is to automate the entire process by using digital technologies as part of the transition toward Industry 4.0. In advanced manufacturing processes, artificial vision systems are interesting because their performance influences the liability and productivity of manufacturing processes. Therefore, developing and validating accurate, reliable and flexible vision systems in uncontrolled industrial environments is a critical issue. This research deals with the detection and classification of fasteners in a real, uncontrolled environment for an aeronautical manufacturing process, using machine learning techniques based on convolutional neural networks. Our system achieves 98.3% accuracy in a processing time of 0.8 ms per image. The results reveal that the machine learning paradigm based on a neural network in an industrial environment is capable of accurately and reliably estimating mechanical parameters to improve the performance and flexibility of advanced manufacturing processing of large parts with structural responsibility. This publication was carried out as part of the project Nuevas Uniones de estructuras aeronáuticas reference number IDI-20180754. This project has been supported by the Spanish Ministry of Ciencia e Innovación and Centre for Industrial Technological Development (CDTI).

Closure of the surgical incision has been the primary function of sutures since their introduction. However, whatever the type, they are known to carry bacteria, which can be a source of infection. Five types of surgical sutures, Gut, Silk, Vicryl, PTFE, and Polyamide, were selected and tested on their ability to carry aerobic and anaerobic bacteria and were rated on the basis of forming colony-forming units (CFUs). Aerobic bacteria grown around gut sutures showed minimum CFUs (&asymp, 30 &times, 104/suture). Though very less anaerobic bacteria growth was seen among all tested suture materials, it was maximum around Vicryl and polyamide sutures. Every suture material is capable, albeit not equally, of holding bacterial biofilm formation, which can be a source of surgical site infection.

This is the peer reviewed version of the following article: [Martínez-Rodríguez N, Barona-Dorado C, Cortés-Breton Brinkmann J, Martín Ares M, Calvo-Guirado JL, Martínez-González JM. Clinical and radiographic evaluation of implants placed by means of inferior alveolar nerve lateralization: a 5-year follow-up study. Clin Oral Implants Res. 2018 Jul;29(7):779-784., which has been published in final form at [10.1111/clr.12857]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions Objective: To evaluate clinical and radiological responses of implants placed in combination with inferior alveolar nerve lateralization, analyzing survival and success rates over 5 years functional loading. Materials and methods: This prospective, longitudinal, single-center study recruited 40 patients with mandibular atrophy in the posterior sectors, who underwent lateralization of the inferior alveolar nerve. Three months after surgery and implant placement, the implants were loaded by means of screw-retained implant-supported partial prostheses or fixed complete prostheses. Clinical and radiographic examinations were performed immediately after implant placement and at 12, 24, 36, 48 and 60-month follow-up visits. Results: The 40 patients received a total of 129 implants (Phibo TSATM, Phibo Dental Solutions, Sentmenat, Barcelona, Spain). Two implants were lost in the first month after surgery, generating an implant cumulative survival rate (CSR) of 98.44%. The success rate after 5 years of loading was 98.44%. No intra-operative or postoperative soft tissue or prosthetic complications occurred during the 5-year follow-up. Conclusions: Inferior alveolar nerve lateralization performed to allow placement of (Phibo TSATM) implants in patients with mandibular atrophy obtained predictable clinical and radiological results over five years of functional loading. Odontología

Objective The present split-mouth prospective study involves an immunohistochemical evaluation of peri-implant soft tissue healing after the osseointegration period, comparing submerged and transmucosal approaches using two-piece implant systems. The null hypothesis was that both surgical procedures elicit a similar immune response of the peri-implant soft tissues. Design Thirty-one healthy patients were included in this study, in which two implants were placed in the right and left maxillary pre-molar regions. A total of 62 dental implants were analyzed, establishing a control side with 31 submerged implants, and a study side with 31 exposed implants bearing healing abutments. After a three-month healing period, a soft tissue biopsy was collected and prepared for immunohistochemical analysis of the proportions of different lymphocyte subpopulations. Results The comparative analysis between the submerged and transmucosal approaches failed to identify statistically significant differences in CD19+ B cells, CD4+ T cells, CD8+ T cells, CD25+ T cells or γd T cells. However, significant differences in NK lymphocytes (p = 0.012) were recorded with the submerged surgical procedure. Conclusions Peri-implant soft tissue immune response with submerged or transmucosal healing protocols demonstrated comparable outcomes after the osseointegration period. There is sufficient evidence that the null hypothesis of no difference cannot be rejected. To the best of our knowledge, this is the first study of its kind. Further research is therefore needed to further clarify the role of these lymphocyte subpopulations in peri-implant soft tissues. Sin financiación 1.663 JCR (2018) Q2, 44/91 Dentistry, Oral Surgery & Medicine 0.610 SJR (2018) Q2, 43/148 Dentistry (miscellaneous) No data IDR 2018 UEV

Background In recent years the use of orthopantomography has been proposed as a low-cost, reliable and non-invasive diagnostic medium for detecting atheromatous plaque. The purpose of this study was to correlate the presence of carotid calcifications (atheroma) in orthopantomographs with specific risk factors for cerebrovascular accidents (previous cerebrovascular accidents, arterial hypertension, and diabetes). Material and Methods The methods used in this observational study of cases and control subjects followed STROBE (Strengthening the Reporting of Observational studies in Epidemiology) recommendations. The study analyzed a total of 1,602 panoramic radiographs taken for dental diagnostic purposes between January 2010 and February 2014. The main variables analyzed were the incidence of atheromatous plaque and other cardiovascular risk factors. Epidat 3.1 statistical software was used to determine minimum sample sizes and the results were analyzed using PASW (Predictive Analytics Software) Statistics 10.0.0. Results For all the variables analyzed, the correlation between radiographic detection of atheromatous plaque and the presence of cardiovascular disease risk factors was found to be statistically significant (RR>1.5). Conclusions The presence of cardiovascular risk factors is related to the incidence of radiopaque lesions at the carotid artery bifurcation, indicating the presence of atheromatous plaque. Key words:Orthopantomography, atheromatous plaque, cerebrovascular accident, diabetes, arterial hypertension.

The study characterized Si-containing α-TCP blocks designed for graft application and examined their osseintegration in rabbit tibiae using histological, histomorphometric and micro-CT techniques. The block grafts were inserted into the critical size defects of 15 rabbits, using both tibiae, and examined at 15, 30 and 60 days. Results showed that new bone grew in direct contact with the block grafts and that the presence of silicon improved the stability and osseointegration of the material. Silicon doped TCP grafts showed enhanced mesenchymal cell differentiation and increased osteoblast activity compared with α-TCP. Furthermore, blocks with the highest concentration of silicon (3% C 2 S, 97% TCP) showed better dimensional stability and increased bone-to-implant contact values after 60 days (67.6 ± 5% lateral bone contact and 57.3 ± 3% base bone contact). None of the implanted materials were seen to produce any adverse inflammation. The study found that α-TCP ceramic blocks containing 3% C 2 S, offer good bioactivity, biocompatibility and allow new bone growth around the block and within the graft body, making this an ideal block graft material.

Objectives: To analyze the height and width of the ridge at the level of the premaxilla in edentulous patients, evaluating whether the sex of the patient, type of prosthetic rehabilitation and antagonist have an influence. Material and Method: We randomly selected a total of 89 patients, having an average age of 66.21 years old. A total of 308 measurements were made, all of them at the level of the premaxilla, in the intercanine area. As dependent variables, we analyzed the patients’ sex, age and the antagonist: removable (dental) prostheses (RP), fixed (dental) prostheses (FD), natural dentition (ND). As independent variables, we measured the height and residual width in sagittal sections provided by tomographic studies using Dentascan®. Results: We observed a significantly smaller ridge in women versus in men, and in patients whose antagonist was a fixed prosthesis; whereas for the type of prosthesis, we did not observe significant differences between the two categories analyzed. Conclusions: Bone resorption at the level of the premaxilla is a variable process in which a smaller size is observed (height and width) in women and when the antagonist is a fixed prosthesis. Key words: Bone resorption, premaxilla, dental prosthesis, edentulous.

Objectives: To evaluate graft types used for maxillary sinus augmentation and review success rates of dental implants inserted in these areas, analyzing the graft materials used, implant surface types and the moment of implant placement. Study Design: A meta-analytic study reviewing articles on sinus augmentation published during the last ten years. Results: 3,975 implants placed in sinus augmentations (with bony windows) were registered, of which 3,749 implants survived, a survival rate of 94.3%. Conclusions: When performing sinus augmentation, bone substitute materials are just as effective as autologous bone, whether used alone or in combination with autologous bone. Implant surface treatments can have an important effect on implant survival and it would appear that roughened surfaces are the best option. When implants are inserted simultaneously to grafting, a higher failure rate can be expected. Key words: Sinus augmentation, bone implant, bone regeneration, dental implant.

To establish whether there is a high enough risk of bleeding in patients who take oral anticoagulants, such that it would justify not using oral anticoagulants when performing a dental extraction, as well as if the reason for and anatomical location of the extraction increases such risk. Study We performed a bibliographic search in order to carry out a meta-analytic study using descriptive statistics. We compiled a sample of 1194 patients from the articles selected. Of these patients, a total of 2392 simple, serial surgical extractions were performed; none of the patients interrupted their anticoagulant treatment with warfarin sodium. Of the sample, 83 patients presented a certain degree of bleeding; in 77 of such cases, the bleeding was controlled with local hemostasis, whereas 6 patients required their dose of oral anticoagulants to be adjusted. There was a higher incidence of bleeding in patients presenting a periodontal pathology, compared to deep caries and pericoronitis. Patients being treated with oral anticoagulants represent a risk that we should be aware of, but local hemostasis has proven to be effective when performing extractions, provided that the INR value is less than 4. There is an increased incidence of bleeding in patients with periodontal problems, due to the greater presence of inflammation in the soft tissues. If the extraction is performed in the maxilla, the incidence of hemorrhagic complications is slightly higher than in the mandible, although this difference is considered to be insignificant.

Background: In a previous study on a nocturnal, every-other-day online haemodiafiltration scheme, different removal patterns were observed for urea, creatinine, β2-​microglobulin, myoglobin and prolactin. The aim of this study was to evaluate the influence of dialysis duration and infusion flow (Qi) on the removal of different molecular weight (MW) solutes, and to quantify the effect of the different treatments on the kinetics of the solutes by using a classical two-compartment model. Methods: This prospective, in-center study was carried out in 10 patients on a nocturnal, every-other-day online post-dilution haemodiafiltration program. Each patient received four dialysis sessions with different conditions, two 4-h sessions (with infusion flows of 50 or 100 ml/min) and two 8-h sessions (with infusion flows of 50 or 100 ml/min). To analyze the solute kinetics, blood samples were obtained hourly during the dialysis treatments and in the first 3 h post-dialysis. Results: Removal patterns differed in the molecules studied, which were quantified by means of the two-compartment mathematical model. The main results show the impact of dialysis duration on the removal of low molecular weight molecules (urea and creatinine), while the impact of Qi is clearly shown for high molecular weight molecules (myoglobin and prolactin). For middle molecular weight solutes, such as β2-microglobulin, both factors (duration and Qi) enhance the removal efficiency of the dialyzer. Conclusions: Our study evaluates experimentally and mathematically how treatment time and infusion flow affect the filtration of solutes of different MW during post-dilution haemodiafiltration. The results provided by the present study should help physicians to select and individualise the most appropriate schedules to deliver an optimum diffusive and convective dialysis dose for each patient.

Purpose: The aim of this study was to evaluate the effect of a new porcine biomaterial and collagen paste in 20 New Zealand rabbits. Materials and Methods: Forty implants using a porcine xenograft made up of 80% corticocancellous collagenated bone particles of ≤300 μm in size were placed in the proximal metaphyseal area of both tibiae. Four periods of time were formed: 1h, 5, 8, and 15 months. After implantation, an anteroposterior and lateral radiological study was carried out. Samples were sectioned at 5 μm and stained using hematoxylin-eosin, Masson's trichromic, and Gordon-Switt reticulin stains. Results: These results confirmed the biocompatibility of this porcine biomaterial-collagen paste; only a few, occasional macrophages and scattered lymphocytes were observed. No fibrosis was observed between the implants and the bone. Moreover, the material was osteoconductive acting as a “scaffold” for bone cells, and there was a progressive increase in bone growth in and around the implants. Conclusion: This new porcine biomaterial-collagen paste seemed to be biocompatible, bioresorbable, and osteoconductive.

Objective: To determine the optimum surgical treatment for oral antral communications (OAC) and to understand the main post-operative complications.Study Design: Meta-analytical, observational and retrospective study of 1,072 cases of OAC obtained from a literature review of 15 articles. Results: OAC occur slightly more often in men and during the fourth decade of life. Its primary etiological factor is dental extraction, most often affecting the third molar. The most common treatment has been the use of Bichat's fat pad grafts, whereas the technique with the highest percentage of complications has been the use of the palatal rotation flap. The most frequent complication has been the fistulization of the OAC. Conclusions: Early diagnosis of OAC and its treatment within 48 hours of evolution are fundamental in order to properly resolve this pathology. The use of Bichat's fat pad grafts is a simple technique that offers excellent vascularization and results. © Medicina Oral.

Transmigrated canines are impacted canines that have crossed the midline. Our objective was to evaluate the epidemiological and clinical aspects that have to do with transmigrated canines. We did a bibliographic review of 209 transmigrated canines obtained from a review of articles from 1971 to the present. The results of the study were that transmigrated canines are most frequent among females and are usually diagnosed within the first two decades of life. They are usually located in the mandible, with transmigration being most frequent in the left mandibular canine. In a large number of cases, the deciduous canine remains in the arcade. Transmigrated canines are most often found impacted, the primary position being mesially inclined, having crossed the midline. There is no pathology that is clearly associated with these canines, although radiolucence compatible with a cyst was found in a great percentage. In conclusion, given that it is not possible to predict when dental transmigration is going to occur, we must monitor those mandibular canines which present a delay in their eruption, in order to try to carry out an interceptive treatment and avoid possible pathologies. 0.119 SJR (2011) Q4, 94/107 Dentistry (miscellaneous)

Since Branemark first started developing its implant system, there has been a continuous and significant evolu tion in oral implantology through experimental and clinical research, and many of the concepts that were once considered valid have now become the subject of debate. The insertion of the implant immediately after extraction of the tooth to be substituted has now become the implant treatment of choice and is associated with preserving the bone structure and the gingival architecture, as well as with reducing the treatment time, which ultimately benefits the patient. Objective: To evaluate the success rate of the immediate post-extraction implants (IPI) subject to immediate loading. Study Design: A meta-analytic study was carried out on 659 immediate post-extraction implants obtained from a bibliographic review of 25 articles published within the last 9 years. Results: We obtained a sample of 322 patients who had been treated with a total of 659 implants placed immediately following extraction. The mean age of the patients was 51 years old. A total of 441 implants were inserted in the maxilla, 152 in the mandible and 64 were placed in an unspecified location. The survival rate ranged between 85% and 100%. Conclusions: Immediate post-extraction implant treatment is an implant alternative with a survival rate similar to that of the conventional technique for implant placement and enables preserving both the bone structure and gingival architecture, as well as providing immediate functional loading, thus improving the quality of the treatment as far as the patient is concerned.

Objectives: To determine the frequency of systemic pathologies in patients aged 65 years or more, who require oral care and possibly oral surgery. Study Design: We carried out a cross-sectional descriptive study reviewing 3,388 medical histories for patients from the Department of Medicine and Oral Surgery of the School of Dentistry at the Complutense University of Madrid, who had requested surgical treatment. Those selected were at least 65 years of age or more, and were grouped according to their medical histories into categories of pathologies, which include: systemic, cardiovascular, digestive, respiratory, endocrine-metabolic, genitourinary, osteoarticular, nervous system and the sensory organs. Results: Patients over the age of 65 most commonly present cardiovascular and digestive pathologies, which represent values of 30.8% and 13.75%, respectively. The rest of the systemic pathologies analyzed were categorized according to frequency, as follows: endocrino-metabolic pathologies 6.66%, respiratory pathologies 6.25%, genitourinary pathologies 3.75%, osteoarticular pathologies 2.91%, and pathologies of the nervous system and sensory organs 2.08%. Conclusions: The demand for surgical treatments by third age patients was relatively low, representing 2.18%. However, the presence of systemic pathologies was constant, and therefore, the anamnesis and patient medical history are fundamental for any surgical treatment.

While there is a hereditary component to tori, this does not explain all cases. Tori tend to appear more frequently during middle age of life; the torus palatinus is more commonly observed in females, but this is not the case with the torus mandibularis. Certain ethnic groups are more prone to one torus or the other. The torus is mainly removed due to prostodontic reasons, as it may also be used as biomaterial, not only in periodontology, but also in implantology. The aim of this study was a review of the literature from the past twenty years. Sin financiación 1.071 JCR (2010) Q3, 52/77 Dentistry, oral surgery & medicine UEM

Objective: To study the presence of sinus disorders and their diagnosis based on clinical and radiographic findings, correlating their presence with tomography tests and panoramic radiography. Study design: We conducted a retrospective study on 152 patients who were seeking implant treatment, thereby allowing us to evaluate 42 patients who had abnormal sinuses. The patients underwent an evaluation of their medical history as well a clinical examination, panoramic radiography and tomographic study. Results: The average age of the patient was 59.8 years old, and 54.76% of the group were males and 45.23% were females. Prior respiratory disorders were present in 52.38% of the patients, and 57.3% of the group presented dental disorders. In assessing the type of wound, we observed that 73.21% were mucosal hyperplasia and 26.78% were mucous cysts. Of the 56 sinuses affected, only 28.57% were diagnosed using panoramic radiography. Conclusions: Panoramic radiography has limitations in the diagnosis of sinus disorders; computerized tomography (CT) remains the most effective diagnostic test.

Objective: To identify and evaluate the frequency of the different odontogenic conditions that may lead to maxillary sinusitis. Study design: An observational and retrospective meta-analysis was carried out on 770 cases of maxillary sinusitis obtained from a literature review of 15 articles. Results: Maxillary sinusitis most commonly manifests itself as chronic maxillary sinusitis. It is more common in females and is most often diagnosed in the fifth decade of life. The teeth most predominantly affected are the molars, with the first molar tooth being the most frequently involved. The principal etiological factor is extraction.

En los últimos años se está produciendo un aumento progresivo de la proporción y el número de personas mayores de 65 años. La gran mayoría de estas personas padecen a menudo algún tipo de enfermedad crónica y a menudo consumen uno o varios fármacos para tratarlas o disminuir sus síntomas. Por tanto debemos estudiar los cambios que se producen en el organismo durante la edad anciana y de que manera afectan a la farmacocinética y farmacodinamia de los medicamentos más utilizados en las consultas odontológicas.

An evaluation is made of the surgical activity in the context of the Master of Oral Surgery (Madrid Complutense University, Madrid, Spain), together with an analysis of social demand in ambulatory oral surgery.A descriptive statistical analysis (frequency and contingency tables) is made of the different parameters relating to the activity carried out in this postgraduate master during two academic years.A total of 6750 interventions were carried out in 5877 patients. Females predominated over males (62% versus 38%), and 59.2% of the subjects were in the 21-40 years age range. The most common procedure was tooth extraction (91%); of these, 83.5% corresponded to molars. Other extractions accounted for 5.5%, while impacted canines represented 1.2% of the interventions, cyst removal 1.2%, and periapical surgery 0.5%.Our results show third molar extraction to be the most commonly demanded intervention in ambulatory oral surgery.

A study is made of the efficacy of the Erbium:YAG laser in granulomatous periapical lesions, based on clinical and radiographic controls.The study comprised a series of 45 patients amenable to periapical surgical treatment of incisors, canines and premolars. A conventional surgical technique was used, with silver amalgam retrograde filling and irradiation of the bone defect and remnant root cement with the Erbium:YAG laser. Clinical and radiographic controls were made during 24 months, assessing the absence of symptoms and the presence of pain, swelling or fistula and ossification of the lesions, respectively.The clinical course proved asymptomatic in 95.5% of the cases. As regards remodeling of the bone cavity, 77.7% had completed ossification after 24 months, 13.3% were in an advanced stage of ossification and 4.5% in an intermediate stage, while 4.5% showed treatment failure.The combination of silver amalgam and irradiation with the Erbium:YAG laser in periapical surgery showed a very high clinical success rate, with a 77.7% bone cavity remodeling rate after 24 months.

To study the composition, surface characteristics and response to removal torque of an implant surface subjected to hydrofluoric acid etching and posterior passivating with hydrofluoric and nitric acid.Twelve implants were initially selected and their physico-chemical characteristics were evaluated by means of energy-dispersive X-rays (EDS), scanning electron microscopy (SEM) and photoelectron spectroscopy (XPS). In addition, 24 implants - 12 measuring 8 mm and 12 measuring 10 mm in length - were implanted in 6 Beagle dogs. Twelve implants were removed after a recovery period of 6 weeks, followed by removal of the remaining 12 implants after 12 weeks, using a torque calibrator (Gauge Tonichi model BGT150CN-S) with a force registry range of 0-150 Ncm.EDS analysis of the surface chemical composition only revealed the presence of titanium in the etched surfaces. In the same way as with the surfaces of other dental implants, XPS analysis revealed traces of other elements present in the surface, fundamentally carbon. Following dual acid etching, the surface showed the roughness resulting from acid action, with a morphology that proved to be quite homogeneous. The roughness values obtained exceeded 1 mm. The mean removal torque values after 6 weeks were 79.7 Ncm for the 8 mm implants and 115 Ncm for the 10 mm implants. After 12 weeks, these values increased to 101.2 Ncm and 139.7 Ncm, respectively.Hydrofluoric and nitric acid etching affords optimum surface characteristics comparable to those of other surfaces. The recorded removal torque values raise the possibility of human clinical application for early or immediate loading procedures.

To determine whether smoking influences the postoperative course (pain and trismus) of lower third molar surgery, with a clinical evaluation of surgical wound condition and analysis of the possible differences between smokers and nonsmokers.The study subjects were randomly distributed into two groups (smokers and nonsmokers) and subjected to lower third molar extraction in the Unit of Oral and Maxillofacial Surgery (Madrid Complutense University, Spain). The study variables were trismus after 7 days, the intensity of pain and the need for rescue medication during a period of one week. The surgical wound was also assessed (color, presence of plaque, etc).Two cases of postoperative infection were documented among the smokers, and postoperative trismus was found to be greater among the latter (p=0.05).There were no statistically significant differences between the two groups in terms of pain, though trismus was greater among the smokers. Smoking did not influence wound condition (color, marginal inflammation, appositioning of the margins, ulceration, etc).