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espanolLa evolucion en los disenos de los sistemas de implantes y en la configuracion de los pilares protesicos ha desarrollado el concepto de plataforma reducida que comprende la colocacion de un pilar mas estrecho que la plataforma del implante para aumentar su distancia de la interfase hueso-implante. La plataforma reducida es considerada un factor importante para preservar la estabilidad del hueso crestal y de los tejidos blandos y asegurar el exito de los implantes dentales a largo plazo. La plataforma reducida reduce las fuerzas oclusales y la contaminacion bacteriana en la interfase entre el hueso crestal y el implante. Los estudios experimentales en animales y clinicos en pacientes muestran su eficacia para prevenir la perdida osea y de los tejidos blandos periimplantarios Conclusiones: La introduccion de la plataforma reducida constituye un importante campo en la investigacion experimental en implantologia oral y en el tratamiento clinico con implantes para mantener los tejidos periimplantarios. EnglishThe evolution of designs of implant systems and abutments configurations has developed the concept of platform-switching that involves the connection of a narrower abutment to the platform implant to allow horizontal distance of the interface bone-implant. Platform-switching is considered an important factor to preserve the stability of crestal bone and soft tissue ensuring the success of dental implants in the long-term follow-up. Platform-switching reduces the forces of occlusal loading and bacterial contamination in the interface between the crestal bone and the implant. Experimental studies in animals and clinical studies in patients showed that implants with platform-switching have demonstrated the effectiveness to prevent peri-implant bone loss and subsequent soft tissue loss. Conclusions: The platform-switching constitute an important field for research of experimental implant dentistry and clinical implant treatment in the maintenance of peri-implant tissues.

Background: The aim of this study is to evaluate the response to the non-surgical treatment of peri-implant mucositis using the diode laser as an adjuvant therapy in patients with implant-supported restorations, in terms of clinical variables, with respect to those patients in whom conventional non-surgical therapy is used. Material and Methods: Randomized controlled clinical trial with simple blind 3 months follow-up. Two groups of patients were established, the non-surgical mechanical debridement of the affected implants was performed in the control group (n = 34) and the diode laser therapy was also performed in the test group (n = 34). The implant was considered the study subject; the variables considered were plaque index, bleeding on probing depth, depth of probing and recession of the peri-implant mucosa. The t-Student test was used to establish the intergroup statistical differences and the analysis of variance (ANOVA) was used to measures intragroup differences over time. Results: In the revaluation at 6 weeks, we observed statistically significant differences (p

Objectives This observational cross-sectional study aimed to evaluate and compare the oral health-related quality of life (OHRQoL) and clinical performance between dentate subjects and edentulous patients restored with conventional dentures or implant overdentures. Methods 85 edentulous patients were grouped as follows: Group-1 (CD): conventional denture wearers (n = 42), and Group-2 (IO): implant-retained overdenture wearers (n = 43). For the OHRQoL comparisons, a control group of subjects with a healthy natural dentition (Group-3, ND; n = 50) was included. Participants completed three validated questionnaires (OHIP-14sp, OHIP-20sp, and QoLIP-10). Socio-demographic data, prosthesis-related factors, clinical condition of the mouth, and patient subjective evaluations, were gathered. Descriptive and non-parametric probes were run (α = 0.05). Results The ND group was the most unsatisfied (OHIP-14sp; p ≤ 0.001). The OHIP-20sp attributed significantly worse Psychological disability (p = 0.029) and Handicap (p = 0.027) to CD wearers when compared to IO wearers. The CD group showed the significantly highest need for relining (p = 0.041), and the lowest retention (p = 0.011). The OHIP-14sp disclosed a significantly worse OHRQoL for those volunteers who had a job (p = 0.003), a basic education instead of a secondary one (p = 0.022), and no partner (p = 0.006). Conclusions The overall OHRQoL was comparable for both prosthodontic groups, being modulated by socio-demographic and prosthesis-related features. Nonetheless, CD wearers presented prosthetic complications more frequently. Clinical significance: While dentate subjects were the most critical about their oral condition and its repercussion in their life, implant overdenture wearers tended to observe a better OHRQoL and clinical performance compared to conventional denture wearers.

Objective: The aim of this study was to evaluate the size, shape and location of the mental foramen (MF) and anterior loop (AL) in the Brazilian population through the analysis of cone beam computed tomography (CBCT) and panoramic radiography (PR). Method: We analyzed the location, shape and size of the MF, the distance between the upper wall of the MF and the alveolar crest (AC), the size of the AL and the presence of lingual anastomosis. Results: Fifty PR and CBCT exams were analyzed. In relation to the MF, the most common location was between premolars (56%), the most common shape was the oval shape (83%) and the average size in the PR was 3.63 mm and in the CBCT was3.66 mm. The average distance from the MF to the AC in the PR was 17.29 mm and in the CBCT was 11.48 mm. The average AL size was 3 mm, the smallest being 1 mm and the largest being 5 mm. Static analysis was performed to verify the relationship between the distance from the foramen to the AC with the values ​​that were found in the PR and CBCT, which showed a statistically significant difference (p=

The treatment of patients with atrophic maxillary alveolar ridge who need oral rehabilitation is a common problem in Implant Dentistry. One of the techniques used is the alveolar ridge splitting technique to expand alveolar ridges with a horizontal bone decrease. The palatal approach technique is also recommended in cases with an insufficient thickness of the alveolar ridge for the placement of implants in the bone envelope. The aim of this work is to describe the splitting expansion and palatal approach technique for the treatment of atrophic maxillary ridges with a horizontal bone deficit and rehabilitation with implant placement. This technique combines the alveolar ridge splitting/expansion technique and the palatal approach technique. It allows alveolar ridge expansion using piezosurgery and immediate placement of implants without thread exposure in the palatal aspect. With one surgical time, this technique avoids the fracture of the buccal bone plate due to the expansion, eliminates the need for bone graft and donor-site morbidity, is simple and effective, and shows great esthetic results and implant success. El tratamiento de pacientes con reborde alveolar maxilar atrófico que necesitan rehabilitación oral es un problema común en Implantología. Una de las técnicas empleadas es la técnica de separación de crestas alveolares para expandir las crestas alveolares con reducción horizontal del hueso. La técnica de abordaje palatino también se recomienda en casos con un grosor insuficiente de la cresta alveolar para colocar implantes en la envoltura ósea. El objetivo de este trabajo es describir la técnica de separación y expansión y el abordaje palatino para el tratamiento de crestas maxilares atróficas con déficit óseo horizontal y rehabilitación con colocación de implantes. Esta técnica combina la técnica de separación y expansión de la cresta alveolar y la técnica de abordaje palatino. Permite la expansión del reborde alveolar con el uso de piezocirugía y colocación inmediata de implantes, sin exposición de roscas en la cara palatina. Con un tiempo quirúrgico, esta técnica evita la fractura de la placa ósea vestibular por expansión, elimina la necesidad de injerto óseo y la morbilidad del sitio donante, es simple y eficaz, y presenta excelentes resultados estéticos y éxito del implante. O tratamento de pacientes com rebordo alveolar maxilar atrófico que necessitam de reabilitação oral é um problema comum em Implantodontia. Uma das técnicas utilizadas é a técnica de separação do rebordo alveolar para a expansão das cristas alveolares com diminuição óssea horizontal. A técnica de abordagem palatina também é recomendada em casos com espessura insuficiente da crista alveolar para colocação de implantes no envelope ósseo. O objetivo deste trabalho é descrever a técnica de separação e expansão e abordagem palatina para o tratamento de cristas maxilares atróficas com déficit ósseo horizontal e reabilitação com colocação de implantes. Essa técnica combina a técnica de separação e expansão da crista alveolar e a técnica de abordagem palatina. Permite a expansão do rebordo alveolar com o uso de piezocirurgia e colocação imediata de implantes, sem exposição de roscas no aspecto palatino. Com um tempo cirúrgico, essa técnica evita a fratura da tábua óssea vestibular devido à expansão, elimina a necessidade de enxerto ósseo e morbidade do local doador, é simples e eficaz e apresenta excelentes resultados estéticos e sucesso do implante.

Introducción: el uso de los implantes extracortos permite la rehabilitación de extremas reabsorciones. Esto obliga en ocasiones a la utilización de prótesis sobre los mismos con una proporción corona-implante desfavorable llegando a ratios de 2:1 o de 3:1 en los casos más extremos. Materiales y métodos: se realizó un análisis de casos clínicos donde se insertaron implantes extracortos con un reborde residual (menor o igual a 5,5mm) y tiempo de carga mínimo de seis meses. Se realizó una prueba de chi-cuadrado para las variables categóricas y una t de Student para las variables continuas. Posteriormente, se realizaron modelos de regresión lineal ajustados. Resultados: fueron reclutados seis casos a los que se les insertaron implantes extracortos. El 21,2% de los pacientes incluidos en el estudio fueron hombres y el 78,8% mujeres, con una edad media de 57 años. La proporción corona-implante medio fue de 3,19 (+/- 0,24). La media de la pérdida ósea mesial de los implantes estudiados fue de 0,86mm (+/- 0,33) y la media de la pérdida ósea prodistal fue de 0,83mm (+/- 0,47). Cuando se analizó la pérdida ósea mesial y distal en función proporción no se encontraron diferencias estadísticamente significativas (p=0,224). Conclusiones: el uso de implantes extracortos no es un factor de riesgo para la pérdida ósea crestal o para el fracaso de la prótesis o del implante según los datos aportados por este estudio aun cuando la proporción corona-implante sea superior a tres.

Dental agenesis consists of an anomaly characterized by the numerical reduction of dental elements and, according to the number of missing teeth, it may receive other names, such as hypodontia, oligodontia, anodontia or congenital absence. Several treatments may be recommended depending on the patient's needs and conditions, such as surgery for the installation of implants and fixed prostheses, and early diagnosis is one of the key parts for proper treatment. The rehabilitation of agenesis of the upper lateral incisor is a great challenge for the professional since several factors can influence the aesthetic result and, in addition, the absence of the dental element can bring unbalance of the occlusion and phonetic problems. It is essential to carry out an adequate planning and a treatment plan with multidisciplinary action so that the final result is effective and meets the expectations of each patient. The present study aimed to report a clinical case of dental agenesis of the upper lateral incisor, where the treatment of choice was the installation of an implant-supported prosthesis and filling of the buccal bone plate with biomaterial. La agenesia dental consiste en una anomalía caracterizada por la reducción numérica de elementos dentarios y, según el número de dientes faltantes, puede recibir otros nombres, como hipodoncia, oligodoncia, anodoncia o ausencia congénita. Se pueden recomendar varios tratamientos en función de las necesidades y condiciones del paciente, como la cirugía para la instalación de implantes y prótesis fijas, y el diagnóstico precoz es una de las piezas clave para un tratamiento adecuado. La rehabilitación de la agenesia del incisivo lateral superior es un gran reto para el profesional ya que varios factores pueden influir en el resultado estético y, además, la ausencia del elemento dental puede traer desequilibrio de la oclusión y problemas fonéticos. Es fundamental llevar a cabo una adecuada planificación y un plan de tratamiento con acción multidisciplinar para que el resultado final sea efectivo y cumpla con las expectativas de cada paciente. El presente estudio tuvo como objetivo reportar un caso clínico de agenesia dental del incisivo lateral superior, donde el tratamiento de elección fue la instalación de una prótesis implantosoportada y el relleno de la placa ósea vestibular con biomaterial. A agenesia dentária consiste em uma anomalia caracterizada pela redução numérica dos elementos dentários e de acordo com o número de dentes faltantes pode receber outras denominações, como hipodontia, oligodontia, anodontia ou ausência congênita. Diversos tratamentos podem ser preconizados dependendo da necessidade e condições do paciente, como cirurgia para instalação de implantes e próteses fixas, sendo que o diagnóstico precoce é uma das peças-chaves para o tratamento adequado. A reabilitação de agenesia de incisivo lateral superior é um grande desafio para o profissional visto que diversos fatores podem influenciar no resultado estético e além disso, a ausência do elemento dental pode trazer desequilíbrio da oclusão e problemas fonéticos. É fundamental a realização de um planejamento adequado e um plano de tratamento com ação multidisciplinar para que o resultado final seja efetivo e supra as expectativas de cada paciente. O presente trabalho objetivou relatar um caso clínico de agenesia dental de incisivo lateral superior, onde o tratamento de escolha foi a instalação de uma prótese implantossuportada e preenchimento da tábua óssea vestibular com biomaterial.

Background: The social diversity, heterogeneous culture, and inherent economic inequality factors in Latin America (LA) justify conducting a comprehensive analysis on the current status and future trends of peri-implant diseases and conditions. Thus, the aim of this Delphi study was to predict the future trends in the diagnosis and treatment of peri-implant diseases and conditions in LA countries for the year 2030. Methods: A Latin American steering committee and group of experts in implant dentistry validated a questionnaire including 64 questions divided into eight sections. The questionnaire was run twice with an interval of 45 days, with the results from the first round made available to all the participants in the second round. The results were expressed in percentages and data was analyzed describing the consensus level reached in each question. Results: A total of 221 experts were invited to participate in the study and a total 214 (96.8%) completed the two rounds. Moderate (65%-85%) to high consensus (≥85%) was reached in 51 questions (79.69%), except in the questions dealing with “prevalence”, where no consensus was reached. High and moderate consensus was attained for all the questions in three fields (risk factors and indicators, diagnosis and treatment of peri-implant conditions and deficiencies, and prevention and maintenance). Conclusions: The present study has provided relevant and useful information on the predictions in the diagnosis and treatment of peri-implant diseases with a high level of consensus among experts. Nevertheless, there is still a lack of agreement in certain domains.

Background: This systematic review evaluates the available scientific literature to demonstrate the aesthetic and clinical benefits and to determine the survival and the success of zirconium dioxide implants concerning titanium implants. Material and Methods: The electronic databases were searched until January 2020. Outcome measures were pink aesthetic score (PAS), white aesthetic score (WAS), bleeding on probing (BOP) and probing depth (PD). The addressed PICO question was: In partially edentulous patients in the upper-anterior sector, do zirconium dioxide implants provide aesthetic benefits over conventional titanium implants? Results: In the 15 articles included after the screening were evaluated respectively, the pink aesthetic score, white aesthetics score, the peri-implant, and crown index, bleeding on probing, plaque index, probing pocket depth, radiographic bone loss, papilla height, and survival and success rate. The results show how the aesthetic and clinical benefits and the survival and success rate of zirconium dioxide implants are, in general, better than titanium implants. Conclusions: Despite the optimal aesthetics, clinical and survival results obtained in the review, more studies are needed to confirm these data. Sin financiación No data JCR 2020 0.481 SJR (2020) Q2, 63/141 Dentistry (miscellaneous) No data IDR 2029 UEV

Background: Implant dentistry has evolved over time, resulting in better treatment outcomes for both patients and clinicians. The aim of this trial was to test whether the immediate loading of implants with a platform-switching design influences the marginal bone level, compared to four-week loading, after one year of follow-up. Moreover, a comparison of clinical data regarding implant survival, implant stability, and patient-reported outcome measures (PROMs) was conducted. Methods: Klockner® VEGA® implants with a ContacTi® surface were placed in partially edentulous patients in the posterior areas. Group A received an immediately loaded prosthesis (one week) and Group B received an early-loaded prosthesis (four weeks). All abutments were placed at the time of surgery. Radiographic and clinical data were recorded. Results: Twenty-one patients were treated (35 implants). No implants were lost during the study. The final marginal bone level did not show differences between groups. The bone loss at 12 months at the implant level was 0.00 mm for both groups (median). The final implant quotient stability (ISQ) values did not differ between groups (median 73 and 70.25), nor did the other clinical parameters or PROMs. Conclusions: The results suggest that neither of the loading protocols with the implants used influenced the marginal bone level—not the osseointegration rate, clinical conditions, or PROMs. Parcialmente financiado por Klockner y U.I.C. fondos de investigación

In the literature, many researchers investigated static loading effects on an implant. However, dynamic loading under impact loading has not been investigated formally using numerical methods. This study aims to evaluate, with 3D finite element analysis (3D FEA), the stress transferred (maximum peak and variation in time) from a dynamic impact force applied to a single implant-supported prosthesis made from different materials. A 3D implant-supported prosthesis model was created on a digital model of a mandible section using CAD and reverse engineering. By setting different mechanical properties, six implant-supported prostheses made from different materials were simulated: metal (MET), metal-ceramic (MCER), metal-composite (MCOM), carbon fiber-composite (FCOM), PEEK-composite (PKCOM), and carbon fiber-ceramic (FCCER). Three-dimensional FEA was conducted to simulate the collision of 8.62 g implant-supported prosthesis models with a rigid plate at a speed of 1 m/s after a displacement of 0.01 mm. The stress peak transferred to the crown, titanium abutment, and cortical bone, and the stress variation in time, were assessed. info:eu-repo/semantics/publishedVersion

Resumen: Objetivo: Determinar las variaciones de la frecuencia cardiaca, presión arterial y temperatura en pacientes con cirugía de implantes dentales. Métodos: Serie de casos clínicos que incluyó a 26 pacientes de 20 a 60 años de edad atendidos en el Centro Médico Naval “Cirujano Mayor Santiago Távara” (Lima. Perú). Se registró la temperatura, frecuencia cardiaca y presión arterial 5 min antes de la cirugía de implantes, 5 min después de la anestesia local y 5 minutos después de la cirugía. Para realizar las mediciones se utilizó un termómetro digital y un monitor digital de muñeca. Resultados: La temperatura corporal durante el preoperatorio fue de 36,9 ± 0,3 °C mientras que en el posoperatorio fue de 36,7°C ± 0,07 (p>0,05). La frecuencia cardiaca aumentó durante el intraoperatorio (80,3 ± 8 lat/min) y se restableció en el posoperatorio (72,5 ± 7,4 lat/min) (p

Background The development of new and innovative materials such as high performance polymers (PEEK) opens a wide therapeutic range in implant prostheses. They are presented as alternative materials to metal and zirconium alloys in the manufacture of structures and attachments for implant prostheses and fixed and removable dental substitutes. The objective of this review is to know the characteristics of this material and thus assess its advantages and disadvantages in its possible applications in prostheses on dental implants. Material and methods A bibliographic search was carried out through the PubMed and Scopus search engines, of articles published from 2007 to 2020, excluding all articles in which PEEK was used for tooth prostheses. The data on the sufficiency of the PEEK material were organized according to its chemical, physical and mechanical properties. Results 148 articles were found in the databases using as keywords; Polyetheretherketone; PEEK; BioHPP; healing abutments; dental prostheses; dental prosthodontics; Full-arch rehabilitation; fixed implant prosthodontics; implant-retained prostheses; implant prostheses. Conclusions It is concluded that PEEK offers greater lightness, good aesthetics, biocompatibility, and an elastic modulus more similar to bone than other materials commonly used in implant prostheses; however, it presents a higher risk of fracture and abrasion. More long-term clinical studies will be necessary to advise its use in implant prostheses. Key words:Polyetheretherketone, PEEK, BioHPP, healing abutments, dental prostheses, dental prosthodontics,Full-arch rehabilitation, fixed implant prosthodontics, implant-retained prostheses, implant prostheses.

Objectives: The objective of this cross-sectional study was to evaluate the vertical bone gain achieved after the sinus lift procedure with beta-tricalcium phosphate (&beta, TCP) used as a bone substitute and simultaneous implant placement. Methods: One hundred and twenty-eight sinus lift procedures (utilizing a synthetic ceramic containing 99.9% tricalcium phosphate as a bone substitute) and simultaneous implant placements were performed on 119 patients. The lateral window approach surgical protocol for maxillary sinus lift was performed on the patients. The implants were evaluated using cone-beam computed tomography (CBCT) at 6 months following placement. The vertical bone gain was considered a primary variable, while implant length, diameter, and location were considered secondary variables. Results: The ANOVA results showed no statistical difference in vertical bone gain with implant parameters like implant length, width, and position. Pearsons correlation revealed a statistically significant positive correlation with vertical bone gain and implant length and diameter. A further multivariate linear regression analysis was performed and it observed statistically significant associations between the variables in the study after adjusting for confounding factors. Conclusions: This study concluded that there was vertical bone gain with the usage of &beta, TCP in maxillary sinus lift surgical procedure with immediate implant placement and that implant variables like length and diameter had a significant influence on the average bone gain values. The implant position did not have a statistically significant influence but there was considerable variation in the bone gain between first, second premolar, and molar regions.

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant (p &lt, 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully.

This study aims to present the dynamic UCLA as a prosthetic option to restore a tilted implant, replacing a missing maxillary left lateral incisor with a functional and aesthetic screw-retained crown. Dental implants show high success rates; however, complications related to three-dimensional positioning of the implant are common. The correction of the implant position usually requires machined angled abutments or complex surgical procedures, which results in long and difficult treatment, and increases the treatment final cost. A 45-years-old male patient sought for specialized dental care to restore the front missing tooth esthetic area. The patient has limited mouth opening, mental and physical disabilities, so the construction of a metal-ceramic prosthesis with the aid of dynamic UCLA was proposed as a straightforward and low-cost procedure under the sign of free and informed consent. The prosthetic treatment provided aesthetic results and patient satisfaction without complications after a four-year follow-up. Este estudio tiene como objetivo presentar el UCLA dinámico como una opción de rehabilitación de un implante mal posicionado, reemplazando un incisivo lateral superior izquierdo ausente por una corona estética y funcional. Los implantes dentales tienen altas tasas de éxito, sin embargo, las complicaciones relacionadas con el posicionamiento tridimensional del implante son comunes. La corrección de la posición del implante generalmente requiere el uso de pilares mecanizados en ángulo o procedimientos quirúrgicos complejos, lo que resulta en un tratamiento largo y difícil que aumenta el costo final. Un paciente masculino de 45 años buscó atención dental especializada para restaurar un diente faltante en el área estética. El paciente tiene una apertura bucal limitada, discapacidades mentales y físicas; por tanto, se propuso la construcción de una prótesis metalocerámica con la ayuda de un UCLA dinámico como un procedimiento directo y de bajo costo, todo fue realizado bajo la firma del consentimiento informado. El tratamiento protésico proporcionó resultados estéticos y satisfacción al paciente con mínimas complicaciones después de cuatro años de seguimiento. Este estudo tem como objetivo apresentar o UCLA dinâmico como opção protética para reabilitação de um implante mal posicionado, substituindo um incisivo lateral esquerdo superior ausente através de uma coroa estética e funcional. Os implantes dentários apresentam altas taxas de sucesso, no entanto, complicações relacionadas ao posicionamento tridimensional do implante são comuns. A correção da posição do implante geralmente requer o uso de pilares usinados angulados ou procedimentos cirúrgicos complexos, o que resulta em tratamento longo, difícil e aumenta o custo final. Paciente de 45 anos de idade, do gênero masculino, procurou atendimento odontológico especializado para restaurar um dente ausente em área estética. O paciente possui abertura bucal limitada, deficiências mentais e físicas; portanto, a construção de uma prótese metalocerâmica com o auxílio da UCLA dinâmica foi proposta como um procedimento direto e de baixo custo sob assinatura do termo de consentimento livre e esclarecido. O tratamento protético proporcionou resultados estéticos e satisfação do paciente com mínimas complicações após quatro anos de acompanhamento.

Background Immediate implants are frequently employed in the anterior maxillary area. However, the installation of dental implants simultaneously with tooth extraction can also provide with benefits in the posterior areas with a reduction in time prior the recovery of the masticatory function. Results previously reported in the literature show high-survival and success rates for implants placed in extraction sockets in molar areas; however, this topic has received limited systematic analysis. Material and methods Electronic and manual literature searches were performed by two independent reviewers in several data-bases, including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to January 2019 reporting outcomes of immediate implants placed in molar areas. Primary outcomes included survival and success rates, as well as marginal bone loss. Secondary outcomes included the influence of implant position, type of implant connection, grafting protocol, flap or flapless approach, implant diameter, surgical phase, presence of buccal plate, and loading protocol. Results Twenty studies provided information on the survival rate, with a total sample of 1.106 implants. The weighted mean survival rate of immediate implants after 1 year of follow-up was 96.6%, and the success rate was 93.3%. On the other hand, marginal bone loss was 1.29 ± 0.24 mm. Secondary outcomes demonstrated that grafting the gap and the loading protocol have an effect on survival and success rates. Similarly, the presence or absence of the buccal bone affect crestal bone levels. Meta-analysis of 4 investigations showed a weighted mean difference of 0.31 mm ± 0.8 IC 95% (0.15–0.46) more marginal bone loss at immediate implant placement versus implants in healed sites (p < 0.001) I2 = 15.2%. Conclusion In selected scenarios, immediate implant placement in molar extraction socket might be considered a predictable technique as demonstrated by a high survival and success rates, with minimal marginal bone loss.

Numerous randomised controlled multicentric studies have investigated various responses to different treatment modalities with dental implants. These studies do not always show the results of daily practice as they are performed under controlled and strict clinical conditions. This multicentric, non-interventionist trial aimed to document the behaviour of implants when used in daily dental practice, without inclusion or exclusion criteria. One hundred and ninety-six screw-shaped, tissue-level implants were placed, and each clinician decided which implant, surgical loading and prosthetic protocol to use. At surgery, data related to the implants were recorded. Additionally, the crestal bone level changes were evaluated for up to two years of follow-up. Two implants were lost before they were loaded. The success rate was 98.31%, and the survival rate was 98.79%. The implant stability quotient (ISQ) at surgery was 68.61 &plusmn, 10.35 and at 2 years was 74.39 &plusmn, 9.64. The crestal&ndash, shoulder distances were 1.25 &plusmn, 1.09 mm and 1.68 &plusmn, 1.07 mm in the mesial and distal aspects on the day of surgery, respectively, and 2.04 &plusmn, 0.91 and 2.16 &plusmn, 0.99 mm at 2 years, respectively. At 2 years, 69.3% of the patients were highly satisfied. The use of implants under standard conditions seemed to have success rates similar to their placement in controlled studies.

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.

Background and Objectives: Implant stability in vivo is contingent on multiple factors, such as bone structure, instrument positioning and implant surface modifications, implant diameter, and implant length. Resonance-frequency analysis is considered a non-invasive, reliable, predictable, and objective method by which to evaluate implant stability, due to its correlation with bone-to-implant contact. The purpose of this study was to evaluate the effect of implant length on the primary and secondary stability of single-implant crown rehabilitations, as measured by resonance-frequency analysis at different times. Materials and Methods: Implants of 10 and 11.5 mm were placed, and the resonance frequency was measured at the time of surgery (T0), as well as at 3 (T1), 6 (T2), and 12 (T3) months post-surgery. Results: A total of 559 implants were placed in 195 patients. Significant differences were observed when comparing the implant stability quotient (ISQ) values at T1, with values for 10-mm implants being greater than those for 11.5-mm implants (p = 0.035). These differences were also observed when comparing ISQ values for buccal and lingual areas. At T0, T2, and T3, no significant differences in ISQ values were observed. The use of 10-mm implants in the anterior maxilla yielded significantly greater values at T0 (p = 0.018) and T1 (p = 0.031) when compared with 11.5-mm implants. Significant differences in measurements were observed only for buccal areas (p = 0.005, p = 0.018). When comparing the sample lengths and sex, women with 11.5-mm implants showed significantly lower results than those with 10-mm implants (p &lt, 0.001). Conclusions: There is a direct relationship between implants of a smaller length and greater ISQ values, with this relationship being most evident in the maxilla and in women.

espanolIntroduccion: El objetivo del presente estudio era mostrar los resultados del tratamiento con implantes cigomaticos utilizados en pacientes con atrofia maxilar severa. Metodos: 18 pacientes fueron tratados con 36 implantes cigomaticos Galimplant ® sumergidos con conexion interna para su rehabilitacion prostodoncica. Las tecnicas quirurgicas de insercion de cigomaticos fueron extrasinusal y la tecnica de la ranura sinusal. Los implantes fueron cargados despues de un periodo de cicatrizacion de 6 meses. Resultados: Los hallazgos clinicos indican una supervivencia de los implantes del 100%. 14 implantes (38,9%) se insertaron por via extrasinusal y 22 implantes (61,6%) por la tecnica de la ranura sinusal. Un total de 18 protesis hibridas atornilladas fueron realizadas. Complicaciones postoperatorias fueron observadas en 4 pacientes (22,2%). El periodo medio de seguimiento clinico ha sido de 12 meses. Conclusiones: Este estudio indica que los implantes cigomaticos pueden ser utilizados con exito en el tratamiento de los pacientes con atrofia maxilar severa. EnglishIntroduction: The aim of this study was to report the outcome of treatment with zygomatic implants used in patients with severe atrophy of maxilla. Methods: 18 patients were treated with 36 Galimplant ® zygomatic implants with internal connection for prosthodontic rehabilitation. Zygomatic surgical techniques were two approach for insertion of implants, extrasinusal and sinus slot technique. Implants were loaded after a healing free-loading period of six months. Results: Clinical results indicate a survival rate of implants of 100%. Fourteen implants (38.9%) were inserted by extrasinusal approach while twenty two implants were inserted by sinus slot approach (61.1%). A total of 18 hybrid screw prostheses were realized. Postoperative complications were observed in four patients (22.2%). The mean follow-up period were 12 months. Conclusions: This study indicate that zygomatic implants can be used with success in treatment of patients with severe atrophic maxilla.

Objectives The purpose of the present systematic review and meta-analysis is to determine the efficacy of antibiotic prophylaxis and specific antibiotic regimens in dental implant placement for prevention of post-operative infection (POI) in overall healthy patients. Materials and methods Electronic database and manual searches were independently conducted to identify randomized controlled trials (RCTs). Publications were selected on basis of eligibility criteria and then assessed for risk-of-bias using the Cochrane Handbook. The primary outcome was POI (total, early, and late). Wound dehiscence, pain, and adverse events were studied as secondary outcomes. Random-effects meta-analysis was conducted for risk ratios of dichotomous data. This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Results With duplicates removed, 1022 abstracts were screened and 22 full-text articles assessed; 10 RCTs of 1934 total patients were included. Meta-analysis did not detect statistically significant differences in total (P = 0.82), early (1–2 week post-op) (P = 0.57), or late (3–4 months post-op) (P = 0.66) POIs, wound dehiscence (P = 0.31), and adverse events (P = 0.21), between antibiotic and no-antibiotic groups. Confounding variables identified. Conclusion The results of this systematic review suggest that antibiotic prophylaxis may not be indicated for prevention of POIs following dental implant placement in overall healthy patients. These findings and in light of antibiotic-associated risks for individual and public health demand revaluation of routine prescription of antibiotic prophylaxis in dental implant placement procedures. Clinical relevance It is up to the clinicians to evaluate the benefits (or lack thereof) of antibiotic prophylaxis for each patient given medical history and surgical complexity, until new evidence becomes available.

espanolObjetivos: Describir la prevalencia y localizacion de la anastomosis intraosea (AIO) del conducto alveolar superior posterior (CASP) con el conducto alveolar superior anterior (CASA) en pacientes portadores de fisura labiopalatina, comparando el lado afectado por la fisura labiopalatina de tipo transforamen incisivo unilateral (FLP) con el contralateral no portador de fisura labiopalatina (NF). Material y metodo: Fueron evaluadas 1500 tomografias computadorizadas de haz conico (TCHC) y de acuerdo con criterios de inclusion, 95 TCHC fueron seleccionadas para analisis (52 hombres, 43 mujeres, edad media 27 anos). La muestra fue conformada por: 1) pacientes con FLP en el lado derecho y NF en el lado izquierdo; y 2) pacientes con FLP en el lado izquierdo y NF en el lado derecho. El analisis fue dividido en 4 etapas: 1) calibracion intra e interexaminador; 2) evaluacion de la presencia/ausencia de la AIO del CASP con CASA; 3) localizacion de la AIO del CASP con CASA, tomando como referencia las caras mesiales de los dientes (17/27), (16/26), (15/5) y (14/24); y 4) comparar la simetria/asimetria de localizacion comparando el lado portador de FLP con el contralateral NF. Resultados: La prevalencia total de la AIO fue de 67,9 %. La prevalencia de la AIO en el lado portador de FLP fue 71,6 % y en el lado NF fue 64,2 % (Test de Fisher > 0,35). La localizacion de la AIO en el lado portador de FLP fue mas prevalente en las areas (15/25), (16/26) y en el lado NF fue en el area (14/24) (Test Chi-cuadrado Conclusiones: La prevalencia de la AIO fue mayor en el lado portador de FLP (71,6 %) comparado con el lado NF (64,2 %). La localizacion de AIO en el lado portador de FLP fue dislocado hacia distal a diferencia de su contralateral NF. La AIO fue asimetrica en 71,5 % de los casos. Esta informacion es relevante en procedimientos quirurgicos que son realizados en pacientes con fisuras labiopalatinas, que tienen por objetivo corregir las discrepancias maxilomandibulares. EnglishObjectives: The purpose of this study was to examine the prevalence of intraosseous anastomosis (AIO) between the posterior superior alveolar canal (CASP) and the anterior superior alveolar canal (CASA) in patients with cleft lip and palate, comparing the side affected by unilateral incisive trans-forame fissure (FLP) with the contralateral side not affected by fissure (NF). Material and method: A total of 1500 Cone Beam Computed Tomography (TCHC) were evaluated and, according to inclusion criteria, 95 TCHC were selected for analysis (52 men, 43 women, average age 27 years). The sample consisted of 1) patients with FLP on the right side and NF on the left side; and 2) patients with FLP on the left side and NF on the right side. The analysis was divided into 4 steps: 1) Intra and inter-rater calibration; 2) evaluating presence or absence of AIO anastomose between the CASP with CASA; 3) Location of the AIO anastomose between the CASP with CASA, as reference to the mesial aspect of each tooth (17/27), (16/26), (15/25) and (14/24); 4) Evaluated symmetry/asymmetry the localization of AIO, comparing them side with FLP, with the contralateral side NF. Results: The total prevalence of AIO was 67.9 %. The prevalence in FLP side was 71.6 %, and NF side was 64.2 % (Fisher's test > 0.35). The location of the AIO in the FLP side was more than prevalent in the areas of (15/25), (16/26) and on the NF side, it was in the area (14/24) (Chi-square test 0.03) asymmetric comparative of the FLP side with the contralateral NF. Conclusions: The prevalence of AIO was higher in FLP side (71.6 %) comparing the NF side (64.2 %). The location of AIO, in the FLP side was dislocated distally when compared with the contralateral side NF. The AIO was asymmetric in 71.5% of the cases. This information is relevant in surgical procedures that are performed in patients with cleft lip and palate, which aim to correct maxillomandibular discrepancies.

Two-pieces dental implants must provide stability of the implant-abutment-interface. The connection type and platform diameter could influence the biomechanical resistance and stress distribution. This study aims to evaluate the fatigue for different types of connections, external and internal, and different platform diameters. Three implant designs with the same length were used: (a) external hexagon/narrow platform, (b) internal double hexagon/narrow platform, (c) internal octagon/regular platform. A fatigue test was developed to establish the number of cycles needed before fracture. A 30&ordm, oblique load with a sinusoidal function of fatigue at a frequency of 15 Hz and 10% stress variation was applied to each system. The fatigue load limit (FLL) for design (a) was 190N, being the nominal-curvature-moment (NCM) = 1.045, FLL = 150 N, with a NCM = 0.825 for (b), and FLL = 325 N, with a NCM = 1.788 for (c). The platform diameter affects the FLL, obtaining lower FLL on a narrow platform. The connection type interferes with the implant walls&rsquo, width, especially in narrow implants, making internal connections more unstable at this level. Long-term clinical studies to assess the restoration&rsquo, s success rate and survival are mandatory.

Posterior mandible region is considered a highly predicable place for primary stability during dental implant placement. Although, this region can present a significant decrease in bone density, which can lead to implant dislocation during insertion. The present case reports an unusual dislocation of dental implant in a 59 old healthy patient's mandible and a secure solution for this kind of complication. During the drilling, bone quality type IV was observed. In sequence, implant was abruptly inserted in the perforation site and dropped into the bone marrow. Panoramic radiograph showed the implant inside bone marrow, close to mandibular base. The implant was removed through the surgical site. The screw of the implant prosthesis transfer was used to reach the displaced implant. A second implant with the same dimensions as the first one, differing by the external hexagon, was inserted into the same implant site. Therefore, the authors strongly recommend the use of the presented technique prior to osteotomy on mandibular body, reserving the second in the impossibility of reaching the internal connection of the displaced implant. La región posterior de la mandíbula se considera un lugar altamente predecible para la estabilidad primaria durante la colocación de implantes dentales. Aunque, esta región puede presentar una disminución significativa de la densidad ósea, lo que puede provocar la dislocación del implante durante la inserción. El presente caso reporta una dislocación inusual de un implante dental en la mandíbula de un paciente anciano sano de 59 años y una solución segura para este tipo de complicación. Durante el fresado se observó calidad ósea tipo IV. En secuencia, el implante se insertó abruptamente en el lugar de la perforación y se dejó caer en la médula ósea. La radiografía panorámica mostró el implante dentro de la médula ósea, cerca de la base mandibular. El implante se retiró a través del sitio quirúrgico. Se utilizó el tornillo de transferencia de la prótesis del implante para llegar al implante desplazado. Se insertó un segundo implante con las mismas dimensiones que el primero, que se diferenciaba por el hexágono externo, en el mismo sitio del implante. Portanto, los autores recomiendan encarecidamente el uso de la técnica presentada antes de la osteotomía en el cuerpo mandibular, reservándose la segunda en la imposibilidad de llegar a la conexión interna del implante desplazado. A região posterior da mandíbula é considerada um lugar altamente previsível para estabilidade primária durante a colocação do implante dentário. Porém, essa região pode apresentar uma diminuição significativa da densidade óssea, o que pode levar ao deslocamento do implante durante a inserção. O presente caso relata um deslocamento incomum de implante dentário na mandíbula de um paciente de 59 anos de idade, saudável, e uma solução segura para esse tipo de complicação. Durante a perfuração, foi observada qualidade óssea tipo IV. Na sequência, o implante foi inserido abruptamente no local da perfuração e inserido na medula óssea. A radiografia panorâmica mostrou o implante dentro da medula óssea, próximo à base da mandíbula. O implante foi removido pelo sítio cirúrgico. O parafuso de transferência da prótese do implante foi utilizado para alcançar o implante deslocado. Um segundo implante com as mesmas dimensões do primeiro, diferindo pelo hexágono externo, foi inserido no mesmo local do implante. Portanto, os autores recomendam fortemente a utilização da técnica apresentada previamente à osteotomia do corpo mandibular, reservando a segunda na impossibilidade de atingir a conexão interna do implante deslocado.

The aim of this study was to review the scientific literature regarding the effectiveness of different biomaterials in the regenerative treatment of peri-implantitis. A systematic literature search was performed in PubMed/Medline, Web of Science, Science Direct, Embase, and the Cochrane Collaboration Library. Studies on the use of biomaterials in the regenerative treatment of peri-implantitis were selected. The search strategy retrieved 253 articles. After selection, six articles met all inclusion criteria and were included in the present systematic review. The studies showed that an initial therapeutic approach consisting of plaque control and implant surface decontamination and subsequent surgery for biomaterial placement were essential for the successful regenerative treatment of peri-implantitis defects. Analysis of all biomaterials used in surgical regenerative treatment showed that bovine bone grafts provided superior outcomes in terms of new bone formation compared to autogenous grafts and nanocrystalline hydroxyapatite. It is important to note that porous titanium granules have emerged as a promising biomaterial for the regenerative treatment of peri-implantitis. In conclusion, biomaterials are promising for the treatment of peri-implant bone defects and the number of in silico biomaterials that can provide treatment of excellence to patients with this condition is expected to increase in the near future. El objetivo de este estudio fue revisar la literatura científica sobre la efectividad de diferentes biomateriales en el tratamiento regenerativo de la periimplantitis. Se realizó una búsqueda bibliográfica sistemática en PubMed / Medline, Web of Science, Science Direct, Embase y Cochrane Collaboration Library. Se seleccionaron estudios sobre el uso de biomateriales en el tratamiento regenerativo de la periimplantitis. La estrategia de búsqueda recuperó 253 artículos. Después de la selección, seis artículos cumplieron con todos los criterios de inclusión y se incluyeron en la presente revisión sistemática. Los estudios demostraron que un enfoque terapéutico inicial consistía en el control de la placa y la descontaminación de la superficie del implante y la cirugía posterior para la colocación de biomaterial era esencial para el tratamiento regenerativo exitoso de los defectos de periimplantitis. El análisis de todos los biomateriales utilizados en el tratamiento regenerativo mostró que los injertos óseos bovinos proporcionaron resultados superiores en términos de formación de hueso nuevo en comparación con los injertos autógenos y la hidroxiapatita nanocristalina. Es importante señalar que los gránulos de titanio poroso han surgido como un biomaterial prometedor para el tratamiento regenerativo de la periimplantitis. En conclusión, los biomateriales son prometedores para el tratamiento de defectos óseos periimplantarios y se espera que aumente en un futuro próximo el número de biomateriales in silico que pueden proporcionar un tratamiento de excelencia para pacientes con esta afección. O objetivo deste estudo foi revisar a literatura científica a respeito da eficácia de diferentes biomateriais no tratamento regenerativo da peri-implantite. Uma busca sistemática da literatura foi realizada no PubMed / Medline, Web of Science, Science Direct, Embase e na Cochrane Collaboration Library. Foram selecionados estudos sobre a utilização de biomateriais no tratamento regenerativo da peri-implantite. A estratégia de busca recuperou 253 artigos. Após a seleção, seis artigos atenderam a todos os critérios de inclusão e foram incluídos na presente revisão sistemática. Os estudos mostraram que uma abordagem terapêutica inicial consistindo no controle da placa e descontaminação da superfície do implante e subsequente cirurgia para colocação de biomaterial foram essenciais para o sucesso do tratamento regenerativo dos defeitos da peri-implantite. A análise de todos os biomateriais utilizados no tratamento cirúrgico regenerativo mostrou que os enxertos ósseos bovinos proporcionaram resultados superiores em termos de neoformação óssea em comparação com os enxertos autógenos e hidroxiapatita nanocristalina. É importante notar que os grânulos de titânio poroso surgiram como um biomaterial promissor para o tratamento regenerativo da peri-implantite. Em conclusão, os biomateriais são promissores para o tratamento de defeitos ósseos peri-implantares e espera-se que aumente no futuro próximo o número de biomateriais in silico que podem proporcionar tratamento de excelência a pacientes com esta patologia.

Rehabilitation of the partially edentulous anterior maxilla is considered one of the most difficult challenges for the restorative dentist due to the esthetic, functional and psychological implications. Implant-supported restorations provide an appealing treatment alternative that responds to today’s patient expectations. The gold standard for this scenario has been the use of an implant-supported fixed partial denture with pontics that masks the soft tissue deficiencies, with acceptable esthetic results. However, nowadays patients are looking for individual single crowns since they believe that this type of restorations resemble the natural dentition, are easy to clean and floss. From the dentist perspective, they are easy to maintain and in case of prosthetic complications they can be repaired or changed without compromising the adjacent restorations. Three parameters have been identified that could guide the decision-making process when multiple adjacent implant supported restorations (MAISR) are selected as the treatment of choice: 1) Smile line 2) Inter-implant distance and tooth-implant distance 3) Patient's expectations and ability to clean.

Background: Early peri-implant bone loss has been associated to long-term implant-prosthetic failure. Different technical, surgical, and prosthetic techniques have been introduced to enhance the clinical outcome of dental implants in terms of crestal bone preservation. The aim of the present cohort study was to observe the mean marginal bone level around two-part implants with gingivally tapered abutments one year after loading. Methods: Mean marginal bone levels and change were computed following radiological calibration and linear measurement on standardized radiographs. Results: Twenty patients who met the inclusion criterion of having at least one implant with the tapered prosthetic connection were included in the study. The cumulative implant success rate was 100%, the average bone loss was &minus, 0.18 &plusmn, 0.72 mm, with the final bone level sitting above the implant platform most of the time (+1.16 &plusmn, 0.91 mm). Conclusion: The results of this cohort study suggested that implants with tapered abutments perform successfully one year after loading and that they are associated with excellent marginal bone preservation, thus suggesting that implant-connection macro-geometry might have a crucial role in dictating peri-implant bone levels.

Background One of the greatest challenges that dentists face today is to rehabilitate severe atrophied alveolar ridges in partially and completely edentulous patients with implants. Despite the high survival rate of implants placed next to sinus elevation, this technique presents complications that can be avoided by placing short implants, an option that also presents high survival rates. For this reason, the aim of this study is to compare the survival rate, marginal bone loss and complications associated with short implants (

espanolLa planificacion preoperatoria de la posicion de los implantes constituye una parte importante de la coordinacion quirurgica y prostodoncica que se ha ido incrementando para conseguir resultados funcionales y esteticos. La cirugia guiada de implantes ha aumentado su popularidad, particularmente debido a los avances y a la utilizacion de la tomografia computarizada de haz conico (CBCT) y a la planificacion del tratamiento con implantes mediante programas informaticos 3D que valoran la localizacion del implante. De hecho, los pacientes edentulos pueden ser diagnosticados con una CBCT y tratados con varios implantes por cirugia guiada y carga inmediata. La CBCT constituye un metodo no invasivo para describir las estructuras maxilofaciales evaluando la cantidad y calidad osea de los rebordes alveolares. La incorporacion de softwares especificos de implantologia guiada puede mejorar la planificacion virtual de la cirugia sin colgajo y los resultados de los implantes colocados con una ferula quirurgica guiada. En muchos casos, la carga inmediata optimiza el exito de la tecnica de cirugia guiada con muchos beneficios como la reduccion del tiempo del tratamiento y el confort del paciente. EnglishPreoperative planning of the implant position as part of a coordinated prosthetic and surgical concept is becoming increasingly important regarding function and esthetics. Guided implant surgery is increasing in popularity, particularly due to advances and increased usage of cone beam computed tomography ( CBCT) and dental implant treatment planning software allowing three-dimensional assessment of the implant site. In fact, edentulous patients can be diagnosed by a CBCT and treated with severa! implants for rehabilitation with guided surgery and immediate loading. The CBCT provides a noninvasive method to describe maxillofacial structures and assess bone volume and density of alveolar ridges. The introduction of specific softwares of guided implant dentistry can improve the virtual planning of flapless surgery and outcomes of dental implant placed in edentulous alveolar ridges by template guided surgery. In many cases, the immediate-loading protocol maximises the sucess of the guided surgery techniques with many benefits, such as short time and maximum patient comfort.

Purpose: The purpose of this prospective study is to evaluate the relationship between implant diameter, and primary and secondary stability. Materials and methods: Five hundred fifty-nine implants with diameters of 3.7, 4.0, and 4.3 mm and lengths of 10 and 11.5 mm were placed in 195 patients. The resonance frequency was measured during surgery and at 3, 6, and 12 months. Results: Related average implant stability quotient (ISQ) values were 69.62 for 3.7-mm implants, 72.02 for 4.0-mm implants, and 69.67 for 4.3-mm implants. Values in men were greater than values in women. Values were greater for the mandible than for the maxilla. There are significant differences between 4.0-mm implants, and 3.7 anterior maxilla and 4.3 posterior maxilla. Conclusions: There is no relationship between increased ISQ values and increased diameters. We observed a preference regarding sex, with men having significantly greater values for 3.7- and 4.3-mm diameters. The mandible obtained the greatest ISQ values, with significant differences for diameters 3.7 and 4.3 mm. Sin financiación 1.452 JCR (2019) Q3, 64/91 Dentistry, Oral Surgery & Medicine 0.743 SJR (2019) Q2, 17/49 Oral Surgery No data IDR 2019 UEM

Extensive treatments can eventually be challenging. Even more so when the patient has limitations such as extensive tooth loss and skeletal changes, including overgrowth of the lower jaw. When indicated, these treatments tend to discourage patients due to the history of previous failures. Therefore, in addition to an interdisciplinary dental team composed of oral and maxillofacial surgeons, and prosthodontists, a nutrologist, a speech therapist, and a psychotherapist were involved in the treatment of this case. A 52-year-old female patient, Angle Class III malocclusion, with few teeth and extensive maxillary bone loss, attended the dental clinic of the Brazilian Association of Dentistry in Uberlândia. The treatment involved reverse planning, extraction of the dental remnants, calvarial bone grafting, placement of 6 titanium implants (Neodent) in the maxilla (upper jaw) and 5 in the mandible (lower jaw), orthognathic surgery, and installation of implant-supported fixed complete dentures in both jaws. Furthermore, psychotherapeutic and nutrologist’s interventions were necessary during the dental treatment, concluding the treatment with speech therapy. Within the limitations of this case, the multidisciplinary approach proved to be efficient. It promoted the reestablishment of the stomatognathic system functions without compromising nutrition during the periods when it was impossible to wear prostheses for better healing of the tissues. Los tratamientos extensos pueden eventualmente ser un desafío. Más aún cuando el paciente tiene limitaciones como la pérdida extensa de dientes y cambios esqueléticos como el crecimiento excesivo de la mandíbula o el maxilar. Estos tratamientos tienden a desanimar a los pacientes debido a la historia de fracaso que a veces los acompaña. Entonces, además de un equipo odontológico interdisciplinario compuesto por cirujanos y prostodoncistas, en el tratamiento de este caso participaron un médico especialista en nutrición, logopeda y psicólogo. Una paciente de 52 años, Clase III de Angle, con pocos dientes y pérdida extensa de hueso maxilar acudió a la clínica de la Asociación Dental Brasileña - Regional Uberlândia. El tratamiento odontológico realizado consistió en planificación inversa, extracción de los remanentes, injerto de calota creaneal, instalación de 6 implantes de titanio (Neodent) en maxilar y 5 en mandíbula, cirugía ortognática e instalación de prótesis totales implantosoportadas maxilar y mandibular. Además, durante el tratamiento odontológico fue necesario un seguimiento psicoterapéutico y médico especialista en nutrición, finalizando con un logopeda. Dentro de las limitaciones de este caso, el enfoque multidisciplinario resultó ser eficaz. Promovió el retorno de las funciones del aparato estomatognático sin comprometer la nutrición durante los períodos en los que no era posible utilizar prótesis para una mejor cicatrización de los tejidos. Tratamentos extensos podem ser eventualmente desafiadores. Ainda mais quando o paciente possui limitações como extensa perda dentária e alterações esqueléticas como crescimento excessivo da mandíbula ou maxila. Tratamentos assim tendem a desanimar pacientes pelo histórico de insucesso que as vezes o acompanha. Então, além de uma equipe interdisciplinar odontológica composta por cirurgiões e protesístas, nutrólogo, fonoaudiólogo e psicólogo foram envolvidos no tratamento deste caso. Paciente com 52 anos, gênero feminino, Classe III de Angle, portadora de poucos dentes e extensa perda óssea maxilar compareceu a clínica da Associação Brasileira de Odontologia – Regional Uberlândia. O tratamento odontológico realizado envolveu planejamento reverso, extração dos remanescentes, enxerto de calota craniana, instalação de 6 implantes de titânio (Neodent) na maxila e 5 na mandíbula, cirurgia ortognática e instalação de próteses totais implantossuportatas superior e inferior. Além disso, durante o tratamento odontológico, acompanhamento psicoterapêutico e nutrólogo se fizeram necessário, finalizando com fonoaudiólogo. Dentro das limitações desse caso, a abordagem multidisciplinar se mostrou eficiente. Promoveu devolução das funções do aparelho estomatognático sem comprometer a nutrição durante os períodos em que não foi possível o uso de próteses para melhor cicatrização dos tecidos.

The present study aimed to evaluate the peri-implantar bone healing in the presence of genistein treatment in ovariectomized rats. Thirty female rats with 4 months old were divided into 3 groups according to the experimental condition and the drug treatment: SHAM (rats submitted to the fictional surgery and gavage with 0.9% saline solution); OVX (rats submitted to bilateral ovariectomy and gavage with 0.9% saline solution); OVX GEN (rats submitted to bilateral ovariectomy and gavage with 1mg/day of genistein). 60 implants were installed, with two implants in each animal. The calcified group was subjected microcomputerized tomography and the parameters analysed was bone volume per tissue volume (BV/TV) and connective density (Cnn.Dn). The decalcified samples were evaluated through immunolabeling analysis, in order to detect the presence of RUNX2, Alkaline Phosphatase, Osteocalcin, Osteopontin and TRAP. All the quantitative data were submitted to the normality curve to determine the most adequate test. The significance level of p

Dental implant fixation techniques are widely studied in order to reduce surgical morbidity. Computer-guided flapless surgery has been considered an efficient alternative that presents several advantages and some limitations. This technique allows the virtual planning and simulation of the prosthetic-surgical treatment that can help predict the difficulties and limitations in order to reduce possible errors. In addition to the prosthetic predictability, computer-guided surgery enhances accuracy and reduces surgical morbidity. Thus, the aim of this study was to report on a 7-year follow-up of immediately loaded implants inserted into an edentulous maxilla using virtual planning and flapless surgery.

Purpose: To evaluate the survival rates of titanium dental implants placed using split crest procedures for alveolar ridge expansion. Materials and Methods: The MEDLINE, CENTRAL, and OpenGrey databases were searched up to January 2015 for studies assessing implants that had been placed in areas submitted to split crest procedures. Two methodologic quality-assessment tools were used based on the type of study. For randomized controlled trials (RCTs), the Cochrane Collaboration tool was used to assess the risk of bias. For the observational studies, an adapted version of the Newcastle-Ottawa scale was used. Results: A total of 1,178 patients received 3,033 implants with ridge expansion. On average, the success rate was 96.6% and the survival rate was 96.8%, with a mean follow-up of 58.3 months. Six of the nine included studies used a bone substitute associated or not with a membrane, and seven studies used an implant in both the maxilla and mandible. In addition, half of the observational studies were considered to be of medium quality, whereas the others were considered to be of low quality; the sole RCT included was classified as having a high risk of bias. Conclusion: The use of split crest techniques appears to provide predictable alveolar ridge augmentation as well as high survival rates in the short and long term for implants placed in the maxilla or mandible. Patients must be selected with caution.

The purpose of this case report / case series was to analyze the pattern of alveolar bone repair after extraction with the use of a collagen membrane associated or not with lyophilized bovine bone (Bio-Oss). The sample consisted of six adult patients, aged from 40 to 60 years, with indication of extraction of the upper incisors and subsequent rehabilitation with dental implants, three participants were randomly distributed in the following groups: Test - Bio-Oss associated with collagen membrane absorbable; Control - blood clot associated with an absorbable collagen membrane. Alveoli with significant bone loss, probe greater than 4 mm, uncontrolled systemic changes and smoker were excluded. The less traumatic extractions, followed by anti-inflammatory and antibiotic protocol. Computed tomography images from the preoperative time (T0) and after 4 months (T1) were used to measure bone filling. The data were compared using the T test, considering a 5% significance level. Less resorption was observed in the test group (p = 0.002). The technique of preserving the alveolar ridge with Bio-Oss and absorbable membrane was satisfactory to prevent changes in the contour of the tissue. El propósito de este reporte de caso / serie de casos fue analizar el patrón de reparación del hueso alveolar después de la extracción mediante membrana de colágeno asociada o no con hueso bovino liofilizado (Bio-Oss). La muestra estuvo constituida por seis pacientes adultos, con edades de 40 a 60 años, con indicación de extracción de los incisivos superiores y posterior rehabilitación con implantes dentales, tres participantes fueron distribuidos en cada grupo aleatoriamente siendo ellos: Test - Bio-Oss asociado a membrana de colágeno absorbible; Control - coágulo de sangre asociado con una membrana de colágeno absorbible. Se excluyeron los alvéolos con pérdida ósea significativa, con sondaje mayor de 4 mm, alteraciones sistémicas no controladas y fumador. Las extracciones fueron poco traumáticas, seguidas de protocolo con antiinflamatorio y antibiótico. Se utilizaron imágenes de tomografía computarizada del tiempo preoperatorio (T0) y a los 4 meses (T1) para medir la formación ósea. Los datos se compararon mediante la prueba T, considerando un nivel de significancia del 5%. Se observó una menor reabsorción en el grupo de prueba (p = 0,002). La técnica de preservación del reborde alveolar con Bio-Oss y membrana absorbible fue satisfactoria para evitar cambios en el contorno del tejido. O objetivo desse relato de caso/série de casos foi analisar o padrão de reparo ósseo alveolar após extração com uso de membrana de colágeno associada ou não ao osso bovino liofilizado (Bio-Oss). A amostra foi composta por seis pacientes adultos, com idade variando de 40 a 60 anos, com indicação de extração dos incisivos superiores e posterior reabilitação com implantes dentários, foram distribuídos três participantes aleatoriamente nos seguintes grupos: Teste - Bio-Oss associado a membrana de colágeno absorvível; Controle - coágulo de sangue associado a uma membrana de colágeno absorvível. Excluídos alvéolos com perdas ósseas significativas, sondagem maior de 4mm, alterações sistêmicas não controladas e tabagista. As extrações foram pouco traumáticas, seguida por protocolo de antiinflamatórios e antibióticos. Imagens de tomografia computadorizada do tempo pré-operatório (T0) e após 4 meses (T1) foram utilizadas para mensurar o enchimento ósseo. Os dados foram comparados pelo teste T, considerando 5% de significância. Menor reabsorção foi observada no grupo teste (p = 0,002). A técnica de preservação do rebordo alveolar com Bio-Oss e membrana absorvível foi satisfatória para prevenir alterações no contorno do tecido.

Avulsion of a permanent tooth is a serious condition and a true dental emergency that can be associated with other traumatic injuries. In addition, in reimplanted avulsed teeth, ankylosis and external replacement resorption (ERR) are two typical biological responses, with long-term progression and outcome associated with the patient's growth stage. The purpose of this report is to present the long-term outcome of an 18-year-old patient who was the victim of a motor vehicle traffic accident that resulted in traumatic injury to the maxillary incisors, including an avulsed central incisor with extensive external replacement resorption (tooth 11). Twenty-two years later, due to the continuous effect of the ERR process on the reimplanted tooth and favorable bone weight, it was decided to perform rehabilitation with immediate guided implant by a simplified method (KEA-TECH system). In young patients, the decision to maintain the tooth even under unfavorable conditions may delay rehabilitation with implants. La avulsión de los dientes permanentes es una afección grave y una verdadera emergencia dental que puede estar asociada con otras lesiones traumáticas. Además, en los dientes avulsionados reimplantados, la anquilosis y la reabsorción radicular externa por sustitución (RES) son dos respuestas biológicas típicas, con progresión a largo plazo y resultados asociados con la etapa de crecimiento del paciente. Este informe de caso describe el resultado a largo plazo de un paciente de 18 años que fue víctima de un accidente automovilístico que resultó en una lesión traumática en los incisivos superiores, incluido un incisivo central avulsionado con RES extenso (diente 11). A los 22 años, debido al efecto continuo del proceso RES del diente reimplantado, se realizó la extracción del elemento dental, seguida de la rehabilitación inmediata con implantación mediante cirugía guiada mediante un método simplificado (sistema KEA-TECH). Se concluye que en pacientes jóvenes, la decisión de mantener el diente incluso en condiciones desfavorables, puede posponer la rehabilitación con implantes. A avulsão de dentes permanentes é uma séria condição e uma verdadeira emergência odontológica que pode estar associada à outras injúrias traumáticas. Além disso, em dentes avulsionados reimplantados, anquilose e reabsorção radicular externa por substituição (RES) são duas respostas biológicas típicas, com progressão e desfecho a longo prazo associados ao estágio de crescimento do paciente. Esse relato de caso descreve o desfecho à longo prazo de um paciente de 18 anos de idade, que foi vítima de um acidente de automobilístico que resultou na injúria traumática dos incisivos superiores, incluindo um incisivo central avulsionado com extensa RES (dente 11). Após 22 anos, devido ao efeito contínuo do processo de RES do dente reimplantado, realizou-se a extração do elemento dental, seguido pela reabilitação imediata com implante por meio de cirurgia guiada através de um método simplificado (sistema KEA-TECH). Conclui-se que em pacientes jovens, a decisão de manter o dente mesmo em condições desfavoráveis, pode postergar a reabilitação com implantes.

Comminuted jaw fractures represent a challenge in terms of treatment. The advancement of fixation techniques and materials has contributed to the surgeon providing faster treatment and less complication. Even so, cases that present severe mandibular fragmentation require additional therapies, such as the use of bone grafts and dental implants, in order to recover function, aesthetics and anatomy of the mandible. This work aims to report a case of comminuted mandibular body fracture, which was treated with reconstruction, initially by rigid internal fixation, and secondly, by iliac bone graft and implant-supported oral rehabilitation. Although studies in the literature demonstrate that autogenous grafts show significant resorption, they are still considered the gold standard, and allow an ideal basis for obtaining osseointegration of dental implants. Thus, we concluded that the use of the autogenous bone graft coming from the iliac crest and rehabilitation with implants can be a satisfactory option for functional and aesthetic repair of patients who presented high impact fractures, and developed significant bone defects. Las fracturas conminutas de la mandíbula representan un desafío clínico. El avance de las técnicas y materiales de fijación ha contribuido a que el cirujano proporcione un tratamiento más rápido y menos complicaciones. Aun así, los casos que presentan una severa fragmentación mandibular requieren terapias adicionales, como el uso de injertos óseos e implantes dentales, para recuperar la función, estética y anatomía de la mandíbula. Este estudio tiene como objetivo reportar un caso de fractura conminuta del cuerpo mandibular, que fue tratado con reconstrucción, inicialmente mediante fijación interna rígida y, posteriormente, mediante injerto de cresta ilíaca y rehabilitación oral implantosoportada. Aunque los estudios en la literatura demuestran que los injertos autógenos muestran una reabsorción significativa, todavía se consideran el estándar de oro y permiten una base ideal para obtener la osteointegración de los implantes dentales. Concluimos de esta manera que el uso de injerto óseo autógeno de cresta ilíaca y la rehabilitación con implantes puede ser una opción satisfactoria para la reparación funcional y estética de pacientes que presentaron fracturas de alto impacto y desarrollaron importantes defectos óseos. As fraturas cominutivas da mandíbula representam um desafio clínico. O avanço das técnicas e materiais de fixação tem contribuído para que o cirurgião proporcione um tratamento mais rápido e com menos complicações. Ainda assim, casos que apresentam fragmentação mandibular severa requerem terapias adicionais, como o uso de enxertos ósseos e implantes dentários, a fim de recuperar a função, estética e anatomia da mandíbula. Este trabalho tem como objetivo relatar um caso de fratura cominutiva do corpo mandibular, que foi tratada com reconstrução, inicialmente por fixação interna rígida e, posteriormente, por enxerto de crista ilíaca e reabilitação oral implantossuportada. Embora estudos na literatura demonstrem que enxertos autógenos apresentam reabsorção significativa, eles ainda são considerados padrão-ouro, e permitem uma base ideal para a obtenção da osseointegração de implantes dentários. Concluímos desta forma que a utilização de enxerto ósseo autógeno proveniente da crista ilíaca e a reabilitação com implantes pode ser uma opção satisfatória para a reparação funcional e estética de pacientes que apresentaram fraturas de alto impacto e desenvolveram defeitos ósseos importantes.

Statement of the problem: Most of the clinical documentation of implant success and survival published in the literature have been issued by either experienced teams from university settings involving strict patient selection criteria or from seasoned private practitioners. By contrast, studies focusing on implants placed and rehabilitated by inexperienced post-graduate students are scarce. Purpose: To record failure rates and identify the contributing factors to implant failure and marginal bone loss (MBL) of implants placed and rehabilitated by inexperienced post-graduate students at the one-year follow-up. Material and Methods: A prospective cohort study was conducted on study participants scheduled for implant therapy at the International University of Catalonia. An experienced mentor determined the treatment plan in accordance with the need of each participant who signed an informed consent. All surgeries and prosthetic rehabilitation were performed by the post-graduate students. Implant failure rate, contributors to implant failure, and MBL were investigated among 24 variables related to patient health, local site, and implant and prosthetic characteristics. The risk of implant failure was analyzed with a simple binary logistic regression model with generalized equation equations (GEE) models, obtaining unadjusted odds ratios (OR). The relationship between MBL and the other independent variables was studied by simple linear regression estimated with GEE models and the Wald chi2 test. Results: One hundred and thirty dental implants have been placed and rehabilitated by post-graduate students. Five implants failed before loading and none after restoration delivery, survival and success rates were 96.15% and 94.62%, respectively. None of the investigated variables significantly affected the implant survival rate. At the one-year follow-up, the mean (SD) MBL was 0.53 (0.39) mm. The following independent variables significantly affected the MBL: Diabetes, implant depth placement. The width of keratinized tissue (KT) and probing depth (PD) above 3 mm were found to be good indicators of MBL, with each additional mm of probing depth resulting in 0.11 mm more MBL. Conclusion: The survival and success rates of dental implants placed and rehabilitated by inexperienced post-graduate students at the one-year follow-up were high. No contributing factor was identified regarding implant failure. However, several factors significantly affected MBL: Diabetes, implant depth placement, PD, and width of KT. Clinical Implications: Survival and success rates of dental implants placed and rehabilitated by inexperienced post-graduate students were high at the one-year follow-up, similar to experienced practitioners. No contributing factors were identified regarding implant failure, however, several factors significantly affected MBL: Diabetes, implant depth placement, PD, and KM.

The present study aimed to compare the conventional scalpel technique and the use of a high-power diode laser for second-stage implant surgery. For that, fifteen patients were randomly assigned to receive either the conventional scalpel technique (Control Group, n = 7) or a diode laser-assisted technique (Laser Group, n = 8) for second-stage surgery of submerged dental implants placed at bone level. The local anesthetic amount required, and the total surgical time was determined just after surgery. Local pain, peri-implant mucosa status, and bleeding were assessed at the end of the surgery and after 7 and 15 days. Information on the need for postoperative pain medication on the first day and during the next two weeks was also gathered. The surgical time was significantly shorter in the Laser Group (P = 0.001) and only the Control Group presented bleeding at the end of surgery and on the seventh day (P =

La pérdida de piezas dentales trae como consecuencia el colapso a nivel de su tejido de soporte circundante, lo que desarrolla una deformidad del reborde. Asimismo los tejidos blandos sufren modificaciones en su estructura que en muchos casos podrían resultar complicadas de restablecer. Cuando se realiza la planificación de cirugía de implantes, no solo debemos enfocarnos en sustituir las piezas dentarias propiamente dichas también debemos lograr un resultado estético y funcional, que en la medida de lo posible se asemeje mucho a la anatomía natural del diente. La conformación de papilas y manejo de tejido blando periimplantario es un desafío que en la actualidad tiene diversas alternativas de tratamiento. El objetivo de este artículo es proporcionar una técnica alternativa para la conformación del perfil de emergencia en prótesis con soporte de implantes en las que se utilizará el método de compresión, mediante el uso de un tornillo de cicatrización personalizado con adición de resina para conformar el tejido periimplantario de los dientes posteriores. Tooth losing results in a collapse of their supporting tissues, which develops a ridge deformity. Soft tissues also undergo modifications in their structure, which in many cases could be difficult to restore. When implant surgery planning is carried out, we should not only we focus on replacing the dental pieces themselves, but we should also achieve an aesthetic and functional result that, to the extent possible, closely resembles the natural tooth anatomy. The papillae conformation and the peri-implant soft tissue management is a challenge that currently has several treatment alternatives. The aim of this article is to provide an alternative technique for emergency profile conformation on implant-supported prostheses in which the compression method will be used, by using a customized healing screw with resin addition in order to conform the posterior teeth peri-implantar tissue.

Introducción: La interfase implante-pilar da lugar a la formación de un espacio, cuyo tamaño varía de acuerdo a variables como las tolerancias de maquinado, los micro-movimientos, el tipo de fabricación de los aditamentos protésicos y el material de los mismos. Este espacio, en cercanía a los tejidos peri-implantares, es una oportunidad para la movilización de microorganismos de forma bidireccional, desencadenando eventualmente respuesta tisular. Objetivo: comparar la filtración de Echerichia coli (E. coli) en la interfase de implantes de conexión interna con pilares prefabricados y personalizados. Materiales y métodos: nueve implantes (Osseotite® Tapered Certain®, 3i Biomet) fueron divididos en tres grupos basados en el tipo de pilar utilizado. Grupo 1 pilares prefabricados Provide®, grupo 2 pilares personalizados Encode® Titanio, grupo 3 pilares personalizados Encode® Zirconia. Los pilares fueron conectados a los implantes y fueron ciclados según la norma ISO 14801:2007 (250.000 ciclos) en un dispositivo de carga dinámica. Fueron sumergidos en caldo infusión cerebro corazón (BHI) inoculado con E. coli. Se tomaron muestras y se midió la turbidez del medio. Se realizó test ANOVA para comparar el tamaño de la interfase implante-pilar. Resultados: se encontró que todas las muestras filtraron en diferentes proporciones. Conclusiones: todas las muestras mostraron filtración de E. coli. Background: the implant-abutment interface leads to the formation of a space whose size varies according to different variables such as machining tolerances, micro-movements, the type of fabrication of prosthetic devices and the fabrication material. This space in close proximity to the peri-implant tissues is an opportunity for the colonization of microorganism bidirectionally, eventually triggering tissue response. Objective: to compare the filtration of Echerichia coli (E. coli) in the interface of implants of internal connection with prefabricated and customized abutments. Materials and methods: nine implants (Osseotite® Tapered Certain®, 3i Biomet) were divided into three groups based on the type of abutment used. Group 1 prefabricated abutment Provide®, Group 2 customized abutment Encode® Titanium, Group 3 customized abutment Encode® Zirconia. The implants were connected to the abutments and cycled according to ISO 14801:2007 norm (250,000 cycles) in a dynamic loading device. They were immersed in brain heart infusion (BHI) medium inoculated with E. coli. Samples were taken and the turbidity of the medium was measured. An ANOVA test was performed to compare the size of the implant-abutment interface. Results: All samples were found to be colonized in different proportions. Conclusions: All samples showed E. coli colonization.

a b s t r a c t Sinus augmentation is a preprosthetic technique for rehabilitating posterior sector of the atrophied maxilla with implant-supported prosthesis. We retrospectively analyzed 34 consecutive sinus augmentations performed using only bovine hydroxyapatite. The presurgical height in 92% of the cases was 4 mm or less. The success rate of the maxillary sinus augmentation was 100% for this technique. 13.4% of the implants were placed immediately with a success rate of implants placement of 93.9%. The non-osseointegrated implants were all successfully replaced. Follow-up period was 1268 days. The success rate obtained using bovine hydroxyapatite alone is similar to that using other types of materials, while avoids morbidity of the autologous bone donor area.

Oral lichen planus is associated with the Koebner phenomenon, and trauma may exacerbate oral lesions. Short dental implants, as alternatives to bony augmentation, would reduce the number of interventions and their morbidity. However, we know of no studies that have analysed the long-term outcomes of short implants in patients with oral lichen planus. We have therefore designed a retrospective study of such patients treated with short implants (≤ 8.5 mm long), with survival of implants as the main outcome. The secondary outcomes were marginal bone loss and the development of complications. We calculated the implants’ survival and compared the outcomes statistically between erosive and reticular oral lichen planus. Sixty-six short implants were placed in 23 patients with a mean (SD) age of 58 (7) years. The mean (SD) peri-implant bone loss was 0.96 (0.89) mm mesially and 0.99 (1.1) mm distally. Sixty-five of the 66 implants survived with a mean (SD) follow-up of 68 (32) months, and there were no significant differences between erosive and reticular disease. Stable long-term outcomes can be expected for short implants placed in patients with oral lichen planus, and graftless rehabilitation of missing teeth could be possible in these patients if short implants were used. Sin financiación 1.164 JCR (2018) Q3, 152/203 Surgery; Q4, 72/91 Dentistry, Oral Surgery & Medicine 0.618 SJR (2018) Q2, 22/50 Oral Surgery, 40/113 Otorhinolaryngology, 154/448 Surgery No data IDR 2018 UEM

Uno de los desafíos de la Odontología es la rehabilitación oral de los pacientes totalmente edéntulos con maxilares atróficos. Este caso clínico reporta un protocolo de tratamiento implantológico realizado en una paciente adulto mayor con maxilares edéntulos totales y con atrofia avanzada, en la cual se realizó una rehabilitación implanto-soportada e implanto-retenida consistente en una prótesis híbrida superior apoyada en seis implantes y una sobredentadura inferior retenida por una barra fija conectada a cuatro implantes, con un seguimiento total de un año, sin reportar complicaciones. Este caso nos otorga una evidencia de un protocolo implantológico y rehabilitador para pacientes con atrofias severas mejorando así la poca retención y estabilidad que presentan las prótesis convencionales en maxilares atróficos, además de mostrar los beneficios en cuanto a eficacia masticatoria y mejor calidad de vida en pacientes con este diagnóstico., One of the challenges of dentistry is oral rehabilitation in totally edentulous patients with atrophic jaws. This case reports a protocol for implant treatment performed in elderly patient with an edentulous jaws and advanced atrophy, in which an implant-retained implant-supported and consistent rehabilitation was conducted in a superior hybrid prosthesis supported by 6 implants and on lower denture retained by a horizontal bar attached to 4 implants, with a total follow-up of 1 year, without reporting complications. This case gives us evidence of an implant and rehabilitation protocol for patients with severe atrophy thus improving poor retention and stability posed by conventional prostheses in atrophic jaws, and show the benefits in terms of masticatory efficiency and better quality of life for patients with this diagnosis.

Ameloblastoma is a rare tumor that affects the maxillomandibular region. Surgical resection is often indicated, and oral rehabilitation becomes a challenge. This study aims to report on the mandibular rehabilitation with implant supported prosthesis using immediate loading with subsequent resection. A patient with a confirmed diagnosis of multicystic ameloblastoma in the left jaw underwent a partial resection of the mandible and a reconstruction with a titanium plate. After 2 years of follow-up with clinical examinations and imaging testing and with no signs of recurrence, the patient underwent the technique of immediate load implants, rehabilitating the mandible with an implant supported fixed prosthesis and the maxilla with a conventional complete denture. During the seven years of follow-up with the patient, there was no sign of recurrence of ameloblastoma. The rehabilitation with oral implants under immediate loading demonstrated to be successful, and the cemented cylinder technique used in this study coupled with passivity showed a favorable prognosis for the longevity of implants.

Objectives: The aim of this study is to evaluate the effectiveness of gel topical anaesthesia in second surgeries of dental implants according to the different treated areas of the oral cavity, as well as the type of oral mucosa in which is effective. Material and methods: Thirteen partially and completely edentulous patients with 30 implants in total were included in the study. The oral mucosa was dried and the anesthetic gel (Benzocaine 20%) was applied with a cotton roll for 2 minutes. The effectiveness was evaluated with an exploratory probe. Those implants whose cover screw was not submerged in a depth higher than 2-4 mm were selected. In the event of the gel topical anaesthesia not being effective, reinforcement with conventional infi ltrative anaesthesia was made. Pain was measured with Visual Analogue Scales (VAS), and the gum thickness with periodontal probe. A one-way Anova and a Pearson correlation were used to perform the statistical analysis (p≤0.05). Results: The 66.67% of the sample needed reinforcement through conventional anesthetic infi ltration. No statistically signifi cant differences were found in the comparison of pain with different gum thickness (p=0.59), although a higher feeling of pain was actually observed in those patients who were firstly subjected to a second-stage surgery (p=0.0335). Conclusion: The use of gel topical anaesthesia cannot be considered as the sole treatment to eliminate the feeling of pain, but as a coadjuvant to infi ltrative anesthesia. No signifi cant differences have been found between the different treated areas of the oral cavity, nor in the thickness or type of oral mucosa. info:eu-repo/semantics/publishedVersion

The objective of the study is to characterise the mechanical properties of Ti-15Zr binary alloy dental implants and to describe their biomechanical behaviour as well as their osseointegration capacity compared with the conventional Ti-6Al-4V (TAV) alloy implants. The mechanical properties of Ti-15Zr binary alloy were characterised using Roxolid© implants (Straumann, Basel, Switzerland) via ultrasound. Their biomechanical behaviour was described via finite element analysis. Their osseointegration capacity was compared via an in vivo study performed on 12 adult rabbits. Young’s modulus of the Roxolid© implant was around 103 GPa, and the Poisson coefficient was around 0.33. There were no significant differences in terms of Von Mises stress values at the implant and bone level between both alloys. Regarding deformation, the highest value was observed for Ti-15Zr implant, and the lowest value was observed for the cortical bone surrounding TAV implant, with no deformation differences at the bone level between both alloys. Histological analysis of the implants inserted in rabbits demonstrated higher BIC percentage for Ti-15Zr implants at 3 and 6 weeks. Ti-15Zr alloy showed elastic properties and biomechanical behaviours similar to TAV alloy, although Ti-15Zr implant had a greater BIC percentage after 3 and 6 weeks of osseointegration.

Background An evaluation is made of possible differences in treatment effects between labial and lingual fixed appliances. Methods A comprehensive search was made of the PubMed-Medline, Cochrane Library and LILACS databases, with an additional manual search covering the period up until April 2017. There were no restrictions in terms of year of publication or language. Agreement between the authors was quantified by the Cohen kappa statistic. A random-effect model was applied to calculate weighted mean differences with 95% confidence intervals. Results A total of 249 patients corresponding to four eligible studies were included in the systematic review. Among the six angles and distances entered in the meta-analysis, a tendency was observed in lingual appliances to increase the interincisal angle (95% CI −0.80-8.99; p = 0.101) and reduce the angle between the major axis of upper central incisor and the sellar-nasion plane - though statistical significance was not reached (95% CI −5.75-0.32; p = 0.079). Conclusion The results obtained indicate that treatment with lingual appliances favors incisor tipping by exerting lingual crown torque, but there are no differences in cephalometric values between labial and lingual fixed appliances. Because of the small number of included studies, the results of this meta-analysis should be interpreted with caution. Future research should focus on the generation of a consensus document allowing selection of the type of orthodontic approach not only conditioned to the esthetic requirements of the patient but also considering the characteristics of the malocclusion. On the other hand, standardized international guidelines are lacking; the measurements of angles and distances therefore have to be unified with a view to future investigations. Sin financiación 1.769 JCR (2017) Q2, 45/91 Dentistry, Oral Surgery & Medicine UEM

Recently, components of the extracellular cellular matrix have been assessed to enhance the biological response to dental implants. This study aims to assess the effect of surface modification with calcium ions on the early marginal bone loss of dental implants placed in a transalveolarly augmented maxillary sinus. Methods A retrospective study of transalveolar sinus floor augmentation was conducted in a single private dental clinic. The predictor variable was the surface of the dental implant. The primary outcome was the marginal bone loss. The secondary outcomes were the intraoperative complications and the dental implant failure. Descriptive analysis was performed for patients’ demographic data and implant details. Results Fifty-one patients with a mean age of 58 ± 11 years had a mean follow-up time of 13 months. Thirty-four dental implants had a Ca2+-modified hydrophilic surface, and 31 had no Ca2 (control). The experimental group showed a statistically significant lower marginal bone loss (0.36 ± 0.42 vs 0.61 ± 0.39 mm). However, there were no statistically significant differences in the implant survival. No implant failed in the experimental group while two implants failed in the control group. Conclusions The modification of an acid-etched surface with calcium ions seems to reduce the marginal bone remodeling around the dental implants, placed after transalveolar sinus floor elevation. Sin financiación No data (2017) UEM