Search

Purpose To evaluate time-dependent administration of ibuprofen in a lower third molar extraction model. Methods Eleven patients requiring bilateral surgical removal of lower third molars were recruited and randomized into a blinded crossover randomized controlled trial. For 3 days after surgery, the control group was prescribed ibuprofen 400 mg every 8 h. On the other hand, the experimental group received also ibuprofen 400 mg at breakfast and lunch, replacing the dinner intake with a placebo. Pain measurements (Visual Analog Scale from 0 to 10) were recorded at baseline, 24, 48, and 72 h postoperatively. Facial swelling and trismus were also measured at baseline, 24, and 72 h postoperatively. Results Postoperative swelling and pain perception did not show significative difference between the control and experimental groups at 24, 48, and 72 h. Trismus was significantly lower in the control group than in the experimental group at 72 h postoperatively (p = 0.008). Rescue medication consumption seemed to be comparable between groups. Conclusion Eliminating night time ibuprofen might be insignificant for pain control after third molar extraction.

Introduction Surgical inferior alveolar nerve (IAN) reposition techniques offer an alternative approach to implant-based rehabilitation in patients with severe mandibular atrophy The aim of this systematic review, was to determine the complications associated with the technique and to determine which of two variants (lateralization or transposition) is less invasive. Materials and methods An electronic search was conducted in databases complimented by a manual search to identify clinical studies investigating complications derived from these surgical techniques. Only studies of adult humans, published in English during the last seven years were included. The initial search located 78 articles, of which seven were included in analysis on the basis of the following characteristics: four investigated inferior alveolar nerve lateralization (IANL), one inferior alveolar nerve transposition (IANT), and two investigated both reposition techniques. Results This review included data from 289 patients who were recruited for lateralization (N = 319) or transposition surgery (N = 33) making a total of 352 reposition procedures. Five patients (1.73%) suffered persistent damage to the IAN at the end of the follow-up periods. The overall implant survival rate was 99.26% of a total of 817 implants. The most common complications were neurosensory problems, mandibular fracture, infection, implant loss, and insufficient anatomical reconstruction of the atrophic mandible; neurosensory complications (hypoesthesia, paraesthesia, and hyperesthesia caused by traumatic damage to the nerve) were the most prevalent. Conclusions Lateralization of the inferior alveolar nerve would appear to be less invasive as it produces lower percentages of persistent neurosensory disorders (1.56%) than transposition (12.12%). Nevertheless, both techniques offer a viable approach to implant placement in edentulous atrophic mandibles, obtaining predictable clinical and radiological results after 5 years implant loading.

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

Los pacientes que sufren dolor debido a trastornos temporomandibulares (TTM) presentan mayores niveles de distrés psicológico, estrés ambiental, síntomas somáticos, ansiedad, depresion, cogniciones de catastrofización, y otras estrategias de afrontamiento al dolor alteradas, comparados con personas libres de dolor. Sin embargo, poco se conoce acerca de los factores psicológicos involucrados en diferentes tipos de TTM. Además, independientemente de la gravedad o el tipo de TTM, el papel de los estilos y estrategias de afrontamiento al estrés en los TTM todavía no está claro. El principal objetivo de este trabajo es estudiar los estilos de afrontamiento al estrés, ansiedad y rasgos de personalidad en un grupo de estudiantes de odontología que sufren mialgia temporomandibular. Una muestra de 102 estudiantes universitarios fue inicialmente reclutada para este estudio. Tras una evaluación clínica, se formaron un grupo de estudiantes con mialgia (24 participantes) y un grupo de estudiantes control (24 participantes). Los participantes de ambos grupos fueron posteriormente evaluados en ansiedad, estrategias de afrontamiento al estrés, y rasgos de personalidad. El grupo con mialgia mostró mayor rasgo de ansiedad y neuroticismo que el grupo control. Los participantes con mialgia también mostraron un mayor uso de estrategias de afrontamiento evitativas. Las estrategias evitativas generalmente se han considerado como desadaptativas, y se ha visto que incrementan el estrés percibido, un fuerte predictor de TTM. Patients suffering pain-related temporomandibular disorders (TMD) exhibit greater levels of psychological distress, environmental stress, somatic symptoms, anxiety, depression, pain catastrophizing, and impaired pain coping strategies compared to pain-free controls. However, little is known about psychological factors involved in the different TMD types. Furthermore, regardless of severity or TMD type, the role of stress-related coping strategies and styles in TMD is not yet well understood. The main goal of this study was to investigate stress-related coping styles, anxiety, and personality traits in a group of dentistry students suffering from temporomandibular disorder with myalgia. A cohort of 102 university students was initially recruited for this study. Following clinical evaluation, a myalgia group (24 participants) and a control group (25 participants) were formed. Participants were later assessed in anxiety, stress coping strategies, and personality measures. The myalgia group presented greater levels of trait anxiety and neuroticism in comparison to the control group. Participants with myalgia also showed higher levels of avoidance coping. Avoidance coping strategies are generally considered maladaptive, as they seem to increase perceived stress, a robust predictor of TMD

Introduction This systematic literature review aimed to evaluate the feasibility of xenogeneic bone blocks for ridge augmentation compared with autogenous blocks by analyzing block survival rates, block resorption, subsequent implant survival rate, post-surgical complications, and histomorphometric findings. Materials and Methods Electronic searches were conducted in the Medline (PubMed), Web of Science and Cochrane databases, complimented by a manual search in specialist journals, for relevant articles published up to March 2020. Inclusion criteria were human studies in which the outcomes of xenogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant survival rates. Results Sixteen articles fulfilled the inclusion criteria and were analyzed. 333 patients were recruited with a total of 337 xenogeneic bone blocks and 82 autogenous bone blocks, showing block failure rates of 6.82% and 6.1%, respectively. Bone gain, in both height and width, was similar among xenogeneic and autogenous bone blocks, but autogenous bone blocks suffered greater resorption. Implant survival rates were slightly lower for xenogeneic bone blocks. Histological and histomorphometric analysis observed more bone formation and less residual bone substitute with autogenous bone blocks than xenogeneic bone blocks. Conclusions Atrophic alveolar crest reconstruction with xenogeneic bone block grafts would appear to offer a viable alternative to autogenous bone block grafts, obtaining similar block graft failure rate, fewer sensitive postoperative complications but a slightly lower implant survival rate. Further investigations generating long term data are needed to confirm the feasibility of xenogeneic bone blocks in different clinical scenarios.

Background and Purpose Alveolar bone resorption after dental extraction frequently leads to situations in which long-term function and esthetic success of rehabilitations with dental implants is a challenge. Socket shield has been described as an alternative technique to maintain the alveolar ridge when placing immediate implants. The aim of this review is to evaluate the medium- and long-term clinical outcomes of the socket shield technique in human studies. Material and Methods This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Cochrane Collaboration tool, the Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. Results Six articles were included in this review. The studies analysed showed lower rates of horizontal and vertical alveolar bone resorption, better maintenance of the buccal plate, less marginal bone loss and better esthetic results than simple placement of immediate implants. However, a lack of homogeneity was found in evaluation methods of the different outcomes, surgical procedures and prosthetic management. Conclusions Based on the results of this review, it is possible to suggest that socket shield technique could be a good alternative in terms of alveolar bone maintenance, marginal bone stability and aesthetic outcomes in immediate implant treatment. However, it is not possible to recommend this technique as an alternative treatment with the same long-terms predictability as conventional immediate implants.

Background Dimensional changes after dental extraction frequently lead to situations in which bone augmentation procedures are required prior to dental implant placement. Bone ring technique (BRT) has been described as a one-stage approach to restore vertical alveolar ridge defects, in which an autogenous or allogeneic cortico-cancellous bone block graft is stabilized with a dental implant inserted simultaneously. The objective of this systematic review was to evaluate the clinical performance of BRT. Materials and methods This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. Results Sixteen studies with a total of 186 patients treated with 219 bone rings bocks were included in the review. The studies showed a mean bone gain of 4.94 mm, mean bone resorption of 0.83 mm, and mean marginal bone loss of 0.57 mm after a mean follow-up period of 13.35 months. A mean bone ring survival rate of 97.26% and implant survival rate of 94.97% were recorded. Conclusions BRT would appear to be an adequate alternative technique for restoring single vertical alveolar ridge defects with simultaneous dental implant placement. However, further studies comparing this technique with other vertical ridge augmentation procedures in different clinical scenarios are needed to confirm the present results.

This work systematically reviews dental implant placement through impacted teeth or residual roots, as an alternative to invasive extraction surgeries, evaluated in terms of survival rates, marginal bone loss, surgical, and prosthetic complications. The authors conducted an electronic search of four databases up to September 2020; also a complementary handsearch was carried out. The quality of the included studies was assessed using a protocol for assessment of risk of bias in exposure studies. Ten studies fulfilled the inclusion criteria and were analysed. A total of 44 patients received 62 dental implants and were monitored for a minimum of 12-months follow-up. An overall mean implant survival rate was 90.32%, reporting 97.56 % for dental implants through impacted teeth and 76.19% through residual roots. No surgical or prosthetic complications were reported. Placing dental implants through impacted teeth may offer a valid therapeutic option for implant-supported restorations in patients for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery. Moreover, additional caution is recommended when placing implants through retained root fragments, as this may involve long-term risk. Further research generating long-term data are needed to confirm these findings.

Background This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis. Material and Methods An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates. Results Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts. Conclusions Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings. Key words:Allogeneic block, clinical outcome, ridge augmentation, dental implants.

Resumen Introduccion La utilizacion de implantes cigomaticos es actualmente una alternativa terapeutica predecible y consolidada en la rehabilitacion de pacientes con maxilares atroficos. Sin embargo, como toda tecnica quirurgica, presenta una serie de complicaciones que no deben obviarse. Objetivo El objetivo de este estudio es analizar la frecuencia y las causas de sinusitis maxilar producida por el tratamiento con implantes cigomaticos. Material y metodo Se realizo una revision bibliografica en diferentes bases de datos analizando la prevalencia y las causas de la sinusitis maxilar tras el tratamiento con implantes cigomaticos. Resultados La mayoria de los estudios citan la sinusitis como la complicacion postoperatoria que aparece con mayor frecuencia, con una frecuencia de 4,93 por cada 100 implantes colocados. Discusion El hecho de que la sinusitis se relacione con la tecnica intrasinusal ha supuesto el desarrollo de tecnicas con el fin de evitarla, tales como la colocacion extrasinusal de los implantes o la utilizacion de tecnicas quirurgicas combinadas como la elevacion de seno simultanea a la colocacion del implante o la cobertura con la bola adiposa de Bichat. Conclusiones A pesar de ser la complicacion mas frecuente, la prevalencia es bastante baja, hecho que corrobora el exito del tratamiento con implantes cigomaticos.

SUMMARYThe aims were to assess the prevalence of HIV infection among young adult heroin users, including injecting heroin users (IHUs) and non-injecting heroin users (NIHUs), and to explore the differences by gender and other factors. The design was a cross-sectional cohort study between April 2001 and December 2003, which included 961 current heroin users (HU), aged 18–30 years: 422 in Madrid, 351 in Barcelona and 188 in Seville; 621 were IHUs and 340 were NIHUs. All were street-recruited by chain referral methods. Face-to-face interviews were conducted using a structured questionnaire with computer-assisted personal interviewing (CAPI). Samples for HIV testing (dried blood spot) were collected and tested with ELISA and Western Blot. Bivariate, logistic regression, and classification and regression tree analyses were performed. The overall prevalence of HIV infection among IHUs was 25·8% (95% CI 22·3–29·3) [32·4% (95% CI 26·6–38·1) in Madrid, 20·5% (95% CI 15·6–25·4) in Barcelona, and 20·6% (95% CI 9·8–31·4) in Seville], whereas in NIHUs it was 4·0% (95% CI 2·1–6·7), with no differences among cities. The prevalence was significantly higher in women than in men in NIHUs (10·9%, 95% CI 4·3–17·5 vs. 1·7%, 95% CI 0·5–4·2) and was non-significantly higher in IHUs (30·4%, 95% CI 23·0–37·8 vs. 24·1%, 95% CI 20·1–28·1). HIV prevalence in short-term IHUs was 12·9% (CI 8·8–17·02), with no differences among cities. In the logistic analysis, the variables associated with infection in IHUs were ever having injected with used syringes (OR 3·4, 95% CI 2·2–5·3), ever having been in prison (OR 2·6, 95% CI 1·6–4·0), and heroin as the first drug injected at least weekly (OR 2·3, 95% CI 1·1–4·5). Factors positively associated with HIV infection in NIHUs were female sex (OR 8·7, 95% CI 2·6–29·2) and age >25 years (OR 3·1, 95% CI 0·9–11·1), while primary educational level was inversely associated (OR 0·26, 95% CI 0·1–0·9). Although there are important geographic differences, HIV prevalence in IHUs remains high, even in short-term IHUs, whereas it was almost six times lower in NIHUs. The prevalence in women is higher than in men, particularly among NIHUs. A wide range of preventive strategies should be developed, aimed primarily at empowering women to negotiate safe sex.