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1.
Cient. dent. (Ed. impr.) ; 20(2): 105-112, mayo- ago. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-225304

RESUMO

Introducción: tras las extracciones, se producen una serie de cambios dimensio nales en sentido horizontal y vertical de la cresta alveolar, los cuales pueden ser minimizados mediante algunas técnicas quirúrgicas, como la preservación alveo lar, que utiliza diferentes sustitutos óseos, entre los que se encuentra actualmente el injerto autólogo de diente. Caso clínico: se presenta el caso clínico de una mujer de 61 años, que acudió a consulta presentando dolor intenso en la zona del segundo premolar superior de recho (1.5). Se realizó la exodoncia del 1.5, usándose como diente donante para realizar una preservación del alveolo tras la extracción. Cuatro meses tras el proce dimiento, se colocó un implante y se tomó una biopsia para realizar un análisis histo morfométrico. Un año tras la carga del im plante se observaron buenos resultados clínicos y radiográficos. Discusión: el diente y el tejido óseo tie nen similitudes en su composición quími ca, tanto en sus componentes inorgáni cos y orgánicos como en la cantidad de agua. En cuanto al contenido orgánico destacan los factores de crecimiento, la proteína morfogenética ósea 2 (BMP-2) y el colágeno tipo 1, dotando al diente como biomaterial de la propiedad de os teoinducción. El empleo del diente como sustituto en preservación alveolar consi gue porcentajes altos de hueso neofor mado, variando entre 37,55% cuando se usa el diente completo, al 48,40% usando dentina desmineralizada. Además de los buenos resultados histomorfométricos, goza de una buena aceptación por parte de los pacientes, fundamentalmente en determinadas ra zas o culturas, y consigue una reducción de las dimensio nes óseas evaluadas mediante escáner de haz cónico. Sin embargo, requiere un tiempo de preparación, que aumenta si el diente tiene restauraciones o tratamientos de conduc tos asociados (AU)


Introduction: following tooth extraction, horizontal and vertical resorption of bone volume occurs, but they can be reduced by many surgical procedures, such as alveolar ridge preservation, which uses different bone substitutes, being one of them autogenous tooth-graft. Clinical case: a 61-year-old woman is presented, who came to private dental clinic presenting intense pain in the area of an upper bicuspid of the first quadrant (1.5). Exodontia of the 1.5 was performed, using it as a donor tooth to obtain the biomaterial to preserve its alveolus. After 4 months re-entry was performed and an implant was placed, harvesting a bone biopsy for histomorphometric analysis. One year post-loading, good clinical and radiographic results were shown. Discussion: human bone and tooth have similarities in their chemical composition, both in their inorganic and organic components and in the amount of water. The organic content, growth factors, bone morphogenetic protein 2 (BMP-2) and type 1 collagen stand out, give the tooth the property of osteoinduction. The use of the tooth as a substitute in alveolar preservation achieves high percentages of neoformed bone, varying between 37.55% when the whole tooth is used, to 48.40% using demineralized dentin. In addition, it is well accepted by patients, especially in certain races or cultures, and achieves a reduction in bone dimensions evaluated by cone beam computed tomography. However, it has a drawback, requiring a long preparation time, which increases if the tooth has associated restorations or root canals. Conclusions: Autologous tooth-graft has a high biocompatibility, a low rate of intraoperative complications and good patient acceptance. It requires 25 minutes for preparation, which increases if there are restorations, root canals and caries. The percentage of vital bone obtained in the present clinical case shows new bone formation of 20% 4 months after alveolar ridge preservation (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Processo Alveolar , Aumento do Rebordo Alveolar , Alvéolo Dental/cirurgia , Implantação Dentária/métodos , Seguimentos , Resultado do Tratamento
2.
Cient. dent. (Ed. impr.) ; 20(2): 113-119, mayo- ago. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-225305

RESUMO

Introducción: La extracción dentaria desencadena una serie de cambios di mensionales en la altura y anchura de la cresta alveolar que se traducen en la pérdida de tejidos blandos y duros, afec tando de forma directa a la calidad de vida de los pacientes. Por ello, se han estudiado diferentes técnicas para la pre servación de la cresta alveolar (PCA) tras las extracciones, con el fin de optimizar los resultados funcionales y estéticos de la futura rehabilitación prostodóncica. El objetivo fue evaluar los resultados de la PCA utilizando un enfoque con colgajo en comparación con un enfoque sin colgajo en términos de cambios óseos en anchu ra y altura. Material y Métodos: Se realizó una búsqueda bibliográfica en tres bases de datos The National Library of Medicine (MEDLINE/PubMed), Scielo y Cochrane Library. Se incluyeron ensayos clínicos aleatorizados en humanos que compara ran la PCA con colgajo y sin colgajo, en los que se analizaran pacientes sanos, mayores de edad, sin hábitos nocivos, en los que era necesaria la exodoncia de un diente mandibular o maxilar. Resultados: Se incluyeron 5 ensayos clí nicos de los últimos 15 años en los que se realizó un total de 74 procedimientos quirúrgicos de PCA con colgajo y 77 sin colgajo en 138 pacientes entre 18 y 75 años, cuyo género sólo se describió en 3 estudios. Los cambios óseos en anchu ra al realizar una PCA con colgajo varían entre –4,18 mm y 3 mm, mientras que al realizar una PCA sin colgajo los cambios son entre 1,74 mm y 3,42 mm. Por otro lado, los cambios óseos en altura al realizar una PCA con colgajo varían entre –0,99 mm y 0,8 mm, mientras que al realizar una PCA sin colgajo los cambios son entre 0,3 mm y 1,42 mm (AU)


Introduction: Tooth extraction triggers a series of dimensional changes in the height and width of the alveolar ridge, which result in the loss of soft and hard tissues, directly affecting patients’ quality of life. Therefore, different techniques for the preservation of the alveolar ridge (PCA) after extractions have been studied in order to optimize the functional and esthetic results of future prosthodontic rehabilitation. The aim was to evaluate the results of PCA using a flap approach compared to a flapless approach in terms of bone changes in width and height. Material and Methods: A literature search was performed in three databases The National Library of Medicine (MEDLINE/ PubMed), Scielo and Cochrane Library. Randomized human clinical trials comparing flap and flapless PCA were included in which healthy patients, over the age of majority, without harmful habits, who needed to have a mandibular or maxillary tooth extraction, were analyzed. Results: A total of 5 clinical trials from the last 15 years were included in which a total of 74 flap and 77 flapless PCA surgical procedures were performed in 138 patients between 18 and 75 years of age and whose gender was only described in 3 studies. Bone changes in width when performing a flapless PCA varied between –4.18 mm and 3 mm, while when performing a flapless PCA the changes were between 1.74 mm and 3.42 mm. On the other hand, bone changes in height when performing a PCA with flap vary between –0.99 mm and 0.8 mm, while when performing a PCA without flap the changes are between 0.3 mm and 1.42 mm (AU)


Assuntos
Humanos , Processo Alveolar , Retalhos Cirúrgicos , Extração Dentária/métodos
3.
Av. odontoestomatol ; 38(4): 143-150, oct.-dic. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-214557

RESUMO

La sobredentadura retenida por dos implantes es una opción para la rehabilitación del edentulismo, pero no se ha estudiado a profundidad su efecto sobre el mantenimiento de la altura del reborde alveolar posterior. El objetivo de este trabajo fue determinar los cambios en altura del reborde alveolar posterior mandibular después de 7 años del uso de una sobredentadura mandibular. Este estudio descriptivo consideró 17 pacientes. Cada paciente había recibido una sobredentadura mandibular retenida por dos implantes no ferulizados cargados de forma inmediata y unidos mediante ajustes en bola. Se realizaron mediciones en dos radiografías panorámicas (una tomada antes de la inserción de la sobredentadura [T0] y otra siete años después [T7]),para los trazos, el área se expresó como un triángulo posterior formado por el gonion, el borde inferior del agujero mental y un punto que fue el centro del triángulo gonion - foramen mental - muesca sigmoidea. El área medida se comparó con el área triangular en el mismo lado.Los resultados en mm con significancia estadística (p< 0.05) fueron: área de referencia ósea “X”( [T0]:494.3- [T7]:431.6) área de referencia ósea izquierda ([T0]:502.0 -[T7]:405.3) y el índice de área posterior([T0]:1.4-[T7]:1.2).Los resultados en mm sin significancia estadísticas(p>0.05)indicaron: área de referencia ósea “X” derecha([T0]:486.1 - [T7]:458.0), área de referencia en “Y” izquierda ([T0]:354.8-[T7]:360.6), derecha ([T0]:361.9-[T7]:375.6) y promedio de longitud del reborde maxilar ([T0]:35.4-[T7]:36.9). La reabsorción del reborde alveolar posterior a los 7 años estuvo dentro de los parámetros normales, no existiría ningún efecto nocivo de la sobredentadura sobre este reborde. (AU)


The overdenture retained by two implants is an option for the rehabilitation of edentulism, but its effect on the maintenance of the posterior alveolar ridge has not been studied in depth.The objective of this work was to determine the changes in height of the mandibular posterior alveolar ridge after 7 years of the use of a mandibular overdenture. This descriptive study considered 17 patients. Each patient had received a mandibular overdenture retained by two non-splinted implants immediately loaded and joined by ball adjustments. Measurements were made in two panoramic radiographs (one taken before the insertion of the overdenture [T0] and another seven years later [T7]), for the lines the area was expressed as a posterior triangle formed by the gonion, the lower edge of the mental hole and a point that was the center of the gonion triangle - mental foramen - sigmoid notch. The measured area was compared to the triangular area on the same side. The results in mm with statistical significance (p< 0.05) were: bone reference area “X”( [T0]:494.3- [T7]:431.6) left bone reference area ([T0]:502.0 -[T7]: 405.3) and the posterior area index ([T0]:1.4-[T7]:1.2). The results in mm without statistical significance (p>0.05) indicated: right “X” bone reference area ([T0]:486.1 - [T7]:458.0), left “Y” reference area ([T0]:354.8-[T7]:360.6), right ([T0]:361.9-[T7]:375.6) and average ridge length maxilla ([T0]:35.4-[T7]:36.9). The resorption of the alveolar ridge after 7 years was within normal parameters, there would be no harmful effect of the overdenture on this ridge. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Processo Alveolar , Prótese Dentária Fixada por Implante , Projeto do Implante Dentário-Pivô , Revestimento de Dentadura , Radiografia Panorâmica , Epidemiologia Descritiva
4.
Med. oral patol. oral cir. bucal (Internet) ; 27(5): e468-e475, September 01, 2022. ilus, graf
Artigo em Inglês | IBECS | ID: ibc-209814

RESUMO

Background: We aimed to histomorphometrically evaluate the effects of Leucocyte-Platelet-Rich Fibrin (L-PRF),with and without the combination of a bone grafting material, for alveolar ridge preservation using an in vivocanine model.Material and Methods: Seven dogs (Female Beagles, ~18-month-old) were acquired for the study. L-PRF wasprepared from each individual animal by drawing venous blood and spinning them through a centrifuge at 408RCF-clot (IntrasSpin, Intra-Lock, Boca Raton, FL). L-PRF membranes were obtained from XPression fabrication kit (Biohorizons Implant Systems, Inc., AL, USA). A split mouth approach was adopted with the first molarmesial and distal socket defects treated in an interpolated fashion of the following study groups: 1) Empty socket (negative control); 2) OSS filled defect 3) L-PRF membrane; and 4) Mix of Bio-Oss® with L-PRF. After six weeks,samples were harvested, histologically processed, and evaluated for bone area fraction occupancy (BAFO), vertical/horizontal ridge dimensions (VRD and HRD, respectively), and area of coronal soft tissue infiltration.Results: BAFO was statistically lower for the control group in comparison to all treatment groups. Defects treatedwith Bio-Oss® were not statistically different then defects treated solely with L-PRF. Collapsed across all groups,L-PRF exhibited higher degrees of BAFO than groups without L-PRF. Defects filled with Bio-Oss® and Bio-Oss®with L-PRF demonstrated greater maintenance of VRD relative to the control group. Collapsed across all groups,Bio-Oss® maintained the VRD and resulted in less area of coronal soft tissue infiltration compared to the emptydefect. Soft tissue infiltration observed at the coronal area was not statistically different among defects filled withL-PRF, Bio-Oss®, and Bio-Oss® with L-PRF.Conclusions: Inclusion of L-PRF to particulate xenograft did not promote additional bone heading at 6 weeks invivo. ... (AU)


Assuntos
Animais , Feminino , Cães , Processo Alveolar , Regeneração Óssea , Leucócitos , Dente Molar , Fibrina Rica em Plaquetas , Extração Dentária , Alvéolo Dental/cirurgia
5.
Med. oral patol. oral cir. bucal (Internet) ; 27(2): e181-e190, mar. 2022. graf, tab
Artigo em Inglês | IBECS | ID: ibc-204481

RESUMO

Background : To review systematically the bone gain and superficial resorption rate of the onlay block bone grafts versus the cortical tenting technique, as well as secondarily study the postoperative complications, implant survival and success rates, and peri-implant marginal bone loss. Material and Methods: Following the recommended methods for systematic reviews and meta-analyses (PRISMA), an electronic search was performed in the PubMed (MEDLINE), EMBASE and the Cochrane Library of the Cochrane Collaboration (CENTRAL) databases to identify all relevant articles published up to March 2021 on onlay block bone grafts and cortical tenting technique. Results: Eighteen papers complied with the inclusion criteria. In onlay grafts, the vertical bone gain mean was 4.24 mm, and resorption 20.91%; and 4.29 mm in the horizontal augmentation with a resorption of 10.28%. The complication rate was 14.8%. The implant survival and success rates were 100% and 92%; and the mean peri-implant bone loss ranged from 0.6 to 1.26 mm. In cortical tenting technique, the vertical bone gain mean was 6.17 mm and the resorption of 9.99%; and 5.55 mm in the horizontal augmentation with a 6.12% of resorption. The complication rate was 24.6%. The implant survival and success rates were 96.63% and 100%; and the mean peri-implant bone loss ranged from 0.27 to 0.77mm. Conclusions: Despite the limitations, both techniques offer a predicTable way to reconstruct atrophic alveolar ridges, though the cortical tenting technique seems to achieve a greater bone gain and a lower surface resorption. Current evidence is still limited due to the inadequate follow-up, lack of information referred to methodological quality and sample attrition.(AU)


Assuntos
Humanos , Processo Alveolar , Aumento do Rebordo Alveolar , Transplante Ósseo , Implantação Dentária , Implantação Dentária Endóssea/métodos
6.
Med. oral patol. oral cir. bucal (Internet) ; 26(3): e304-e313, May. 2021. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-224508

RESUMO

Background: To perform a morphologic classification based on the results of bone augmentation after a distractionosteogenesis.Material and Methods: Thirty-four (34) patients (24 women and 10 men; mean age, 47.1 years (SD=9.5); age range,23 to 62 years) underwent a total of 42 alveolar ridge distractions before the placement of a total of 89 dentalimplants. Ridge bone morphology was evaluated as the main ordinal variable. Chi-squared, Kruskal-Wallis andANOVA one-way test were used.Results: Category I (30.95%): consisted of wide alveolar rim and no bone defects Category II (28.57%): widealveolar rim, lateral bone surface concavity. Category III (23.81%): narrow alveolar rim, lateral bone surface con-cavity. Category IV (2.38 %): distraction transport segment forming a bridge, without bone formed beneath andrequiring guided bone regeneration. Category V (9.52%): return of the transport segment to its initial position dueto the reverse rotation of the distractor screw. Category VI (4.76 %): distraction transport segment completely lost.Subcategory D (28.57%), consisted of lingual deviation of the distraction axis, occurring in any of the categories Ito IV. More men (76.9 %) presented with category I (p<0.001). The use of the chisel resulted mainly in categories I and II (69.4 %) (p<0.001). GBR was only required in 23.1 % of the cases in Category I (p=0.011). The bone heightachieved decreases as the category increases, due to the accompanying osteogenic limitations (p<0.001). The im-plants placed in category I were longer 11.5 ± 0.9 mm (CI95% 10.9-11.9 mm) compared to those placed in categoryIII with a length of 10.4 ± 1.5 mm (CI95% 9.5-11.4 mm) (p=0.035).Conclusions: The alveolar ridge after distraction osteogenesis could be divided into six morphologic categorieswhich provide a useful basis for decision-making regarding implant placement.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Processo Alveolar/patologia , Osteogênese por Distração , Implantes Dentários , Alongamento Ósseo , Técnica de Ilizarov , Patologia Bucal , Saúde Bucal , Cirurgia Bucal , Medicina Bucal
7.
Cient. dent. (Ed. impr.) ; 18(2): 103-110, abr. 2021. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-216976

RESUMO

Introducción: Los procesos biológicos que acontecen tras las exodoncias dentales provocan defectos en los tejidos blandos y duros de los maxilares, lo que dificulta las técnicas rehabilitadoras con implantes. Los procedimientos de preservación alveolar han sido propuestos para disminuir estos cambios dimensionales. A pesar de que el hueso autógeno se presenta como el material con mejores propiedades, también conlleva un aumento de la morbilidad en el paciente. Por ello, el propio diente se presenta como alternativa. Los objetivos de esta revisión fueron analizar los cambios dimensionales en la altura/anchura de la cresta alveolar tras los procedimientos de preservación alveolar con dentina particulada, además de las posibles complicaciones intra y postoperatorias, formación de hueso nuevo y tiempo de reentrada en la zona injertada. Material y método: Se realizó una revisión de la literatura relevante a través de PubMed en la base de datos MEDLINE, identificando los estudios en los que se evaluaran los procedimientos de preservación alveolar con dentina particulada en pacientes humanos y se registrara su seguimiento. Resultados: Un total de 12 estudios se incluyeron en el análisis sistemático. Los cambios dimensionales, tras el injerto con dentina particulada, fue comparable al de otros biomateriales y menor que en los grupos control. La aparición de complicaciones fue baja. La formación de hueso nuevo y el tiempo de reentrada fue similar al de otros biomateriales. Conclusiones: El uso de dentina particulada en procedimientos de preservación alveolar se presenta como una opción prometedora respecto a otros materiales de relleno y superior a la ausencia de preservación alveolar. (AU)


Introduction: The biological processes that take place following dental extractions cause defects in the soft and hard tissues of the jaw, which hinders rehabilitation techniques with implants. Alveolar preservation procedures have been proposed to decrease these dimensional changes. Although autogenous bone is presented as the material with the best properties, it also leads to an increase in morbidity in the patient. Therefore, the tooth itself is presented as an alternative. The objectives of this review were to analyse the dimensional changes in alveolar ridge height/width after alveolar preservation procedures using particulate dentin, as well as possible intraoperative and postoperative complications, new bone formation and re-entry time in the grafted area. Material and method: A review of the relevant literature in the PubMed and MEDLINE databases was carried out, identifying studies evaluating alveolar preservation procedures with particulate dentin in human patients with recorded follow-up. Results: A total of 12 studies were included in the systematic analysis. The dimensional changes, after grafting with particulate dentin, were comparable to those of other biomaterials and lower than in the control groups. The occurrence of complications was low. New bone formation and re-entry time was similar to that of other biomaterials. Conclusions: The use of particulate dentin in alveolar preservation procedures is presented as a promising option compared with other filling materials and superior to the absence of alveolar preservation. (AU)


Assuntos
Humanos , Processo Alveolar , Dentina , Transplante Ósseo , Regeneração , MEDLINE
8.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e565-e575, sept. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-196511

RESUMO

BACKGROUND: Many studies have addressed socket preservation, though fewer publications considering buccal wall loss can be found, since the literature typically considers sockets with four walls. A systematic review was made on the influence of type II buccal bone defects, according to Elian's Classification, in socket grafting materials upon volumetric changes in width and height. MATERIAL AND METHODS: An electronic and manual literature search was conducted in accordance to PRISMA statement. The search strategy was restricted to randomized controlled trials (RCTs) and controlled clinical trials (CCTs) describing post-extraction sockets with loss of buccal wall in which alveolar ridge preservation (ARP) was carried out in the test group and spontaneous healing of the socket (SH) was considered in the control group. RESULTS: The search strategy yielded 7 studies. The meta-analysis showed an additional bone loss of 2.37 mm in width (p > 0.001) and of 1.10 mm in height (p > 0.001) in the absence of ARP. The reconstruction of the vestibular wall was not evaluated in any study. The results also showed moderate to great heterogeneity among the included studies in terms of the changes in width and height. CONCLUSIONS: Despite the heterogeneity of the included studies, the results indicate a benefit of ARP versus SH. Further studies are needed to determine the volumetric changes that occur when performing ARP in the presence of a buccal bone wall defect


No disponible


Assuntos
Humanos , Processo Alveolar/cirurgia , Extração Dentária/métodos , Boca/cirurgia , Alvéolo Dental/cirurgia , Ensaios Clínicos como Assunto , Substitutos Ósseos/uso terapêutico , Preservação Biológica
9.
Med. oral patol. oral cir. bucal (Internet) ; 24(3): e409-e415, mayo 2019.
Artigo em Inglês | IBECS | ID: ibc-185652

RESUMO

Background: The purpose of this cross-sectional study was to evaluate radiologically, the relation between the distance from the cement enamel junction (CEJ) to the facial bone crest (FBC), and the facial alveolar bone (FAB) width at maxillary anterior teeth. A further aim was to assess if the CEJ-FBC distance had an impact in the prevalence to find a FAB thickness greater than one mm. Study design: CBCT images were retrospectively obtained from the database of the Oral Surgery Unit of the University of Valencia. The teeth were divided in 3 groups according to the CEJ-FBC distance: Shorter (≤ 3mm), Middle (>3 ≤ 4.5 mm) and Larger (> 4.5 mm). FAB thickness was measured by two different examiners at 1, 2 and 3 mm apical to the FBC. Normality of means were evaluated by Kolmogorov-Smirnov test and an ANOVA-type linear model was performed. Results: 82 patients were included in the study, with 156 central incisors, 149 lateral incisors and 152 canines analyzed. A significant greater FAB thickness in Shorter (≤ 3 mm CEJ-FBC) than Middle and Larger group was observed in all distances measured apical to the FBC. There was a significant inverse relation between the distance CEJ-FBC and FAB thickness at all distances measured. The prevalence of a FAB thickness equal or greater than one mm was 35.9% of all teeth analyzed from Shorter, 17.4% of Middle and 8.9% of Larger group at 1 mm apical to the FBC


No disponible


Assuntos
Humanos , Processo Alveolar , Colo do Dente , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Maxila , Estudos Retrospectivos
10.
Av. odontoestomatol ; 34(3): 151-158, mayo-jun. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-173006

RESUMO

Introducción: El objetivo del presente estudio era mostrar los resultados del tratamiento con implantes dentales insertados mediante la técnica de elevación transcrestal en el maxilar superior. Pacientes y Metodos: 47 pacientes (18 hombres y 29 mujeres) con pérdidas dentales maxilares fueron tratados con 60 implantes IPX ® Galimplant con conexión interna y superficie arenada y grabada fueron insertados mediante la técnica de elevación sinusal transcrestal para la rehabilitación del maxilar posterior. Los implantes fueron cargados después de un periodo de cicatrización de 6 meses. Resultados: Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 100%. La ganancia media de hueso vertical fué de 4,8 mm (rango: 2-6,5 mm). 46,7% de los implantes se insertaron en localización molar y el 53,3% en la localización premolar. Biomateriales fueron utilizados en el 91,7% de los implantes. Después de un periodo medio de carga funcional de 37,6 meses (rango: 24-52 meses), no ha habido complicaciones tardías. El 70% de los implantes fueron rehabilitados con coronas unitarias y el 30% con puentes fijos. Conclusiones: Este estudio indica que el tratamiento con implantes dentales mediante su inserción con elevación transcrestal del seno maxilar superior constituye una terapéutica implantológica con éxito


Introduction: The aim of this study was to report the outcome of treatment with maxillary dental implants inserted by transcrestal sinus elevation. Patients and Methods: 47 patients (18 males and 29 females) with maxillary tooth loss were treated with 60 IPX ® Galimplant internal connection and sandblasted and acid-etched surface implants inserted by transcrestal sinus elevation for rehabilitation of posterior maxilla. Implants were loaded after a healing free-loading period of 6 months. Results: Clinical results indicate a survival and success rate of implants of 100%. The mean elevation height was 4.8 mm (range: 2-6.5 mm). 46.7% of implants were inserted in molar and 53.3% in premolar localization. Bone substitutes were used in 91.7% of implants. After a mean functioning period of 37.6 months (range: 24-52 months), no late complications were reported. 70% of implants were restored with single crowns and 30% with fixed bridges. Conclusions: This study indicate that treatment with dental implants inserted in maxilla by transcrestal sinus elevation constitute a successful implant treatment


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Processo Alveolar/cirurgia , Implantação Dentária/métodos , Levantamento do Assoalho do Seio Maxilar/métodos , Perda de Dente , Osteotomia Maxilar/métodos , Materiais Revestidos Biocompatíveis
11.
Av. odontoestomatol ; 34(2): 79-86, mar.-abr. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-172661

RESUMO

Introducción: Las cirugías reconstructivas del proceso alveolar con uso de injertos óseos son frecuentes, el gold standard en injertos óseos continua siendo el hueso autógeno, sin embargo, presenta limitaciones conocidas, por lo cual se ha trabajado en desarrollar nuevos materiales, como los injertos sinteticos, principalmente aquellos en base a hidroxiapatita o beta fosfato tricálcico, sin embargo, al ser éstos principalmente osteoconductores, el empleo de algunos coadyudantes en regeneración ósea pueden ser de utilidad para potenciar la regeneración ósea basada en materiales aloplásticos, como es el caso del PRF, hemoderivado de segunda generación obtenido a través de un protocolo específico de centrifugación de la propia sangre del sujeto. El objetivo de ésta revisión fue realizar un analisis de los resultados histológicos y ultraestructurales donde se asocie el empleo de injertos óseos sintéticos en conjunto con PRF y analizar la regeneración ósea descrita mediante una búsqueda sistemática. Material y Método: Se realizó una búsqueda sistemática de la literatura científica entre Diciembre del 2002 y Julio de 2017, en las bases de datos MEDLINE, EMBASE, LILACS y SciELO. Resultados: Se observó en los artículos analizados, que la calidad de la regeneración ósea fue superior al asociar el material aloplástico correspondiente con PRF. Conclusión: El uso de biomateriales sintéticos junto a PRF presenta resultados positivos en la estimulación de la neofofmación ósea. No obstante, los resultados no son totalmente concluyentes debido a la limitada cantidad de estudios y a la metodología variada empleada en diferentes modelos animales


Introduction: Reconstructive surgeries of the alveolar process using bone grafts are frequent, with the gold standard in bone grafts continues today to be autogenous bone; despite its known limitations, requiring the continuous development of new materials and alternatives, such as synthetic grafts, mainly those based on hydroxyapatite or beta tricalcium phosphate. Yet, are mainly osteoconductive; hence, the use of some bone regeneration adjuvants can be useful to enhance bone regeneration based on alloplastic materials, as is the case with PRF, a second-generation blood by-product obtained through a specific protocol for centrifugation of the subject's own blood. The aim of this review is to perform a systemic analysis of the histological and ultrastructural results for the use of synthetic bone grafts in combination with PRF and to analyze the resulting bone regeneration. Material and Method: A systematic search of the scientific literature was carried out between December 2002 and July 2017, in the MEDLINE, EMBASE, LILACS and SciELO databases. Results: The quality of the regenerated bone was superior when combined with the corresponding alloplastic material with PRF. Conclusion: The use of synthetic biomaterials together with PRF presents positive results in the stimulation of bone neoformation. However, the results are not totally conclusive due to the limited number of studies and the varied methodology used in different animal models


Assuntos
Humanos , Perda do Osso Alveolar/cirurgia , Aumento do Rebordo Alveolar/métodos , Enxerto de Osso Alveolar/métodos , Adesivo Tecidual de Fibrina/uso terapêutico , Substitutos Ósseos/uso terapêutico , Processo Alveolar/cirurgia , Materiais Biocompatíveis/uso terapêutico
12.
Med. oral patol. oral cir. bucal (Internet) ; 21(6): e758-e765, nov. 2016. graf, tab
Artigo em Inglês | IBECS | ID: ibc-157757

RESUMO

BACKGROUND: In a variable proportion of maxillary sinuses alveolar antral artery is located close to the residual ridge, increasing the chances for haemorrhagic complications during sinus floor elevation procedures. MATERIAL AND METHODS: Retrospective observational study of CBCT explorations performed for implant-treatment planning. The upper first molar area was selected for this study. The relative uncertainty (standard deviation of the measurement divided by its mean and expressed as a percentage from 0% to 100%) was chosen for determining the observational errors. For modeling the chances of AAA detection, the generalized additive models (GAM) approach was chosen. RESULTS: A total of 240 maxillary sinuses were studied (46.25% males) whose median median age was 58 years old (IQR: 52-66). Univariate models showed that the chances for an AAA-alvelar crest distance ≤15mm increase in wider sinuses with lower, subsinusally edentulous crests. When distance is considered as a continuous variable, the best mutivariate model showed an explained deviance of 67% and included AAA diameter, distance AAA-sinus floor, sinus width, and shape, height and width of the residual ridge. Thinner AAAs are found closer to the crest (within the ≤15mm safe distance). CONCLUSIONS: Bearing in mind the inclusion criteria and the limitations of this investigation, it is concluded that there is a high proportion of maxillary sinuses where AAA describes a course close to the alveolar crest (≤15mm), which was classically considered a safe distance for SFE. This position is related to the presence of atrophic crests (depressed ridge form) and wide maxillary sinuses where the distance of the vessel to the floor of the sinus is small. This information may permit a better surgical planning of SFE procedures


Assuntos
Humanos , Levantamento do Assoalho do Seio Maxilar/métodos , Processo Alveolar/anatomia & histologia , Tomografia Computadorizada de Feixe Cônico/métodos , Complicações Intraoperatórias/prevenção & controle , Estudos Retrospectivos
13.
Av. periodoncia implantol. oral ; 28(2): 71-81, ago. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-155815

RESUMO

La pérdida dentaria produce una serie de cambios dimensionales que afectan tanto a los tejidos duros como a los tejidos blandos ocasionando frecuentemente defectos en el reborde alveolar. La prevención y el tratamiento de dichos defectos, tiene como objetivo la preservación o el aumento de los tejidos duros y/o blandos para mejorar las condiciones del reborde para una futura restauración protésica. Existen diversas técnicas quirúrgicas encaminadas a prevenir o minimizar los cambios dimensionales en alveolos postextracción (técnicas de preservación de alveolo) y otras destinadas a la reconstrucción de dichas alteraciones anatómicas. En general, en defectos pequeños o moderados una técnica de aumento de tejidos blandos puede ser suficiente. Sin embargo, en defectos más severos o en aquellas localizaciones en las que se planifique la posterior colocación de implantes, un enfoque combinado (aumento de tejido duros y blandos) y/o en distintas fases puede ser necesario. En este artículo se revisan los cambios dimensionales tras la extracción o pérdida dental, los tipos de la deformidad del reborde así como las diferentes técnicas de preservación de alveolo y de aumento de la cresta alveolar


The extraction of single as well as multiple teeth induces a series of adaptative changes in the soft and hard tissues that results in an overall regress of the edentulous site(s). The prevention and treatment of alveolar ridge deformities aims preserving and reconstructing soft and hard tissues of the edentulous ridge in order to render better conditions at the site for the future prosthesis installation. Different surgical techniques have been proposed to prevent ridge collapse after tooth extraction or to reconstruct the lost anatomy prior to prosthesis installation. In general terms, in mild defects, soft tissue augmentation may be sufficient to repair the deformity. However, in more severe deformities a combined or staged approach may be more appropriate. This article reviews the dimensional changes after tooth extraction, types alveolar ridge deformities and various techniques for the prevention and treatment of alveolar ridge defects


Assuntos
Humanos , Perda do Osso Alveolar/cirurgia , Processo Alveolar/fisiopatologia , Aumento do Rebordo Alveolar , Levantamento do Assoalho do Seio Maxilar , Procedimentos Cirúrgicos Pré-Protéticos Bucais/métodos
14.
Med. oral patol. oral cir. bucal (Internet) ; 20(3): 340-346, mayo 2015. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-139050

RESUMO

BACKGROUND: This study aimed to review the results related to head and jaw disorders in cases of ectodermal dysplasia. The evaluation of ectodermal dysplasia cases was made by clinical examination and examination of the jaw and facial areas radiologically and on cone-beam 3-dimensional dental tomography (CBCT) images. MATERIAL AND METHODS: In the 36 cases evaluated in the study, typical clinical findings of pure hypohidrotic ectodermal displasia (HED) were seen, such as missing teeth, dry skin, hair and nail disorders. CBCT images were obtained from 12 of the 36 cases, aged 1.5- 45 years, and orthodontic analyses were made on these images. RESULTS: The clinical and radiological evaluations determined, hypodontia or oligodontia, breathing problems, sweating problems, a history of fever, sparse hair, saddle nose, skin peeling, hypopigmentation, hyperpigmentation, finger and nail deformities, conical teeth anomalies, abnormal tooth root formation, tooth resorption in the root, gingivitis, history of epilepsy, absent lachrymal canals and vision problems in the cases which included to the study. CONCLUSIONS: Ectodermal dysplasia cases have a particular place in dentistry and require a professional, multi-disciplinary approach in respect of the chewing function, orthognathic problems, growth, oral and dental health. It has been understood that with data obtained from modern technologies such as three-dimensional dental tomography and the treatments applied, the quality of life of these cases can be improved (AU)


Assuntos
Humanos , Displasia Ectodérmica , Anormalidades da Boca , Imageamento Tridimensional , Tomografia Computadorizada por Raios X/métodos , Processo Alveolar/anormalidades , Diagnóstico Precoce , Estudos Retrospectivos
15.
Av. odontoestomatol ; 30(6): 315-323, nov.-dic. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-132695

RESUMO

En la práctica odontológica, cada vez son más comunes las alteraciones con sintomatología dolorosa en la región maxilofacial que no son apropiadamente diagnosticadas, a causa del desconocimiento de síndromes craneofaciales y cervicofaríngeos, como el síndrome de Eagle. Este último se describe como el dolor orofacial relacionado con la elongación de la apófisis estiloide y/o calcificación del ligamento estilohioideo. La aparición de una patología asociada a tal estructura, está acompañada de otros síntomas como: disfonía, disfagia, dolor faríngeo, glositis, otalgia, tonsilitis, dolor facial, cefalea, odinofagia, dolor en la articulación temporomandibular e imposibilidad de realizar movimientos laterales del cuello. El presente artículo es una revisión bibliográfica cuyo objetivo consistió en describir los aspectos generales del Síndrome de Eagle y la aplicabilidad de ayudas imagenológicas actuales en su identificación y diagnóstico. Se realizó una búsqueda de literatura en bases de datos como: MEDLINE (Ovid), Pubmed, Science Direct, y scirus empleando descriptores como: Eagle syndrome, cone beam, styloid process, Eagle syndrome in dentistry. A partir de la búsqueda se seleccionaron 37 artículos. Finalmente se pudo concluir que entre los diversos métodos diagnósticos, el que permite un análisis detallado de los patrones radiográficos de síndrome de Eagle, es la tomografía computarizada de haz cónico (Cone Beam Coputed Tomography) (AU)


In dental practice, alterations with painful symptomatology located in the maxillofacial region, which are not being diagnosed correctly, are every time more common, due to lack of knowledge of craniofacial and cervicofaringeal syndromes, such as the Eagle Syndrome. The latter, makes part of the head and neck disorders, and is described as an orofacial pain associated with the elongation of the styloid process and/or stylohyoid ligament calcification. The appearance of a pathology associated with such a structure, is accompanied by other symptoms such as: dysphonia, dysphagia, sore throat, glossitis, otalgia, tonsillitis, facial pain, headache, odynophagia, pain in the temporomandibular joint and inability to perform lateral movements of the neck. This article is a literature review aimed to describe the general aspects of Eagle syndrome and applicability of current imaging aids in their identification and diagnostics. Literature research was performed using databases such as MEDLINE (Ovid), PubMed, Science Direct, Scirus and using descriptors such as: Eagle syndrome, cone beam, styloid process, Eagle syndrome in dentistry. From that search, 36 articles were selected. Finally it was concluded that among the various diagnostic methods, the one which allows a detailed analysis of radiographic patterns of the Eagle syndrome is the cone beam computed tomography (AU)


Assuntos
Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Dor Facial/diagnóstico , Processo Alveolar/fisiopatologia , Síndromes de Compressão Nervosa/diagnóstico , Doenças do Nervo Glossofaríngeo/complicações
16.
Med. oral patol. oral cir. bucal (Internet) ; 19(6): 639-646, nov. 2014. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-130361

RESUMO

Alveolar bone regeneration by means of titanium meshes is a widespread procedure, however to date, only few relevant studies were reported in literature concerning this technique. Consequently, the aim of the present systematic review was to analyze the reliability of the titanium mesh as a barrier, in conjunction with horizontal and vertical ridge reconstruction for implant placement purposes. A total of 17 articles complying with the inclusion and exclusion criteria were reviewed. Three outcome variables were defined: a) horizontal and vertical bone regeneration obtained, b) complication rate, defined as the percentage of membrane exposures and c) evaluation of implant survival, success and failure rate. In regards to the vertical regeneration the mean was 4.91 mm (range: 2.56 - 8.6), while a mean of 4.36 mm (range: 3.75 - 5.65) was calculated for horizontal reconstruction. Considering the exposure rate, a mean of 16.1% was found, nevertheless, implant placement were placed in almost all of the sites. A mean success rate of 89,9%, a mean survival rate of 100% and a failure rate of 0% emerged from the data evaluation. A meta-analysis could not be performed due to the heterogeneity of the data, however the final results were comparable with those reported in case of bone regeneration obtained through other types of non-resorbable membranes. An advantage in favour of the titanium mesh was found in terms of bone loss after exposure, as implant placement was not jeopardized in almost all of the cases. It could be deduced that titanium meshes represented a reliable solution for alveolar ridge reconstruction. The clinical studies currently available in literature have shown the predictability of this technique in both lateral and vertical bone regeneration


Assuntos
Humanos , Titânio/uso terapêutico , Processo Alveolar/cirurgia , Implantação Dentária/métodos , Procedimentos de Cirurgia Plástica/métodos , Regeneração Óssea , Telas Cirúrgicas
17.
Med. oral patol. oral cir. bucal (Internet) ; 19(5): e531-e537, sept. 2014. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-126476

RESUMO

INTRODUCTION: Alveolar bone grafting is a vital part of the rehabilitation of cleft patients. The factors that have been most frequently associated with the success of the graft are the age at grafting and the pre-grafting orthodontic treatment.OBJECTIVES:1) Describe the cases of alveolar bone grafts performed at the Maxilofacial Unit of Hospital Sant Joan de Déu, Barcelona (HSJD); and 2) Analyze the success/failure of alveolar grafts and related variables. MATERIAL AND METHODS: Descriptive retrospective study using a sample of 104 patients who underwent a secondary alveolar graft at the Craniofacial Unit of HSJD between 1998 and 2012. The graft was done by the same surgeon in all patients using bone from the iliac crest. RESULTS:70% of the patients underwent the procedure before the age of 15 (median 14.45 years); 70% of the graft patients underwent pre-graft maxillary expansion. A total of 100 cases were recorded as successful (median age of 14.58 years, 68 underwent pre-graft expansion) and only 4 were recorded as failures (median age of 17.62 years, 3 underwent pre-graft expansion). We did not find statistically significant differences in age at the time of grafting or pre-surgical expansion when comparing the success and failure groups. We found the success rate of the graft to be 96.2%. CONCLUSIONS: The number of failures was too small to establish a statistically significant conclusion in our sample regarding the age at grafting and pre-grafting expansion. The use of alveolar bone grafting from the iliac crest has a very high success rate with a very low incidence of complications. Existing controversies regarding secondary bone grafting and the wide range of success rates found in the literature suggest that it is necessary to establish a specific treatment protocol that ensures the success of this procedure


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Retalhos Cirúrgicos , Processo Alveolar/cirurgia , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia
18.
Cient. dent. (Ed. impr.) ; 11(2): 83-92, mayo-ago. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-126679

RESUMO

Inmediatamente después de la extracción de una pieza dental, comienzan a producirse una serie de cambios que originan una disminución tanto en altura como en anchura de la cresta ósea alveolar. Para minimizar dichos cambios se han ido proponiendo diferentes técnicas de "preservación de cresta alveolar". Esta se define como un procedimiento diseñado para mantener las dimensiones de la cresta ósea alveolar tras la extracción de una pieza dental; con estas técnicas se posibilita la correcta colocación de un implante dental osteointegrado, dismi-nuyendo la necesidad de una posibleregeneración ósea guiada a posteriori y con-siguiendo así los requerimientos estéticosnecesarios en prostodoncia.En esta revisión de la literatura se analiza-ron las diferentes técnicas y procedimientosclínicos para la preservación de la crestaalveolar; se compararán algunos de los dife-rentes tipos de biomateriales utilizados, larealización de exodoncias con o sin eleva-ción de un colgajo, el cierre primario, lautilización de membranas reabsorbibles o la colocación de un implante inmediato; se tratará de llegar a una serie de conclusionessobre el procedimiento más adecuadobasándonos en la evidencia científica (AU)


After tooth extraction the edentulous site begin a series of changes that affect height and width of the socket. To counteract these changes various "ridge preservation" techniques were purposed. It is defined as a advantageous procedure to maintain an acceptable ridge contour, after tooth extraction, this techniques allow the correct placement of an osteointegrated implant, lowering a consequent guided bone regeneration and reaching the esthetical requirements necessary for prosthodontics, In this literature review different ridge preser-vation techniques and clinical procedureshave been analyzed. Different types of bio-material, flap or flapless extractions, primaryclosure , use of resorbable membrane andimplants placed in the fresh extraction soc-ket will be compared; we will try to find aseries of conclusions about the most indicated clinical procedures, basing on thescientific literature (AU)


Assuntos
Humanos , Processo Alveolar/cirurgia , Alveoloplastia/métodos , Aumento do Rebordo Alveolar/métodos , Regeneração Óssea/fisiologia , Transplante Heterólogo/métodos , Materiais Biocompatíveis/uso terapêutico , Extração Dentária/efeitos adversos
19.
Cient. dent. (Ed. impr.) ; 11(2): 133-138, mayo-ago. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-126686

RESUMO

Introducción: En muchos casos, la rehabilitación de pacientes que sufren atrofia maxilar severa es muy difícil. En estas situaciones, el uso de hueso autógeno conlleva unas ventajas debido a su capacidad osteogénica, osteoconductiva y osteoinductiva, además de ser biológicamente compatible. Se prefiere la cresta ilíaca cuando se requieren grandes cantidades de tejido óseo. Objetivo: El objetivo del presente artículo ha sido exponer un caso de reconstrucción ósea con injertos de cresta iliaca y posterior rehabilitación con implantes tras un seguimiento de diez años. Caso clínico: Se presenta un caso de una mujer de 36 años, que acudió a consulta por presentar inestabilidad de su prótesis removible completa superior. Tras el estudio tomográfico, se observó atrofia severa antero posterior, por lo que se informó a la paciente de la posibilidad del aumento óseo mediante injertos procedentes de la cresta ilíaca. Se realizó la intervención y después de 6 meses se colocaron 6 implantes. Tras 4 meses, se procedió al descubrimiento de los implantes y a la confección de una sobredentadura. La primera revisión se le realizó a los 6 meses y posteriormente al año, a los dos y medio, a los cinco y a los diez años, donde se objetivó un resultado satisfactorio. Conclusiones: La supervivencia de los implantes situados en las zonas reconstruidas con injertos en bloque de la cresta ilíaca, en nuestro caso, ha sido comparable a la supervivencia de los implantes en hueso nativo


Introduction: In many cases, the rehabilitation of patients with severe atrophy maxillary is very difficult. In this situation, the use of autogenous bone entail some advantages due to their osteogenic, osteoconductive and osteoinductive potential, as well as being biologically compatible. The iliac crest is preferred where large amounts bone tissue are required. Objective: The objective of this article was to show a case of bone reconstruction with iliac crest grafts and posterior implant rehabilitation follow-up for more than ten years. Clinical case: A case is presented a 36 years old woman, who went to the consultation due to instability of the upper complete removable prosthesis. After the CT scan, antero-posterior severe atrophy was observed, so that the patient was informed of the possibility of bone augmentation by iliac crest grafts. The intervention was carried out and after 6 months the 6 implants were placed. After 4 months, implants were discovered and a over denture was concocted. The first review was performed at six months and a year later, two and a half, five and ten years, where a satisfactory outcome was observed. Conclusions: The survival of the implants in reconstructed areas with iliac crest grafts is comparable to the survival of the implants in native bone


Assuntos
Humanos , Feminino , Adulto , Processo Alveolar/cirurgia , Anormalidades Maxilomandibulares/cirurgia , Retalhos Cirúrgicos , Implantação Dentária/métodos , Reconstrução Mandibular/métodos , Implantes Dentários
20.
Cir. plást. ibero-latinoam ; 40(2): 171-177, abr.-jun. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-126695

RESUMO

Entre las principales causas de la reducción progresiva y sin dolor de la apertura bucal en pacientes jóvenes, se encuentra la denominada hipertrofia del proceso coronoideo. Se trata de una patología secundaria a la elongación anormal del proceso coronoideo por el crecimiento del hueso que provoca una alteración mecánica al abrir la boca. Presentamos nuestra experiencia con la recogida de 5 casos clínicos (AU)


Among the causes of reduction in mouth opening gradually and without pain in young patients, we find the hypertrophy of the coronoid process. It is a disease due to abnormal elongation of the bone growth process, which causes a mechanical disruption when the patient opens the mouth. We present our experience with a casuistic of 5 clinical cases (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Processo Alveolar/cirurgia , Anormalidades Maxilofaciais/cirurgia , Registro da Relação Maxilomandibular/métodos , Radiografia Panorâmica
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