Study on the association between sleep disorders versus oral health related variables / Estudio sobre la asociación entre los trastornos del sueño versus variables relacionadas con la salud bucal

Background: To study the association between sleep quality and oral health related variables, which still haveconflicts in the literature.Material and Methods: This was a population-based case-control study between subjects with versus withoutsleep disorders from the Brazilian Public Health System (SUS), city of Maringá (N=1,643). Subjects answeredself-reported questionnaires: a) Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), b)Sleep Assessment Questionnaire (SAQ) and c) North York Dental Health Survey (NYDHS).Results: No significant difference was found for gender, marital status, or income; however, non-Caucasians, peo-ple with lower levels of education, and those between 20 to 50 years old had worse scores of sleep disorders in theSAQ. Self-perceived oral health, masticatory capacity to eat foods, and gingival bleeding was significantly worseamong subjects with self-reported sleep disorders. Self-reported tooth loss, edentulism and use of removable par-tial dentures (with clasps) or complete dentures showed no significant difference between groups. Self-reportedsleep disorder subjects presented significantly higher prevalence of both self-reported tooth and TMJ pain.Conclusions: It can be concluded that individuals with self-reported sleep disorders presented worse self-perceivedoral health for most studied variables.(AU)

Atrofia combinada maxilo-mandibular. Uso de implantes cortos y estrechos (BTI(R) CORE y BTI(R) 3.0) / Combined maxillo-mandibular atrophy. Use of short and narrow implants (BTI(R) CORE AND BTI(R) 3.0)

Cada día con más frecuencia en las clínicas odontológicas nos enfrentamos a atrofias maxilares y mandibulares más extremas y en muchos casos con el retratamiento de implantes fracasados biológica y/o mecánicamente. En el presente caso clínico mostramos una paciente con una atrofia combinada (horizontal y verticalmente) además de un tratamiento con implantes dentales fracasado

More and more frequently in dental clinics we are confronted with more extreme maxillary and mandibular atrophy and in many cases with the retreatment of biologically and/or mechanically failed implants. In the present clinical case we show a patient with a combined atrophy (horizontally and vertically) in addition to a failed dental implant treatment

Regeneración ósea vertical y horizontal mediante la técnica de Khoury tras un fracaso implantológico / Vertical and horizontal bone regeneration by the Khoury technique after implant failure

Los implantes dentales constituyen una alternativa predecible para la rehabilitación de los maxilares edéntulos, sin embargo, el éxito del tratamiento puede ver-se comprometido cuando existen graves atrofias maxilares. Para el tratamiento de estos casos complejos, se han desarrolla-do técnicas de regeneración ósea, entre las que destacan la regeneración ósea guiada y los injertos en bloque. Dentro de estos últimos, cabe destacar la técnica de Khoury. Se trata de un procedimiento indicado para regenerar defectos horizontales y verticales, mediante la obtención de finas láminas de hueso autógeno procedentes de la línea oblicua externa mandibular. Se presenta un caso clínico de un gran defecto mandibular reconstruido con la técnica de Khoury, secundario a un fracaso implantológico que además ocasionó patología nerviosa

Dental implants constitute a predictable alternative for the rehabilitation of edentulous jaws. However, the success of the treatment can be limited when severe atrophic alveolar ridges are present. For the treatment of these complex cases, several regeneration techniques have been developed, such as guided bone regeneration and block grafts. Within the last, it should be noted the Khoury technique. It is a procedure indicated for the regeneration of horizontal and vertical defects, through the obtention of autologous graft in form of thin plates, derived from mandibular external oblique line.A clinical case is presented, that consists in a great mandibular defect which was reconstructed by the Khoury technique. The defect was secondary to an implant failure, which was also related with nervous pathology

Oral health and systemic inflammatory, cardiac and nitroxid biomarkers in hemodialysis patients

Background: Periodontal diseases have systemic inflammatory effects and have been adversely associated with cardiovascular diseases, which are also the most frequent cause of death in the end-stage renal disease. The aim of this cross-sectional study was to investigate the oral health and serum biomarkers among the hemodialysis (HD) patients in Slovenia. Material and Methods: 111 HD patients were periodontally examined and their sera were assayed for C-reactive protein (CRP), cardiac troponin T (TnT), nitrite/nitrate (NOx) and antibody levels to A. actinomycetemcomitans and P. gingivalis. The association of oral health with systemic response was analyzed with Kruskal-Wallis test, Fisher’s exact test and multivariate linear regression. Results: Bleeding on probing without periodontal pockets was present in 5.2%, calculus without periodontal pockets in 42.1%, shallow periodontal pockets in 39.5% and deep periodontal pockets in 13.2% of dentate patients. There were 28.8% edentulous participants. 63.1% of the patients had CRP levels higher than 3 mg/L and 34.2% higher than 10 mg/L. TnT was detectable in all participants, with 25.2% exhibiting levels higher than 100 ng/L. The median level of NOx was 43.1 µmol/L. Participants with higher CRP were more likely to be edentulous and have higher TnT levels. A direct association of oral health with TnT or NOx was not detected. Conclusions: HD patients in Slovenia have compromised oral health and increased serum inflammatory and cardiac biomarkers. Edentulousness was an independent predictor for the increased CRP, indicating a need for improved dental care to retain the teeth as long as possible (AU)

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Inflammatory papillary hyperplasia: A systematic review

INTRODUCTION: Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use. OBJECTIVES: The aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated. MATERIAL AND METHODS: A search was carried out in PubMed (January 2005 to October 2015) with the key words «inflammatory papillary hyperplasia», «denture stomatitis», «granular stomatitis» and «Newton's type III» The inclusion criteria were studies including at least a sample of 50 apparently healthy patients, articles published from 2005 to 2015 written in English. The exclusion criteria were reviews and non-human studies. RESULTS: Out of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH. CONCLUSIONS: IPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among nondenture-wearers is extremely unusual

Wearing complete dental prostheses - Effects on perioral morphology

BACKGROUND: To adequately perform rehabilitation of edentulous patients by a complete removable dental prosthesis (CRDP) is from basic interest to dentists to understand the morphologic changes caused by re-establishment of a physiologic jaw relationship. Anthropometric analyses of standardized frontal view and profile photographs may help elucidate such changes. MATERIAL AND METHODS: Photographs of 31 edentulous patients were compared in relaxed lip closure and after insertion of a CRDP in stable occlusion. 2232 anthropometric distances were raised. Eighteen anthropometric indices reflecting the perioral morphology and its integration in the vertical facial harmony were investigated. RESULTS: The intercanthal - mouth width index (p < 001), medial - lateral cutaneous upper lip height index (p = .007), lower vermilion contour index (p = .022), vermilion - total upper lip height index (p = .018), cutaneous - total upper lip height index (p=.023), upper lip - nose height index (p = .001), nose - upper face height index (p = .002), chin - mandible height index (p = .013), upper lip - mandible height index (p = .045), nose - lower face height index (p = .018), and nose - face height index (p = .029) showed significant pre- to post-treatment changes. CONCLUSIONS: The investigated anthropometric indices presented reproducible results related to an increase in occlusal vertical dimension. Their application may be helpful in assessment, planning, and explanation of morphologic effects of CRDPs on the perioral and overall facial morphology, which may helps to improve the aesthetic outcome

Sobredentaduras con implantes en pacientes geriátricos edéntulos totales / Overdentures-supported with implants in totally edentulous geriatric Patients

En la actualidad, la implantología oral constituye una modalidad terapéutica en el tratamiento prostodóncico de los pacientes mayores edéntulos totales. La utilización de implantes oseointegrados para rehabilitar la mandíbula o el maxilar edéntulos ha aumentado en el tratamiento de los pacientes geriátricos. La odontología clínica ha demostrado la aplicación con éxito de las técnicas implantológicas orales en los pacientes ancianos. Las sobredentaduras son una excelente modalidad terapéutica de prótesis sobre implantes con una buena respuesta funcional y estética en estos pacientes. La valoración médica y un plan de tratamiento es necesaria para optimizar los beneficios de la rehabilitación oral con sobredentaduras implantosoportadas sobre la calidad de vida de los pacientes geriátricos. Algunos implantes pueden constituir los elementos retentivos, mediante ataches de las sobredentaduras. Los resultados clínicos de muchos estudios demuestran que la rehabilitación prostodóncica mediante una sobredentadura con implantes de los pacientes edéntulos representa una terapéutica implantológica con éxito (AU)

Today, oral implantology constitute a therapeutic modality in the prosthodontic treatment of totally edentulous patients. Use of osseointegrated implants to restore edentulous mandible and maxilla has increased in the treatment of geriatric patients. Clinical dentistry have demonstrated the successfull application of oralimplantology techniques in older patients. Overdentures are an excellent treatment modality of implant prosthesis with a good functional and aesthetic response in these patients. Medical assessment and treatment planning is needed for optimize the benefits of oral rehabilitation with implant overdentures over quality of life in geriatric patients. Several implants can be retentive components, by attachments, of overdentures. Clinical outcomes of many studies demonstrate that prosthodontic rehabilitation in the maxilla or mandible of edentulous patients with overdentures supported by several implants is a successful implant treatment (AU)

Prótesis removible en el paciente geriátrico / Removable prosthesis in the geriatric patient

En nuestro entorno sociodemográfico, según las condiciones económicas actuales, cada vez más pacientes ancianos optan por rehabilitar su boca mediante prótesis removible, y aun siendo las prótesis parciales removibles y prótesis completas tratamientos estudiados y descritos desde hace mucho tiempo, todavía hoy es básico el conocimiento de las técnicas y pasos para su elaboración. Además, son la base sobre la que se construyen las rehabilitaciones removibles sobre implantes, que ayudan a muchos pacientes geriátricos con problemas de retención y estabilidad en su prótesis removible. En el artículo se resume la situación actual delas prótesis removibles parciales, completas y sobre implantes, las técnicas clásicas de confección y las novedades más actuales en cuanto a materiales, diseño y elaboración por CAD-CAM, y se describe la importancia del conocimiento por parte del paciente y sus cuidadores de las instrucciones de higiene y mantenimiento para garantizar buenos resultados a largo plazo (AU)

Actually, in our sociodemographic environment, and according to the economic conditions, more and more elderly patients use removable prostheses, and being removable partial dentures and complete dentures, treatments studied and described long ago, the knowledge of techniques and steps for developing this type of prosthesis remain basic yet today. In addition, it is also the basis for the removable restorations on implants, which help many elderly with retention and stability requirements in their removable dentures. The article summarize the current situation of partial, complete and implant dentures, classical confection techniques and the latest developments in materials, design and fabrication by CAD-CAM, and describes the importance of the patient and caregivers knowledge for a correct hygiene and maintenance to ensure long-term success (AU)

El tratamiento con implantes dentales en los pacientes adultos mayores / Dental implant treatment in elderly patients

En las últimas décadas, la implantología oral ha representado una técnica creciente en gerodontología. En este sentido, la edad avanzada no es una contraindicación para la implantología oral. Desde un punto de vista integral, es necesario la valoración de las condiciones médicas del paciente mayor, un diagnóstico oral, y una correcta planificación de tratamiento, con un estricto protocolo quirúrgico y prostodóncico. Muchos pacientes candidatos para la cirugía de implantes son mayores, y su perfil médico puede ser complejo. La comunicación con su médico puede ser importante para minimizar los riesgos quirúrgicos. Después de la fase quirúrgica, el éxito a largo plazo de los implantes dentales exige una buena reacción de los tejidos blandos y duros periimplantarios. Prótesis fijas y removibles pueden estar indicadas en los pacientes mayores edéntulos, según diferentes protocolos de carga funcional. El mantenimiento por el paciente y las revisiones periódicas por el dentista son muy importantes. Las prótesis implanto soportadas mejoran la calidad de vida oral y el bienestar psicosocial de los pacientes ancianos edéntulos (AU)

During last decades, implant dentistry has been an increased technique in geriatric dentistry. Aging is not a contraindication for oral implantology. From a comprehensive point of view, are necessary a medical assessment of the aged patient, an oral diagnosis, a correct treatment planning, with a strict protocol of surgical and prosthetic procedures. Many patients for dental implant surgery are elderly, and their overall medical condition may be complex. Consultation with the patient´s physician is important to ensure that surgical risks are minimized. After the surgical step, a good reaction of hard and soft tissues is necessary for long-term success of dental implants. Fixed and removable prostheses supported by dental implants were been indicated in edentulous older patients, according several functional loading protocols. Maintenance by the patient and periodical follow-up by the dentist are very important. Implant-supported prostheses improve oral quality of life and psychosocial well-being of edentulous aged patients (AU)

Análisis de las causas de exodoncia en dentición permanente en pacientes que acuden a la consulta de odontología de un Centro de Salud de Atención Primaria / Analysis of the causes of permanent teeth extraction in patients that attend a Dentistry Practitioner at a Primary Care Centre

Introducción: El presente estudio persigue conocer las causas de exodoncia en la consulta de odontología de Atención Primaria en el Centro de Salud Juncal (Torrejón de Ardoz) y valorar que diente/s es/son los más subsidiarios de ser extraídos, ver si hay un mayor número de exodoncias según edad y sexo, conocer la frecuencia de extracciones en población inmigrante y conocer la carga que suponen las exodoncias en el contexto de la presión asistencial diaria en la unidad de Salud bucodental. Método: Realizamos un estudio de campo, epidemiológico descriptivo, observacional transversal, siendo la población de estudio los pacientes mayores de 6 años que acuden a la consulta a demanda de odontología de Atención Primaria y que se les exodoncia uno o varios dientes de la dentición permanente. Resultados: Se realizaron 773 exodoncias, un 48% a varones y un 52% a mujeres. La media de edad fue 46,72 años y el grupo con mayor número de exodoncias fue el comprendido entre 60-69 años (21,73 %). La caries fue la causa más frecuente de exodoncia (63,9%), seguida de la enfermedad periodontal (17,6%) y la alteración de la erupción de los cordales (6,7 %). Conclusiones: Es necesario potenciar el desarrollo de actividades de promoción y prevención dental en la población infantil de 6-15 años en Atención Primaria e implementar actividades de higiene oral en población adulta, para disminuir la tasa de exodoncias en las unidades de Salud bucodental (AU)

Introduction: The aim of this study is to describe the causes of tooth extraction in the Primary health dental clinic in Juncal health Centre (Torrejón de Ardoz) and evaluate which tooth/teeth is/are the most susceptible to be extracted, determinate if there is a high number of dental extractions depending of the age and sex, know the dental extraction incidence in the immigrant population and the burden of tooth extractions into the daily healthcare context at the Oral health unit. Method: An epidemiological descriptive, prospective observational field study has been done, in the study population of patients older than 6 years of age who come to the Primary health dental clinic demanding treatments and one or several permanent teeth extractions. Results: 773 tooth extractions were done: 48% in male and a 52% in female. The average age was 46.72 years and the group with the highest number of dental extractions was the one between 60-69 years old (21.73%). Caries was the main reason of tooth extraction (63.9%), followed by the periodontal disease (17.6%) and the wisdom tooth problems (6.7%). Conclusions: Dental promotion is necessary to encourage the development of preventive activities among child population between 6-15 years old in Primary health and improving oral hygiene conduct among adult population to reduce the rate of tooth extractions at the Oral health unit (AU)

The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: a systematic review

AIM: The purpose of this study was to systematically review clinical studies examining the survival and success rates of implants placed with intraoral onlay autogenous bone grafts to answer the following question: do ridge augmentations procedures with intraoral onlay block bone grafts in conjunction with or prior to implant placement influence implant outcome when compared with a control group (guided bone regeneration, alveolar distraction, native bone or short dental implants.)?Material and METHOD: An electronic data banks and hand searching were used to find relevant articles on vertical and lateral augmentation procedures performed with intraoral onlay block bone grafts for dental implant therapy published up to October 2013. Publications in English, on human subjects, with a controlled study design -involving at least one group with defects treated with intraoral onlay block bone grafts, more than five patients and a minimum follow-up of 12 months after prosthetic loading were included. Two reviewers extracted the data. RESULTS: A total of 6 studies met the inclusion criteria: 4 studies on horizontal augmentation and 2 studies on vertical augmentation. Intraoperative complications were not reported. Most common postsurgical complications included mainly mucosal dehiscence (4 studies), bone graft or membrane exposures (3 studies), complete failures of block grafts (2 studies) and neurosensory alterations (4 studies). For lateral augmentation procedures, implant survival rates ranged from 96.9% to 100%, while for vertical augmentation they ranged from 89.5% to 100%. None article studied the soft tissues healing. CONCLUSIONS: Survival and success rates of implants placed in horizontally and vertically resorbed edentulous ridges reconstructed with block bone grafts are similar to those of implants placed in native bone, in distracted sites or with guided bone regeneration. More surgical challenges and morbidity arise from vertical augmentations, thus short implants may be a feasible option

Implantes cigomáticos, ¿Cuándo y cómo se pueden emplear? / Zygomatic implants, When and how it can be used?

Mediante esta revisión bibliográfica se pretende evaluar cuáles son las indicaciones de los implantes cigomáticos, además de establecer las diferentes técnicas para llevarlos a cabo. Los implantes cigomáticos poseen unas características especiales que los hacen idóneos para la rehabilitación de maxilares extremadamente atróficos. Ofrecen excelentes ventajas frente a las técnicas convencionales: técnica menos invasiva, más económica, con menor tiempo de duración, y con posibilidad de realizar carga inmediata con muy altos porcentajes de éxito. También presentan ciertas complicaciones. Las técnicas para llevarlas a cabo se basan en función de si el seno es atravesado o no por el implante, intrasinusal o extrasinusal; y ambas técnicas pueden realizarse mediante un protocolo convencional o con cirugía guiada. La revisión realizada muestra una tasa de éxito superior al 96% a medio y largo plazo. Por lo que debe tenerse en cuenta entre las opciones terapéuticas

Through this literature review is to assess what are the indications of zygomatic implants, in addition to establishing the different techniques to accomplish them are. Zygomatic implants have special characteristics that make them suitable for the rehabilitation of extremely atrophic jaws. Offer great advantages over conventional techniques: less invasive technique, more economical, less duration, with the possibility of immediate loading with very high success rates. Also presents certain complications. The techniques for carrying out a function based on whether or not the heart is traversed by the implant, or extrasinusal intrasinusal, and both techniques may be performed by a conventional protocol or guided surgery. The review shows a success rate of over 96% in the medium and long term. It should be noted that among the therapeutic options

Relación entre calidad de vida relacionada con la salud oral, pérdida dental y prótesis removible en adultos mayores de 50 años derechohabientes del IMSS / The relationship between oral health- related to quality of life, tooth loss and removable prostheses in IMSS beneficiaries adults over the age of 50

Objetivo: Identificar la relación que hay entre la calidad de vida relacionada con la salud oral (CVRSO) en pacientes con pérdida dental y uso de prótesis removible. Material y métodos: Estudio transversal en 533 adultos mayores de 50 años de la Unidad Médica Familiar 20 -IMSS-. Se aplicó un cuestionario que incluyó el OHIP-14 (escala que mide la CVRSO) y medición clínica de la pérdida dental y las prótesis removibles. Resultados: La prevalencia de edentulismo total fue de 9,9% y de uso de prótesis 35%, de éstas 66% tenían mala calidad. La media del OHIP-14 fue de 9,83. Se clasificó a los sujetos en siete grupos siguiendo dos criterios: pérdida dental (menos de 20 dientes) y uso de prótesis removible. En la evaluación, el grupo con peor CVRSO fue el grupo que no usaba prótesis removible pero sí requería al tener menos de 20 dientes. Discusión: El uso de prótesis removible, cuando las personas tienen menos de 20 dientes, mejora la CVRSO aun siendo éstas de mala calidad. Si se tienen 20 dientes o más puede ser una opción no usar prótesis removible para tener una buena calidad de vida relacionada con la salud oral, pero si se tiene menos de 20 dientes sí es necesario

Objective: To identify the relation between oral health and quality of life (OHRQoL) in patients with tooth loss and prosthesis. Material and methods: Cross-sectional study in 533 patients of the Instituto Mexicano del Seguro Social (IMSS), which included OHIP-14 and also clinical measures of the oral conditions, considering tooth loss and prosthetic rehabilitation. Results: The prevalence of total edentulism was of 9.9%, and the use of removable prosthesis of 35%, from which 66% were of poor quality. The mean of OHIP was of 9.83. Subjects were classified into seven groups according to two criteria: tooth loss (less than 20 teeth) and the use of removable prosthesis. The group with the worst results regarding OHRQoL was the group that did not use removable prosthesis, but required them due to having less than 20 teeth. Discussion: The use of removable prosthesis in people with less than 20 teeth improves the OHRQoL, even though the prosthetics may be of poor quality. It may be an option not to use removable dentures when the amount of teeth is more than 20, but it is necessary when people have less than 20 teeth

Evaluation of socket healing in patients undergoing bisphosphonate therapy: Experience of a single Institution

Objective: To assess the clinical features of exodontias performed in cancer patients who have been receiving intravenous bisphosphonates (BPs). Study Design: This is a retrospective cohort study using a sample of 20 patients receiving BPs who had 62 teeth extracted. An univariate analysis was applied to calculate socket healing time (HT), comparing among exodontias performed according to cause, such as periodontal disease or caries, type of BP, and use of corticosteroid. In order to analyze the influence of each variable on HT, multiple statistical analyses were performed through logistic multiple regression. Results: From the 62 tooth extractions performed, 5 exodontias had evolved to 4 sites of bisphosphonate-related osteonecrosis of the jaws (BOJ). Of another 57 exodontias without development of BOJ, HT was significantly better for tooth extraction performed in patients receiving corticosteroid (p= .01), for tooth extracted due to caries (p= .04), and for extractions under pamidronate (p= .03). Sockets after exodontias due to periodontal diseases had OR= 5.22 (95% CI 1.73-133.66, p=0.01) for delayed HT, exodontias performed under corticosteroid use had OR=0.04 (95% CI 0.01-0.40, p<0.001), and exodontias performed under zoledronate had OR=0.31 (95% CI 0.08-1.25, p=0.10). Conclusions: Exodontias performed in patients under BP therapy had a low rate of BOJ occurrence. Zoledronate and periodontal diseases influence delayed socket healing. Adjuvant antibiotics could be relevant procedures aimed at reducing the risk of BOJ development (AU)

Oral health-related quality of life in complete denture wearers depending on theirsocio-demographic background, prosthetic-related factors and clinical condition

Objectives: To investigate the differences in impact on oral health-related quality of life (OHRQoL) among complete denture wearers depending on their socio-demographic characteristics, prosthetic-related factors and oral status. Study Design: 51 patients aged 50-90 years treated, from 2005 to 2010, with at least one complete denture at the Department of Buccofacial Prostheses of the Complutense University (Madrid) were enrolled in this crosssectional study. All of the participants answered the Oral Health Impact Profile (OHIP-14sp) questionnaire. The additive scoring method was used. The prevalence of impacts was calculated by using the occasional threshold (..) (AU)

Comparison of implant primary stability between maxillary edentulous ridges receiving intramembranous origin block grafts

Purpose: The purposes of the present study were: to compare the resonance frequency analysis (RFA) values of implant placed in either ramus or calvaria block grafts; and to determine if implant diameter influences RFA implant stability quotient (ISQ) value. Material and Methods: This was a retrospective study that included 16 consecutives healthy patients treated with autogenous on lay block grafts for horizontal bone reconstruction in maxilla. Ten ramus and ten calvaria block graft treated patients were selected and compared. Results: Totally, 59 implants were placed, 35 (59.3%) were placed on the calvaria bone grafts and the remaining24 (40.7%) were on the ramus bone graft. Of all the implants studied, 13 (22%), 35 (59.3%), and 11 (18.6%) were10 mm, 11.5 mm and 13 mm in length respectively. Regarding the diameter, 4 (7%) were 3.3 mm, 3 (5%) were 3.5mm, 20 (34%) were 3.7 mm and 32 (54%) were 4 mm. Mean ISQ value obtained by RFA was 73.06 ± 6.08, being72.19 ± 6 and 74.47 ± 6.06 for the calvaria and ramus treated group respectively. No significant differences were noted between the two groups (p= 0.154). Implants were pooled and divided by their diameter. Mean ISQ value obtained for 3.3 mm was 80 ± 5.09, while for 4.0 mm was 72.5 ± 7.19. Again, no significant differences were found among the groups (p= 0.138).Conclusion: For RFA ISQ value, the bone graft origins (calvaria or ramus) or implant diameters did not influence the outcome (AU)

Factors associated with edentulousness in an elderly population in Valencia (Spain) / Factores asociados con el edentulismo en población anciana de Valencia (España)

Objective: To determine the prevalence of edentulism and its association with various socioeconomic factors and oral health habits in the population aged 65-74 years old in the region of Valencia. Methods: A cross sectional study was designed. Thirty-four primary health centers and five nursing homes were chosen at random in the region of Valencia (10-15 voluntary participants per sampling point). Clinical examinations were carried out by three calibrated dentists (kappa>0.85) in the same centers. The total sample consisted of 531 individuals (235 men and 296 women). Results: The percentage of toothlessness was 20.7% and the mean number of natural teeth present was 14.92. The prevalence of edentulism was significantly higher (p <0.05) in men, institutionalized persons, those with no schooling, those with poor oral hygiene, those who visited the dentist regularly and those living in peri-urban/rural areas. In a multivariate logistic regression model with edentulism as the dependent variable, the following factors were identified as significant independent variables: institutionalization (odds ratio [OR]=2.88), poor oral hygiene (OR=2.35), regular visits to the dentist (OR=2.34) and age (OR=1.19). Conclusion: Edentulousness is a complex phenomenon that involves distinct social and economic factors (AU)

Objetivo: Determinar la prevalencia del edentulismo y su asociación con diferentes factores socioeconómicos y de hábitos de salud oral en la población valenciana de 65 a 74 años de edad. Métodos: Se diseñó un estudio transversal. Se seleccionaron aleatoriamente 34 centros de salud de atención primaria y cinco residencias geriátricas de la Comunidad Valenciana (10 a 15 individuos voluntarios por punto de muestreo). Las exploraciones clínicas las realizaron tres odontólogos previamente calibrados (kappa>0.85) en los mismos centros. La muestra total fue de 531 personas, 235 hombres y 296 mujeres. Resultados: El porcentaje de desdentados totales fue de 20,7, y la media de dientes naturales presente de 14,92. La prevalencia de edentulismo fue significativamente mayor (p <0.05) en los hombres, en las personas institucionalizadas, que no tienen estudios, con pobre higiene oral, que visitan regularmente al odontólogo y en las que viven en zonas periurbanas o rurales. En un modelo de regresión logística multivariada con el edentulismo como variable dependiente se han hallado como variables significativas la institucionalización (odds ratio [OR]=2,88), la pobre higiene oral (OR=2,35), las visitas regulares al odontólogo (OR=2,34) y la edad (OR=1,19). Conclusión: El edentulismo es un fenómeno complejo, con diversos factores sociales y económicos implicados (AU)

Satisfacción de los pacientes con tratamientos implantológicos. Revisión de la literatura / Patient satisfaction with implant treatments. Review of the literature

La pérdida de dientes, definida por la Organización Mundial de la Salud como una discapacidad, conlleva cambios físicos y psicológicos en el paciente. El profesional puede diagnosticar el estado físico, pero no puede analizar la situación psicológica si no utiliza instrumentos que midan la salud oral y la influencia que esta tiene en el modo de vida de los pacientes. Lo cual, ha derivado en múltiples estudios que analizan la calidad de vida relacionada con la salud oral. Se realizó una revisión bibliográfica de la literatura científica publicada sobre el tema. La literatura aporta un consenso entre los autores, en que la satisfacción de los pacientes tras un tratamiento implantológico, mejora sustancialmente. Entre los factores que pueden condicionar el grado de satisfacción de estos pacientes, están el tipo de prótesis, los años de rehabilitación, la edad, el sexo, el estado de salud general, factores socioeconómicos, la dieta y la ansiedad preoperatoria. El tratamiento implantológico de los pacientes desdentados, deriva en resultados funcionales, estéticos y psicológicos, altamente satisfactorios. El tipo de prótesis, así como las características de cada paciente, condicionarán el grado de satisfacción (AU)

The loss of teeth, defined by the World Health Organization as a disability, entails physical and psychological changes in the patient. The professional can diagnose the physical state, but he cannot analyze the psychological situation if he does not use instruments that measure the oral health and the influence that this has on the patient’s lifestyle. This has led to many studies that analyze the quality of life related to oral health. A bibliographical review was conducted of the scientific literature published on the subject. The literature provides a consensus among the authors, in which patient satisfaction after an implant treatment improves substantially. Among the factors that may condition the degree of satisfaction of these patients are the type of prosthesis, the years of rehabilitation, age, gender, state of general health, socioeconomic factors, diet and preoperative anxiety. The implant treatment of the edentulous patients leads to highly satisfactory functional, aesthetic and psychological results. The type of prosthesis, as well as the characteristics of each patient, condition the degree of satisfaction (AU)

Intravenous bisphosphonate-related osteonecrosis of the jaws: Influence of coadjuvant antineoplastic treatment and study of buccodental condition

Objectives: To determine whether coadjuvant antineoplastic treatment can influence the number and size of bone exposures among patients with intravenous bisphosphonate-related osteonecrosis of the jaws (iBRONJ), and to analyze the buccodental condition of these patients. Material and methods: The study sample comprised 67 patients with iBRONJ, 53 patients without iBRONJ receiving treatment with intravenous bisphosphonates, and 36 healthy subjects. In all three groups, measurements were made of the CAO index and of resting whole saliva and stimulated whole saliva. In the patients with iBRONJ, the size (cm) and number of bone exposures were recorded. The data obtained were subjected to analysis of variance (ANOVA), the Mann-Whitney U-test, and multivariate logistic regression analysis. Results: A total of 57.6% of the patients presented single bone exposure, 25.4% presented two, and 17% more than two exposures. The mean exposure size was 2.3±1.9 cm. Neither the bivariate analysis nor the multivariate multiple regression analysis found coadjuvant antineoplastic treatment to exert a statistically significant effect upon the number and size of bone exposures. On the other hand, there were statistically significant differences among the three study groups in relation to the CAO index (p=0.02) and the number of missing teeth (p=0.00). The resting whole saliva and stimulated whole saliva levels were similar in the three groups, though the patients with osteonecrosis of the jaws showed comparatively lower SWS levels. Conclusions: Coadjuvant antineoplastic treatment alone appears to exert no influence upon the size and number of bone exposures in iBRONJ. The patients with this disease show a higher CAO index and a larger number of missing teeth (AU)

Oral Health-Related Quality of Life in institutionalized elderly in Barcelona (Spain)

Objective: The objective of this study is to describe the oral health status and the factors associated with oral health-related quality of life (OHRQoL) in people aged 65 and older institutionalized in Barcelona in 2009. Study Desing: Cross sectional study in 194 elderly. The dependent variable was poor OHRQoL, according to the Geriatric Oral Health Assessment Index (GOHAI). The independent variables were socio-demographic data, last dental visit, subjective and objective oral health status. Robust Poisson regression analysis was used to determine the factors associated with OHRQoL as well as the strengths of association (Prevalence Ratios with respective confidence intervals at 95%). Results: According to GOHAI, 94 women (68.1%) and 36 men (64.3%) had poor OHRQoL. The average DMFT index (number of decayed, missing and filled teeth) was 22.8, with mean 10.2 remaining teeth. According to the Community Periodontal Index only 1.9% were healthy. 33.8% of the sample (35.5% of women and 30.4% of men) presented edentulism, 54.2% needed upper dental prostheses (51.1% of women and 60.7% of men) and 64.7% needed lower ones (61.6% of women and 71.4% of men). Only 7.2% had visited a dentist in the past year (8.8% of women and 3.6% of men). After fitting several multivariate adjusted robust Poisson regression models, poor OHRQoL was found to be associated to self-reporting problems with teeth or gums, self-reporting poor opinion about teeth/gums/denture and also associated to functional edentulism, needing upper denture, but not to sociodemographic factors or time since last dental visit (AU)