Candida albicans biofilms on different materials for manufacturing implant abutments and prostheses

BACKGROUND: Morphological, physical and chemical properties of both implants and prostheses can determine the biofilm formation on their surface and increase the risk of biological complications. The aim of this study was to evaluate the capacity of biofilm formation of Candida albicans on different materials used to manufacture abutments and prostheses. MATERIAL AND METHODS: Biofilm formation was analyzed on cp grade II titanium, cobalt-chromium alloy and zirconia, silicone, acrylic resin (polymethylmethacrylate) and nano-hybrid composite. Some samples were partially covered with lithium disilicate glass ceramic to study specifically the junction areas. C. albicans was incubated in a biofilm reactor at 37 °C with agitation. The biofilm formation was evaluated at 24 and 48 hours. In addition, the morphology of the biofilm was evaluated by scanning electron microscopy. RESULTS: C. albicans developed biofilms on the surface of all materials tested. Cobalt-chromium alloy showed the lowest density of adhered biofilm, followed by zirconia and titanium. Silicone and resin showed up to 20 times higher density of biofilm. A higher biofilm formation was observed when junctions of materials presented micro-pores or imperfections. CONCLUSIONS: The biofilm formed in the three materials used in the manufacture of abutments and prostheses showed no major differences, being far less dense than in the resins. Two clinical recommendations can be made: to avoid the presence of resins in the subgingival area of implant prostheses and to design prostheses placing cobalt-chromium alloy/ceramic or titanium/ceramic junctions as far as possible from implants

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Tasa de supervivencia de implantes simultáneos con elevación crestal sin injerto óseo ≤ 5 mm hueso residual (RBH) / Survival rate of simultaneous implants with crestal elevation without bone graft ≤ 5 mm residual bone (rbh)

Antecedentes: La técnica de elevación de suelo del seno maxilar con osteótomos (OSFE) consiste en la realización de un lecho en la cresta ósea por don-de se despega y eleva la membrana de Schneider usando los osteótomos con el fin de colocar implantes de una manera menos invasiva, reduciendo el tiempo de la cirugía y disminuyendo las molestias postoperatorias. Hay diferentes factores a la hora de realizar la técnica, como es la cantidad de hueso residual que posee el maxilar atrófico o el tipo de injerto que se va a situar en el seno. El objetivo principal es evaluar la tasa de supervivencia de los implantes colocados de manera simultánea en maxilares atróficos de ≤ 5 mm RBH (hueso residual) y sin colocación de injerto en la cavidad sinusal. Material y métodos: El estudio consiste en una revisión sobre la realización de elevaciones crestales ≤ 5 mm de hueso residual sin el uso de injertos. Para ello hemos analizado 7 estudios, 2 RCT (en-sayos clínicos aleatorizados), 3 estudios retrospectivos y 2 estudios prospectivos. Resultados: Se produjeron 24 perdidas de implantes, siendo 17 tempranas (antes del año) en 379 implantes colocados. Obteniendo tasas de supervivencia de entre 91,4% al 100% en los respectivos estudios analizados. La pérdida ósea marginal del grupo injerto y grupo no injerto era similar. La ganancia ósea sinusal era mayor en el grupo injerto que en el grupo no injerto. Conclusiones: La tasa de supervivencia de la elevación crestal con colocación simultánea de implantes ≤ 5 mm de hueso residual sin colocación de injerto, mostró ser un tratamiento seguro y eficaz, aunque se necesitan más estudios al respecto

Background: The osteotome maxillary sinus floor elevation technique (OSFE) consists in the realization of a bed at the top of the ocean where the Schneider’s membrane is detached and raised using the osteotomes in order to place implants in a lesser invasive manner, reducing the time of surgery and reducing postoperative discomfort. There are different factors when performing the technique, such as the amount of residual bone that has the maximum flow type or the type of injection that will be placed in the breast. The main objective is to evaluate the survival rate of implants placed simultaneously in atrophic maxillae of ≤ 5 mm RBH (residual bone) and without graft placement in the sinus cavity. Material and methods: The study consists of a systematic review approach on the performance of crestal elevations ≤ 5 mm of residual bone without the use of grafts. This analysis is based on 7 studies, 2 RCT (randomized clinical trials), 3 retrospective studies and 2 prospective studies. Results: There were 24 implants lost, 17 in the short-term (prior to a year) from the 379 implants placed. Obtaining survival rates of between 91.4% to 100% for the cases analyzed. The marginal bone loss of the injected group and non-injected group was similar. Sinus bone gain was greater in the group that participated in the non-graft group. Conclusions: The survival rate of crestal elevations with the simultaneous placement of implants ≤ 5 mm of residual bone was a safe and effective work, although greater detailed investigations are required

Tasa de supervivencia de los implantes dentales de óxido de circonio. Una revisión sistemática y metaanálisis / Survival rate of zirconium oxide dental implants. A systematic review and meta-analysis

Antecedentes. A pesar de que el titanio es un material popular en implantología, su color grisáceo puede dar lugar a problemas estéticos. Por lo tanto, la investigación se ha centrado en la búsqueda de un material para el implante que posea el mismo color del diente, que mejore su apariencia estética, y al mismo tiempo, que sea altamente biocompatible y capaz de soportar las fuerzas presentes en la cavidad oral. Objetivo. Determinar, por medio de una revisión sistemática y un metaanálisis, las tasas de supervivencia de los implantes dentales de óxido de circonio. Material y método. Se realizó una búsqueda de la literatura hasta diciembre del 2015, en las bases de datos biomédicas Pubmed, Scopus, Web of Science y Google Académico. Se definieron previamente los criterios de selección de los estudios que consideraban los implantes dentales de óxido de circonio, con una antigüedad máxima de 5 años, que reportaran tasa de supervivencia, tiempo de seguimiento mayor o igual a un año y un tamaño de muestra mayor o igual a 10 pacientes. Se analizó la calidad metodológica de los estudios por medio de las escalas JADAD y CMQ. Resultados. La estrategia de búsqueda resultó en 13 artículos en los que la tasa de supervivencia global fue del 91,43% con un seguimiento de entre 1 y 5 años. Conclusión. La literatura revisada señala que los implantes dentales de óxido de circonio poseen la misma tasa de supervivencia que los implantes dentales de titanio, sin embargo, se necesitan más investigaciones para recomendar su uso clínico (AU)

Background. Although titanium is a popular material in implantology, its greyish colour can lead to aesthetic problems. Therefore, research has focused on finding a material for implants that has the same colour of the tooth, in order to improve its aesthetic appearance, and at the same time is highly biocompatible and able to withstand the forces present in the oral cavity. Objective. To determine the survival rates of zirconium oxide dental implants, using a systematic review and meta-analysis. Material and methods. A literature search was conducted up to December 2015 in the biomedical databases, PubMed, Scopus, Web of Science, and Google Scholar. The selection criteria of the studies considered to use zirconium oxide dental implants, with a maximum age of 5 years, that reported survival rates, time greater than or equal to one year follow-up, and a sample size equal to or greater than 10 patients. The methodological quality of the studies was analysed using the JADAD and CMQ scales. Results. The search strategy resulted in 13 articles, in which the overall survival rate was 91.43%, with a follow up of between 1 and 5 years. Conclusion. The literature reviewed suggests that zirconium oxide dental implants have the same survival rate than titanium dental implants, however more research is needed to recommend clinical use (AU)

Análisis in vitro de la resistencia a la fractura de estructuras de fibra de carbono termocicladas / In vitro resistance to fracture testing of carbon fiber structures after thermal cycling

Objetivos: Comparar la resistencia a la fractura de estructuras de fibra de carbono con estructuras de cobalto-cromo, unidas a resina y tras termociclado. Materiales y métodos: se confeccionaron cinco probetas de fibra de carbono y cinco de cromo-cobalto y se unieron a resina acrílica. Ambas probetas se sometieron a 5000 ciclos de termociclado, permaneciendo durante 30 segundos en saliva artificial entre 5º y 55º C de temperatura entre cada ciclo. Posteriormente se realizó un ensayo por carga en tres puntos hasta producirse fractura de las probetas. Resultados: Dos de las cinco probetas de fibra de carbono presentaron separación de los materiales tras el termociclado. El grupo de fibra de carbono obtuvo valores más bajos en la resistencia a la fractura (305,6 N), mientras que el grupo de cromo-cobalto alcanzó los 664,8 N de media (p=0,008). Conclusiones: Dentro de los límites del estudio, la resistencia a la fractura de las probetas de fibra de carbono fue significativamente menor que la de las probetas de cromo-cobalto. Es necesario mejorar las estructuras para poder indicar este material como alternativa al cromo-cobalto en prótesis híbridas implantosoportadas (AU)

Objective: To compare the resistance to fracture of carbon fiber and acrylic resin structures and with cobalt-chromium alloy and acrilic resin structures after thermal cycling. Material and methods: Five carbon fiber reinforced acrylic resin and five cobalt-chromium alloy embebed in acrylic resin specimens were fabricated. All specimens were thermal cycled from 5º to 55ºC for 5000 cycles with a 30-s dwell time. A three point loading test until fracture of specimens was performed. Results: In two of five specimens separation of carbon fiber from acrylic resin was observed after thermal cycling. The carbon fiber reinforced group presented lower resistance values (305,6 N) while cobalt-chromium group reached an average of 664,8 N (p=0.008). Conclusions: Within the limitations of this study, the resistance to fracture of carbon fiber specimens were significantly lower than cobalt-chormium group. More studies and improvment of carbon fiber reinforced resins are necessary in order to be used as alternative material for implant-supported hybrid prosthesis (AU)

Hypersensitivity reactions to implanted metal devices: facts and fictions

The use of metals in the medical field has become increasingly prevalent over the past few decades. Patients find themselves being exposed metals in a variety of ways, ranging from external exposure to instruments such as the stainless steel in surgical blades to internal exposure via medical devices being implanted in their bodies. There has been growing interest in the possibility of developing hypersensitivity reactions to constituent metals in medical implant devices, both in cutaneous and systemic forms. Hypersensitivity reactions to metals are uncommon, but they are reported and require appropriate evaluation and management, particularly if they are symptomatic. In view of the lack of consensus in the field on the appropriate steps to evaluate and manage patients with suspected metal hypersensitivity reactions, this review aims to analyze current evidence on hypersensitivity reactions to metallic implants in orthopedic surgery, endovascular surgery, obstetrics and gynecology, and dental surgery (AU)

El empleo de metales dentro de la medicina ha ido aumentando de forma progresiva en las últimas décadas. Los pacientes se exponen a metales de diferentes formas desde fuentes externas, como instrumental quirúrgico como el presente en las hojas de acero de los bisturíes, hasta implantes metálicos. Como consecuencia de ello se está produciendo un interés creciente por la posibilidad de desarrollar reacciones de hipersensibilidad a metales presentes en los materiales y objetos implantados, tanto en forma de reacciones cutáneas como sistémicas. Las reacciones de hipersensibilidad a metales no son frecuentes, pero pueden desarrollarse, y por ello, requieren de un diagnóstico y tratamiento adecuado, especialmente en aquellos pacientes que desarrollen síntomas. No existe un consenso en el proceso diagnóstico ni en el tratamiento de estas reacciones en los pacientes con sospecha de alergia a metales. Esta revisión tiene por objeto actualizar la evidencia existente sobre las reacciones de hipersensibilidad a implantes metálicos en cirugía ortopédica, cirugía endovascular, cirugía obstétrica y ginecológica (OB-GYN) así como la dental (AU)

Comparación de la dureza superficial de diferentes tipos de materiales restauradores en premolares birradiculares, un estudio in vitro / Comparison of surface hardness of different types of restoratives materials in premolars birradiculares, a in vitro study

Objetivo: Evaluar y comparar la dureza superficial en restauraciones con ionómero de vidrio y de resina compuesta en cavidades clase I según Black en premolares birradiculares. Métodos: Se realizó un estudio descriptivo, comparativo in vitro donde se midió la dureza de dos tipos de materiales restauradores odontológicos, en cavidades clase I a dos distintas profundidades diseñadas en 32 premolares birradiculares. Distribuidos en 4 grupos con características distintas entre ellos, ya fuera por el material restaurador (ionómero de vidrio, resina compuesta) o por la profundidad de la cavidad (2-4 mm). Todas las muestras de cada grupo fueron sometidos a una fuerza vertical monitorizada a través del texturómetro EZ-S SHIMADZU hasta producir la fractura del material. Para evaluar la normalidad los datos obtenidos se sometieron a la prueba Shapiro Willk que rechazó la hipótesis nula. El análisis de los datos totales se realizó a través del test t de Student para muestras independientes. Resultados: Se evaluaron las durezas de la resina a 2 y 4 mm y el ionómero de vidrio a las mismas profundidades, encontrando una diferencia estadística a favor de la resina compuestas frente al ionómero de vidrio en ambas profundidades (p = 0,000001445 y p = 2,99E-9) y, en la comparación intragrupal, sólo diferencia significativa entre los dos grupos de resina a distinta profundidad (p = 0,016). Conclusión: Los órganos dentarios con cavidades de 4 mm de profundidad que fueron restaurados con resina Tetric N-Ceram evaluados presentan mayor dureza que los restaurados con resina Vitremer a 2 y 4 mm y que la misma resina a 2 mm de profundidad

Objective: To evaluate and compare the surface hardness on restorations with glass ionomer and composite resin in Class I cavities according to Black in birradiculares premolars. Methods: Descriptive, comparative In Vitro study, in which the hardness of two types of restorative materials was measured was performed in cavities class I at two different depths designed in 32 birradiculares premolars, which were divided into 4 groups with different including features, either by the restorative material (glass ionomer, composite resin) or the depth of the cavity (2-4 mm), all specimens from each group were subjected to a vertical force through the texturometer monitored to generate the fracture of the material. To assess normal data obtained were subjected to the test Shapiro Wilk to reject the null hypothesis, while the total data analysis was performed using Student's t-test for independent samples. Results: Evaluated the hardness of the resin at 2 and 4 mm and the glass ionomer to the same depths, showing a statistical difference in favor of the composite resin Vs glass ionomer both depths (p = 0.000001445 p = 2.99E-9) and intragroup comparison showing only significant difference between the two groups at different depths resin (p = 0.016). Conclusion: Of the materials tested in this comparative hardness study, the dental organs with cavities 4 mm depth were restored with Tetric N-Ceram have greater hardness than Vitremer 2 and 4 mm and the same resin to 2 mm depth

Toxicity of a dental adhesive compared with ionizing radiation and zoledronic acid

BACKGROUND: To determine the toxicity of aqueous dilutions of a universal self-priming dental adhesive (DA) and comparing these with those elicited by exposure to ionizing radiation (IR), Zoledronic acid (Z) treatment and the synergic effects of the combined treatment with IR+Z. MATERIAL AND METHODS: The genotoxic effect of DA was determined by the increase in the frequency of micronuclei in cytokinesis-blocked in cultured human lymphocytes before and after exposure to 2Gy of X-rays. The cytotoxic effect was studied by using the MTT cell viability test in normal prostate cell lines (PNT2) after exposure to different X-ray doses (0Gy-20Gy). The cell lines divided into different groups and treated with different test substances: DA in presence of O2 , DA in absence of O2 , Z-treated and control. RESULTS: An in vitro dose-dependent and time-dependent cytotoxic effect of DA, Z and IR on PNT2 cells (p > 0.001) was demonstrated. DA without-O2, following the recommendations of manufacturers, had a more pronounced effect of increasing cell death than DA with-O2 (p < 0.001). In the genotoxicity assay, DA at 25% of its original concentration significantly increased chromosome damage (p < 0.001). The samples studied were found to be toxic, and the samples photo-polymerized in absence of O2 showed a bigger cytotoxic effect comparable to the additive toxic effect showed by the combined treatment of IR+Z. CONCLUSIONS: Additional effort should be carried out to develop adhesives, which would reduce the release of hazardous substances; since toxic effects are similar to that reported by other agents whose clinical use is controlled by the health authorities

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BT-Race - Instrumentación biológica y conservadora de los conductos radiculares teniendo en cuenta la restauración final / BT-Race - Biologic and conservative root canal instrumentation in order to final restoration

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Análisis espectrofotométrico de la decoloración dental inducida por MTA blanco y Biodentine / Spectrophotometric analysis of tooth discoloration induced by white MTA and biodentine

Objetivo: Evaluar el potencial de decoloración del ProRoot BMTA y del Biodentine en dientes humanos bajo condiciones de iluminación artificial. Material y métodos: 19 dientes humanos fueron divididos en dos grupos experimentales (n=8) y un grupo control (n=3). Los dientes fueron seccionados1 mm por debajo de la unión amelocementaria (UAC), se les extirpó la pulpa cameral y se les preparó una cavidad. Las cavidades de los grupos experimentales fueron obturadas con ProRoot BMTA(R) y con Biodentine(R), en el grupo control no se colocó ningún material. Tras 48 horas, todas las cavidades se obturaron con composite y se colocaron 10 cm debajo de una lámpara, al 100% de humedad. El color fue registrado utilizando un espectrofotómetro en cuatro momentos: tras la colocación de material, tras la restauración coronal, una y dos semanas después de la restauración. Resultados: Se observaron diferencias significativas entre los dos grupos experimentales. El grupo BMTA mostró un cambio de color mayor que el de Biodentine, a las 48 horas, a la semana y a las 2 semanas. A las 48 horas, el BMTA presentó oscurecimiento, que fue aumentado con el tiempo, revelando diferencias significativas entre los tres intervalos. No se observaron diferencias significativas entre el Biodentine y el grupo control durante todo el tiempo. Conclusiones: Debido al hecho de que el Biodentine mostró una mayor estabilidad de color que el BMTA, este se podría recomendar en tratamientos que requieran de materiales de silicato cálico (CSM) en zonas de compromiso estético. Sin embargo, se necesitan estudios a más largo plazo

Objective: To evaluate the discoloration potential of ProRoot WMTA and Biodentine in human teeth under artificial lighting conditions. Methods: 19 human teeth were divided into two experimental groups (n=8) and one control group (n=3). The teeth were sectioned 1 mm below the CEJ, the pulps were extirpated and a cavity was prepared. The experimental groups’ cavities were filled with ProRoot WMTA(R) and with Biodentine(R), no material was placed in the control group. After 48 hours, all the cavities were sealed with composite and the specimens were placed 10 cm below a lamp in a 100% humidity environment. Color values were recorded using a spectrophotometer at four time points: after the material placement, after the coronal restoration, at one and two weeks after restoration. Results: Significant differences were observed between the experimental groups. WMTA group showed a more perceptible discoloration than did Biodentine at 48 hours, 1 week and 2 weeks. At 48-hour time point WMTA presented a discoloration, which increased over time, showing significant differences between the three time intervals. No significant differences were observed between Biodentine and the control group in the three time intervals. Conclusions: Due to the fact that Biodentine showed greater color stability than did WMTA, Biodentine is recommended in treatments requiring calcium silicate materials (CSMs) for esthetically sensitive areas. However, more long-term studies are needed to verify our findings

Revisión crítica actualizada sobre la obturación con el Sistema Thermafil y su sucesor: GuttaCore / Updated critical review of the obturation with the Thermafil System and its successor: GuttaCore

El sistema de obturación Thermafil se basa en un vástago de plástico recubierto de gutapercha. Su evolución, GuttaCore, consta de un núcleo de gutapercha entrelazada con el objetivo de facilitar la remoción de éste manteniendo a la vez las buenas propiedades ofrecidas por la gutapercha termoplástica. El objetivo de este trabajo es describir ambos sistemas y analizar algunos de los aspectos más importantes de la obturación endodóntica como la capacidad desellado, la facilidad de retratamiento y la filtración apical. Para ello se ha efectuado un búsqueda bibliográfica a través de Medline utilizando publicaciones posteriores al año2002, exceptuando la inclusión de artículos más antiguos dada su relevancia. Como resultado, hemos observado que el sistema Thermafil consigue obturaciones herméticas y tridimensionales en todo tipo de conductos a excepción de reabsorciones internas o ausencia de constricción apical. Su curva de aprendizaje es rápida, así como su tiempo de ejecución. Los inconvenientes de esteción de su vástago y las frecuentes sobre obturaciones. El sistema GuttaCore parece facilitar el tiempo de retratamiento pero faltan estudios acerca su comportamiento a largo plazo. Dado que la mayoría de los estudios sobre el comportamiento de Thermafil se han realizado ex vivo, los resultados no pueden extrapolarse directamente a la práctica clínica

The root filling system Thermafil is based on a plastic carrier covered by gutta-percha. Its successor, GuttaCore, consists of a cross linked gutta-percha core with the purpose offacilitate its removal keeping the good properties offered by the thermoplastic gutta-percha. The aim of this review is to describe both based - in - carrier root filling systems Thermafil and GuttaCore and analyze some of the most important aspects of the endodontic obturation such as the sealing ability, the easiness of retreatment and the apical leakage. For this we have carried out a literature search through Medline using publications after the year2002, except for the inclusion of older articles because of its importance. As a result, we found that Thermafil System achieves hermetic and tridimensional obturations in all kinds of root canals except in resorptivecavities and in the absence of the apical constriction. Its learning curve is fast as well as the time of its performance. The disadvantages of this system are the longer time for the removal of the carrier and the often overextended obturations. The GuttaCore system seems to facilitate the retreatment's time but there are no studies about its longterm outcome. Giben that most of the studies on Thermafil's behavior has been performed ex vivo, The results cannot be directly extrapolated to the clinical practice

Bacterial adhesion efficiency on implant abutments: A comparative study

The attachment of Escherichia coli ATCC 25922 and Staphylococcus aureus ATCC 28213 onto six different materials used to manufacture dental implant abutments was quantitatively determined after 2 and 24 h of contact between the materials and the bacterial cultures. The materials were topographically characterized and their wettability determined, with both parameters subsequently related to bacterial adhesion. Atomic force microscopy, interferometry, and contact angle measurement were used to characterize the materials’ surfaces. The results showed that neither roughness nor nano-roughness greatly influenced bacterial attachment whereas wettability strongly correlated with adhesion. After 2 h the degree of E. coli attachment markedly differed depending on the material whereas similar differences were not observed for S. aureus, which yielded consistently higher counts of adhered cells. Nevertheless, after 24 h the adhesion of the two species to the different test materials no longer significantly differed, although on all surfaces the numbers of finally adhered E. coli were higher than those of S. aureus (AU)

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Effect of pH on compressive strength of some modification of mineral trioxide aggregate

Objectives: Recently, it was shown that NanoMTA improved the setting time and promoted a better hydration process which prevents washout and the dislodgment of this novel biomaterial in comparison with WTMA. This study analyzed the compressive strength of ProRoot WMTA (Dentsply), a NanoWMTA (Kamal Asgar Research Center), and Bioaggregate (Innovative Bioceramix) after its exposure to a range of environmental pH conditions during hydration. Study Design: After mixing the cements under aseptic condition and based on the manufacturers` recommendations, the cements were condensed with moderate force using plugger into 9 × 6 mm split molds. Each type of cement was then randomly divided into three groups (n=10). Specimens were exposed to environments with pH values of 4.4, 7.4, or 10.4 for 3 days. Cement pellets were compressed by using an Instron testing machine. Values were recorded and compared. Data were analyzed by using one-way analysis of variance and a post hoc Tukey's test. Results: After 3 days, the samples were solid when probed with an explorer before removing them from the molds. The greatest mean compressive strength 133.19±11.14 MPa was observed after exposure to a pH value of 10.4 for NanoWMTA. The values decreased to 111.41±8.26 MPa after exposure to a pH value of 4.4. Increasing of pH had a significant effect on the compressive strength of the groups (p<0.001). The mean compressive strength for the NanoWMTA was statistically higher than for ProRoot WMTA and Bioaggregate (p<0.001). Moreover, increasing of pH values had a significant effect on compressive strength of the experimental groups (p<0.001). Conclusion: The compressive strength of NanoWMTA was significantly higher than WMTA and Bioaggregate; the more acidic the environmental pH, the lower was the compressive strength (AU)

Actualización en microimplantes de relleno perioral atendiendo a su permanencia / Update on facial filler microimplants and their durability

Introducción y objetivo. El uso de materiales de relleno facial para la corrección de arrugas, pliegues y otros defectos es cada vez más demandado por nuestros pacientes. Se trata de materiales que al ser infiltrados provocan un aumento de volumen. Pueden clasificarse en función del tiempo de permanencia en el cuerpo en temporales o biodegradables (entre 4 y 8 meses), semipermanentes (entre 12 y 18 meses) y permanentes (no biodegradables). Nuestro trabajo tiene por objeto repasar los materiales de relleno que actualmente están aprobados por la Agencia del Medicamento en septiembre de 2010. Material y métodos. Hemos revisado a través de la página web oficial de la Agencia Española del Medicamento los materiales de rellenos aprobados por la misma en septiembre de 2010, para posteriormente hacer una revisión de la literatura científica más reciente sobre ellos. Resultados. Estos son: el ácido hialurónico, colágeno y agarosa para los materiales temporales; el ácido poliláctico, la hidroxiapatita de calcio y la policaprolactona como materiales semipermanentes; y el polimetilmetracrilato y las acrilamidas en el grupo de los materiales permanentes. Discusión. Las características ideales que debería cumplir un relleno facial son ser biocompatible, no cancerígeno, no teratógeno, no migratorio y tener resultados satisfactorios con durabilidad. Estos tipos de materiales son productos sanitarios y deben cumplir la normativa de la Agencia Española del Medicamento. Por tanto, solo deben ser utilizados por profesionales cualificados y preparados específicamente en este terreno. Conclusiones. Los rellenos temporales son los que más se emplean con fines estéticos. Sin embargo, es necesario el conocimiento de la naturaleza de cada material, sus indicaciones y las posibles complicaciones que pueden aparecer tras su uso para poder así sacar el máximo beneficio y obtener los mejores resultados posibles(AU)

Introduction and aim. The use of facial filling materials for the correction of wrinkles, folds and other faults is increasingly demanded by our patients. They are materials that on having been infiltrated lead to an increase in volume. These products can be classified depending on the time of they remain in the body and as temporary or biodegradable (between 4 and 8 months), semi-permanent (between 12 and 18 months) and permanent (not biodegradable). The aim of this work is to review the facial filling materials that are currently approved by the Spanish Medicines and Health Devices Agency (AEMPS) in September, 2010. Material and methods. The official web page of the AEMPS was searched for facial filling materials approved in September, 2010. A review was then made of the most recent scientific literature on these materials. Results. The temporary materials used are hyaluronic acid, collagen and agarose gel, with polylactic acid, calcium hydroxyapatite, and polycaprolactone as semi-permanent materials, and polymethyl methacrylate and the acrylamides in the group of the permanent materials. Discussion. The ideal characteristics for a facial filler are that it should be biocompatible, non-carcinogenic, non-teratogenic, non-migratory, and have satisfactory results with permanence. These types of materials are health products and must comply with the regulations of the AEMPS. Therefore, they must only be used by qualified professionals specifically trained in this area. Conclusions. The temporary face fillers are those that are most used for aesthetic purposes. Nevertheless, knowledge is required on the nature of every material, its indications, and the possible complications that can appear after his use, to be able to achieve the maximum benefits and obtain the best possible results(AU)

Papel de la prótesis hecha a medida a medida para la sustitución de la articulación temporomandibular / The role of custom-made prosthesis for temporomandibular joint replacement

La sustitución aloplástica de la articulación temporomandibular plantea problemas exclusivos debido al papel esencial y polifacético que esta articulación desempeña en el sistema estomatognático para establecer y mantener la función y forma mandibular apropiadas. La articulación temporomandibular no sólo actúa como un centro prepuberal del crecimiento mandibular secundario sino que también es decisiva en el mantenimiento de la masticación, el habla, soporte de las vías respiratorias y deglución apropiadas. Además, estas funciones vitales esenciales producen en la articulación una mayor carga y descarga cíclicas que en cualquier otra articulación corporal durante la vida. Por consiguiente, cuando está indicada una sustitución aloplástica de la articulación, el dispositivo elegido debe ser capaz de proporcionar desenlaces favorables de la funcionalidad y forma mandibular a largo plazo. La patología terminal de la articulación, acompañada de distorsiones de la funcionalidad fisiológica y de la forma anatómica, dicta la necesidad de su sustitución. Debido a la naturaleza compleja de las asociaciones funcionales y anatómicas de la articulación relacionadas con los músculos de la masticación, no es razonable esperar que la reconstrucción autóloga de la articulación o una sustitución aloplástica puedan restablecer la función premórbida «normal». Por consiguiente, como se entiende con cualquier sustitución ortopédica de una articulación, el cirujano y el paciente deben estar de acuerdo (y aceptar) que, en la reconstrucción o sustitución de la articulación, siempre estará presente cierto grado de discapacidad funcional. Por otra parte, en pacientes con una distorsión anatómica por múltiples intervenciones, el dolor neuropático crónico, mediado centralmente, siempre será un importante componente de su discapacidad. Por esta razón, es indispensable que el cirujano y el paciente entiendan que el objetivo primario de cualquier sustitución de la articulación es el restablecimiento de la funcionalidad y forma mandibular y que el alivio del dolor debe considerarse tan sólo un beneficio secundario. En este artículo, se describirá el papel que desempeñan los dispositivos hechos a medida para la sustitución de la articulación temporomandibular en el manejo de las enfermedades graves y debilitantes de la articulación(AU)

Alloplastic temporomandibular joint replacement (TMJ TJR) presents unique problems due to the integral and multifaceted roles this joint plays within the stomatognathic system to establish and maintain appropriate mandibular function and form. The TMJ not only acts as a secondary mandibular growth center pre-puberty, but is also crucial in maintaining proper mastication, speech, airway support and deglutition. Further, these essential life functions place the TMJ under more cyclical loading and unloading than any other body joint over a lifetime. Therefore, when TMJ TJR is indicated the device chosen must be able to provide long-term mandibular function and form outcomes. End-stage TMJ pathology accompanied by physiological function and anatomical form distortions dictates the need for replacement. Due to the complex nature of joint related masticatory muscle functional and anatomical associations, it is unreasonable to expect an autogenous reconstructed TMJ or an alloplastic replaced TMJ can be returned to “normal” pre-morbid function. Therefore, as is understood with any orthopaedic joint replacement, patient and surgeon must agree and accept that there will always be some functional disability involved with any reconstructed or replaced TMJ. Further, in the multiply operated, anatomically distorted patients, chronic neuropathic centrally mediated pain will always be a major component of their disability. Therefore, it is imperative that surgeon and patient understand that the primary goal of any TMJ TJR is the restoration mandibular function and form and that any pain relief must be considered of only secondary benefit. This paper will discuss the role of custom TMJ TJR devices have in the management of severe and debilitating TMJ disorders(AU)

Puesta al día en adhesivos para prótesis removibles / No disponible

Los adhesivos para prótesis removibles son un método alternativo para pacientes que presentan condiciones particulares por lo tanto es nuestra obligación como profesionales estar debidamente informados para poder prescribirlos adecuadamente, conociendo sus presentaciones, formulaciones, indicaciones y contraindicaciones para cada tipo de paciente y sus circunstancias particulares (AU)

The adhesives for removable prostheses are an alternative method for patients that present particular conditions on which it is our obligation as professionals to be duly informed in order to be able to prescribe them appropriately, knowing their presentations, formulas, indications and contraindications for each type of patient and their particular circumstances (AU)

Determination of susceptibility to sensitization to dental materials in atopic and non-atopic patients

Introduction: Some studies report that atopic patients have a greater frequency of delayed-type sensitization than non-atopic patients. Objective: To determine the influence of the atopic condition on delayed sensitization to dental materials. Design: cross-sectional study. Methods: Forty (40) atopic subjects and forty (40) non-atopic subjects, of both sexes, between 20 and 65 years of age were included. The determination of delayed sensitization to dental materials was performed using patch test. An oral exam was also carried out to check for lesions of the oral mucosa. Results: 61.25% of the patients were positive for delayed-type sensitization to one or more allergens, being palladium chloride (21.25%), ammoniated mercury (20%), benzoyl peroxide (12.5%) and amalgam (10%) the most frequent. The frequency of sensitization was 67.5% in the group of atopic patients, compared to 55% in the non atopic group (p>0.05). The materials with the greatest difference of sensitization in atopic compared to non-atopic patients were ammoniated mercury, benzoyl peroxide, amalgam and Bisphenol A Dimethacrylate(BIS-GMA) Conclusion: The atopic condition is not related to a higher frequency of delayed sensitization to a battery of dental materials (AU)

Comparación biomecánica entre los sistemas convencionales y uni-lock en osteosíntesis del ángulo mandibular. Estudio fotoelástico / Biomechanical comparison of the conventional and uni-lock systems for mandibular osteosynthesis. A photoelastic study

Introducción. Las implicaciones biomecánicas de la interacción de las placas y tornillos de titanio con la mandíbula fracturada no son del todo conocidas. Los modelos matemáticos desarrollados hasta hoy en día muestran ciertas limitaciones, y los estudios experimentales han fracasado en reproducir las fuerzas musculares y la distribución de las tensiones internas en la interfaz entre mandíbula e implante. Material y métodos. En el presente estudio, empleamos un simulador estático del sistema musculo-esquelético masticatorio para demostrar en réplicas mandibulares de resina epoxi, por medio de la fotoelasticidad tridimensional, la distribución de tensiones que se produce en fracturas del cuerpo mandibular tras la aplicación de diferentes métodos de osteosíntesis. Resultados. Los resultados muestran que el simulador y la fotoelasticidad 3D son útiles para estudiar las interacciones entre el hueso y el material de osteosíntesis. Los sistemas «lock» o bloqueados reflejaron la distribución de tensiones más favorable en la mandíbula de resina epoxi fracturada. Conclusiones. La fotoelasticidad tridimensional en modelos de resina epoxi es un método útil para evaluar la distribución de tensiones en una estructura para estudios biomecánicos. En lo que se refiere a la osteosíntesis mandibular, las placas tipo «lock» mostraron ser las menos agresivas para el hueso(AU)

Introduction. The biomechanical effects of the interaction between titanium plates and screws and the fractured mandible are not well known. The mathematical models that have been developed to date show limitations and the experimental studies fail in reproducing muscle forces and internal stress distributions in the bone-implant interface with the mandibular structure. Material and methods. In the present study we use a static simulator of the masticatory system to show, in epoxy resin mandibular models, by means of 3D (three-dimensional) photoelasticity, the stress distribution using different osteosynthesis methods in mandibular body fractures. Results. The results showed that the simulator and 3D photoelasticity were useful for studying interactions between bone and osteosynthesis materials. The "Lock" system displayed the most favourable stress distribution in the epoxy resin mandible. Conclusions. 3D photoelasticity in epoxy resin models is a useful method to evaluate stress distribution for biomechanical studies. In terms of mandibular osteosynthesis, "lock" plates show the most favourable stress distribution due to being less aggressive to the bone(AU)

Accidentes con Material Biológico entre Estudiantes Universitarios de Odontología / Accidents with biological material among University Students of Dentistry

Objetivo. Evaluar la prevalencia de los accidentes con material biológico entre los estudiantes de pregrado en las Facultades de Odontología del Norte de Minas de las Naciones en el ejercicio de su actividad clínica. Métodos. Estudio cuantitativo descriptivo, con una muestra de 73 estudiantes del 4º al 9º semestre que aceptaron participar en el proyecto. Los datos fueron tabulados y comparados por medio de análisis cuantitativo, mostrando los valores de frecuencia y porcentaje, calculados en función del número de individuos. El valor p fue del 5%. Resultados. La edad media de los estudiantes fue de 23,6 años. En relación a los accidentes con material biológico, el 23,3% de los estudiantes expresaron una experiencia o algún tipo de accidente, y desarrollaron estos accidentes en los que utilizaban el explorador odontológico. La mayoría de los eventos ocurrió mientras realizaban la limpieza del instrumental. El órgano más frecuentemente lesionado fue la mano. La mayoría de los estudiantes que sufrieron accidentes con material biológico han participado en el programa de vacunación contra la hepatitis B, pero no participaron en el protocolo después de la exposición, lavado de la herida con agua y jabón, y el procedimiento de guantes al momento del accidente. Mediante la prueba de Chi-cuadrado se observó una relación estadísticamente significativa entre la ocurrencia de accidentes con material biológico y el sexo (p = 0,024). Los varones, en un porcentaje de 83%, sufren menos accidentes de riesgo biológico en comparación con las mujeres. Conclusiones. La presencia de accidentes con instrumental entre estudiantes de odontología tiene un resultado de considerable aparición. Se deben manejar protocolos que refuercen actitudes de bioseguridad más estrictos (AU)

Objective. To evaluate the prevalence of accidents with biological material among undergraduate students in the faculties of Dentistry of Northen Minas de las Naciones. Methods. A descriptive, quantitative study with a sample of 73 4th to 9th semester students who agreed to participate in the project. Data were tabulated and compared by means of quantitative analysis with Excel and showing frequency values and percentages calculated based on the number of individuals. The p value was 5%. Results. The average student age was 23.6 years. Twenty three point three percent of the students said they experienced some kind of accident mainly when they were using a dental explorer. Most accidents occurred while cleaning instruments. The hand was the part of the body most frequently injured. Most students who had an accident had participated in the vaccination program against hepatitis B However at the time of the accident they did not participate in this program after exposure, wash the wound with soap and water or follow the procedure for gloves. The Chi-square test revealed a statistically significant relationship between the occurrence of accidents with biological material and gender (p=0,024). Males, at a rate of 83%, have fewer biohazard accidents compared with females. Conclusions. There is a significant occurrence of accidents with dental material amongst dental students. Protocols should be introduced to reinforce attitudes of more stringent biosecurity (AU)

Zirconia implant abutments: A review

Objectives: An increasing aesthetic demand within developed populations conducted to the fabrication of metalfree restorations and to a wide use of ceramic materials, due to its excellent characteristics of biocompatibility and aesthetics. With the incessant increase of commercial labels involved in this technological advance, a review is imposed on ceramic abutments, specifically on zirconia. We made a search of articles of peer-reviewed Journalsin PubMed/ Medline, crossing the terms “Dental Abutments”, “Dental Porcelain” and “Zirconia”. The review was divided by subtopics: zirconia physical and mechanical properties, precision fit in the implant-abutment interface,zirconia abutments strength and, finally, bacterial adherence and tissues response. Several studies demonstratethat zirconia abutments offer good results at all the levels but relevant issues need further studies and evaluation.One of the most important is the clinical long term success of zirconia abutments on implants, given that in the literature there are no sufficient in vivo studies that prove it (AU)

Allergic contact dermatitis to manganese in a prosthodontist with orthodontics

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