An evaluation of the effect of ozone therapy on tissues surrounding dental implants.

BACKGROUND: Dental implant surgery despite its growing popularity poses several challenges like include tissue inflammation, pain discomfort and tissue injury. OBJECTIVE: To evaluate the effect of ozone therapy on inflammation, pain and wound healing after implant surgery. METHODS: A clinical study was conducted on 60 systematically healthy patients- 30 patients treated with ozone (Experimental group) and 30 patients without ozone treatment (control group). In the control group osteotomy procedure was performed with saline irrigation and in the experimental group irrigation was done with ozonated water at 25 µg/mL concentration, along with ozone gas. Clinical assessment was done by evaluating C-reactive Protein (CRP) for inflammation, pain using Visual Analogue Scale (VAS) score and tissue wound healing using wound healing index. Side effects, if any, were noted. RESULTS: Postoperative increment in CRP levels was 0.10 and 0.63 mg/dl in Experimental and control groups respectively (p < 0.001). At 24-hr, 48-hr and 7 day post-operative intervals mean VAS scores for pain were significantly higher in Control group as compared to that in Experimental Group (p < 0.001). At day 7, mean VAS scores for pain were 3.50 ± 0.63 and 37.70 ± 4.17 in Experimental and Control groups respectively (p < 0.001). Mean tissue healing indices were significantly higher on Day 7 and Day 14 in Experimental Group (4.23 ± 0.43 and 4.97 ± 0.18) as compared to that in control group (3.07 ± 0.45 and 4.03 ± 0.18) (p < 0.001). No potential side effects were noted in either of two groups. CONCLUSION: Ozone therapy accelerated the tissue wound healing, minimized tissue inflammation and decreased pain.

[CLINICAL AND PSHYSIOLOGICAL FEATURES OF INTRAOSSEOUS ANESTHESIA DURING DENTAL IMPLANTATION].

The aim of research - to assess the feasibility and effectiveness, of the intraosseous method of anesthesia, with the Quick Sleeper injection system on the toothless area of ​​the alveolar bone during dental implantation. Clinical and physiological studies were conducted to study the features of performing intraosseous anesthesia on the site of alveolar bone adentia in the absence of the usual anatomical topographic landmarks. New computer technologies, as well as modern methods of patient examination and observation were used. The results of the analysis confirmed the advantages of intraosseous anesthesia compared with alternative methods of local anesthesia during dental implantation. The advantages of the intraosseous method of anesthesia are characterized, the features of conducting, the anatomical guidelines have been indicated for an effective intraosseous anesthesia in the area of ​​the alveolar bone adentia, during dental implantation.

Systemic Effects of Photobiomodulation on the Morphology of the Thyroid and Sublingual Glands: A Study in Rabbits.

Objective: To investigate whether photobiomodulation (PBM) applied in a clinical situation with the purpose of improving the healing process of implants placed in the rabbit mandible would cause any morphological change in the thyroid and sublingual glands as a systemic effect of laser irradiation. Methods: Thirty-two New Zealand rabbits were randomly divided into four groups of eight animals each, one control group (CI, nonirradiated animals) and three experimental groups (EI, EII, and EIII) that received PBM postoperatively with an aluminum/gallium/arsenide laser diode (Theralase®) at a wavelength of 830 nm (infrared) and 50 mW output power applied to two irradiation fields per session, for a total of seven sessions. All rabbits underwent surgical extraction of the mandibular left incisor, followed by immediate placement of an osseointegrated implant in the fresh socket. The experimental groups EI, EII, and EIII received PBM at an energy density of 5, 2.5, and 10 J/cm2, respectively, per irradiation field. Results: There was no histomorphometric change in any of the groups. Conclusions: PBM, based on the irradiation protocol used in this study, does not cause morphological changes in the thyroid and sublingual glands when used to stimulate peri-implant bone healing in the rabbit mandible.

Photobiomodulation in Periodontology and Implant Dentistry: Part 1.

(Part 2 of this article can be located at www.liebertpub.com/doi/10.1089/photob.2019.4731.) Objective: Finding evidence-based treatment strategies for low-level light therapy (LLLT) and the correct incorporation of these treatment methods in the clinical practice of periodontics. Background: Photobiomodulation has been shown to have biostimulatory, anti-inflammatory and analgesic effects that can be beneficial in periodontal and dental implant treatment procedures. Methods: In this review we have addressed some clinical questions regarding the potential clinical application of low-level light irradiation and its photobiomodulatory effects in periodontology and implantology. The literature was searched for in vivo (animal or clinical) articles written in English in four electronic databases of PubMed, Scopus, Google Scholar, and Cochrane Library until April 2019. Only studies with low irradiation doses without any thermal effects used only for their photobiomodulatory purposes were included. Results: We were able to find relevant studies for all of our questions, and positive effects for the application of light therapy were reported in most of the studies. However, there is still great deal of heterogeneity in terms of study designs and most importantly in light irradiation devices and the parameters used. Owing to this issue it was not possible to reach specific evidence-based irradiation protocols for the questions addressed in this review. Conclusions: Based on our search results, an obvious positive effect of LLLT on stimulation of healing of periodontal soft and hard tissues and reduction of inflammation can be seen. Future well-designed randomized control studies with the same irradiation settings and systematic reviews evaluating the studies found on the questions mentioned are necessary to reach evidence-based recommendations.

Photobiomodulation in Periodontology and Implant Dentistry: Part 2.

(Part 1 of this article can be located at www.liebertpub.com/doi/10.1089/photob.2019.4710.) Objective: Finding evidence-based treatment strategies for low-level light therapy and the correct incorporation of these treatment methods in the clinical practice of periodontics. Background: Photobiomodulation has been shown to have biostimulatory, anti-inflammatory, and analgesic effects that can be beneficial in periodontal and dental implant treatment procedures. Methods: In this review, we have addressed some clinical questions regarding the potential clinical application of low-level light irradiation and its photobobiomodulatory effects in periodontology and implantology. The literature was searched for in vivo (animal or clinical) articles written in English in four electronic databases of PubMed, Scopus, Google Scholar, and Cochrane Library until April 2019. Only studies with low irradiation doses without any thermal effects used only for their photobiomodulatory purposes were included. Results: We were able to find relevant studies for all of our questions, and positive effects for the application of light therapy were reported in most of the studies. However, there is still a great deal of heterogeneity in terms of study designs and most importantly in light irradiation devices and the parameters used. Due to this issue, it was not possible to reach specific evidence-based irradiation protocols for the questions addressed in this review. Conclusions: Based on our search results, an obvious positive effect of low-level light therapy on stimulation of healing of periodontal soft and hard tissues and reduction of inflammation can be seen. Future well-designed randomized control studies with the same irradiation settings and systematic reviews evaluating the studies found on the questions mentioned are necessary to reach evidence-based recommendations.

Hydroxyl radicals generated by hydrogen peroxide photolysis recondition biofilm-contaminated titanium surfaces for subsequent osteoblastic cell proliferation.

Titanium dental implants have been successfully used for decades; however, some implants are affected by peri-implantitis due to bacterial infection, resulting in loss of supporting bone. This study aimed to evaluate the effect of an antimicrobial chemotherapy employing H2O2 photolysis-developed to treat peri-implantitis-on biofilm-contaminated titanium surfaces in association with osteoblastic cell proliferation on the treated surface. Titanium discs were sandblasted and acid-etched, followed by contamination with a three-species biofilm composed of Porphyromonas gingivalis, Fusobacterium nucleatum, and Streptococcus mitis. This biofilm model was used as a simplified model of clinical peri-implantitis biofilm. The discs were subjected to ultrasound scaling, followed by H2O2 photolysis, wherein 365-nm LED irradiation of the disc immersed in 3% H2O2 was performed for 5 min. We analysed proliferation of mouse osteoblastic cells (MC3T3-E1) cultured on the treated discs. Compared with intact discs, biofilm contamination lowered cell proliferation on the specimen surface, whereas H2O2 photolysis recovered cell proliferation. Thus, H2O2 photolysis can recover the degraded biocompatibility of biofilm-contaminated titanium surfaces and can potentially be utilised for peri-implantitis treatment. However, to verify the findings of this study in relation to clinical settings, assessment using a more clinically relevant multi-species biofilm model is necessary.

Impact of Hyperbaric Oxygen on Tissue Healing around Dental Implants in Beagles.

BACKGROUND The impact of hyperbaric oxygen (HBO) on the healing of soft tissues around dental implants was studied in a beagle model. MATERIAL AND METHODS Beagle dogs were randomized to receive implants, followed by postoperative HBO therapy or not (n=10 per group). On postoperative days 3, 7, and 14, tissue specimens were paraffin-embedded and analyzed by hematoxylin-eosin and Masson staining, as well as immunohistochemistry against CD31. RESULTS Scores for inflammation pathology based on hematoxylin-eosin staining and mean optical density of collagen fibers were significantly different between the HBO and control groups on postoperative days 3 and 7 (P<0.05), but not on day 14. Mean optical density due to anti-CD31 staining was significantly higher in the HBO group on postoperative days 3, 7, and 14 (P<0.05). CONCLUSIONS These results suggest that HBO may promote early osteogenesis and soft tissue healing after implantation.

Effect of Platelet-rich Fibrin and Free Gingival Graft in the Treatment of Soft Tissue Defect preceding Implant Placement.

INTRODUCTION: Free gingival graft is a procedure that is used to increase keratinized tissue around teeth and edentulous sites for future dental implants. Keratinized tissue is critical for maintainability of surgical site and flap management. Platelet-rich fibrin consists of bioactive and biological components, mainly composed of growth factors. Growth factors attract stem cells to the site of release and stimulate cell proliferation. Moreover, growth factors promote angiogenesis, which accelerates wound healing. Site preparation is critical in implant dentistry, including soft tissue and hard tissue augmentation. AIM: To improve free gingival graft (FGG) healing by using platelet-rich fibrin (PRF) at the soft tissue defect area of extracted upper right first molar in order to restore keratinized tissue and prepare the site for bone grafting followed by dental implant placement. CASE REPORT: A healthy female patient, 59 years old, presented to the dental clinic at the University at Buffalo, School of Dental Medicine, seeking dental implants to restore missing teeth. The patient had an extraction for upper right first molar 4 months ago. The surgical extraction left severe soft and hard tissue defects at the site. Free gingival graft was placed at the site to increase keratinized tissue band followed by PRF to improve healing. Cyanoacrylate adhesive was used to stabilize PRF Two months later, a full-thickness flap was reflected, and tenting screws placed with bone grafting at the site. Titanium-reenforced membrane was placed over the bone graft. Three months later, tenting screws were removed and two dental implants were placed at the site. CONCLUSION: The use of PRF accelerates the healing of FGG. More tissue handling could be achieved by increasing the kera-tinized tissue during surgical procedures. CLINICAL SIGNIFICANCE: The combination of PRF and FGG could help in the healing process during soft tissue procedures.

Unravelling the effect of macro and microscopic design of dental implants on osseointegration: a randomised clinical study in minipigs.

Several dental implants are commercially available and new prototype design are constantly being fabricated. Nevertheless, it is still unclear what parameters of the design affect most the osseointegration of dental implants. The purpose of this study is to assess the effects of the microscopic and macroscopic design of dental implants in the osseointegration by comparing three macroscopic designs (Straumann tissue level (STD), essential cone (ECD) and prototype design (PD)) and six surface treatments. A total of 96 implants were placed in 12 minipigs. The implant stability quotient (ISQ), was assessed at the time of implantation, as well as at 2, 4 and 8 weeks. Histomorphometric and statistical analyses were conducted at the different sacrifice times, being 2, 4 and 8 weeks, to analyse the bone to implant contact (BIC), the bone area density (BAT) and the density of bone outside the thread region (ROI). The macroscopic design results showed higher ISQ values for the ECD, whereas the histomorphometric analysis showed higher ossoeintegration values for the STD. Regarding the microscopic design, both Sandblasted plus acid etching (hydrochloric/sulphuric acid) in a nitrogen atmosphere (SLActive) and Shot-blasted or bombarded with alumina particles and posterior alkaline immersion and thermal treatment (ContacTi) showed superior results in terms of osseointegration and reduced the osseointegration times from 8 weeks to 4 weeks compared to the other analysed surfaces. In conclusion, each of the macroscopic and microscopic designs need to be taken into account when designing novel dental implants to enhance the osseointegration process.

Intense, Instantaneous, and Shooting Pain During Local Anesthesia for Implant Surgery.

Administration of local anesthetics is daily routine for most dental practitioners. Normally, the effect is achieved, and no adverse effects are seen. In this article, the authors describe the complications of immediate, intense and shooting pain, numbness, and marked pallor of the cheek, which occurred during infiltration of a local anesthetic in buccal vestibule infiltration. The patients moved suddenly because of pain and marked pallor of the cheek near the root of the nose and lower eyelid pallor was observed. The pain was very short and the injection was performed again after a few minutes. Two patients also reported an alteration of vision or paralysis of the extra-ocular muscles and drooping eyelid due to paralysis of the levator palpebrae superioris muscle and signs of numbness in the infraorbital area on the same side as the anesthesia. While 3 patients were also apprehensive and started to scare with heart palpitations, as they did not understand what was happening. Probably the anesthetic solutions were injected into an intravascular artery and passed from the extraosseous branch of posterior superior alveolar artery through to the infraorbital artery, which could produce the clinical signs observed in the present study. At the same time, the inoculation of anesthetic in the artery could be grounds for legal disputes for the dentist. In fact, in the absence of vascular disease, anomalies documented by the dentist, they would, however, respond to professional liability and be liable for damages caused to the patient. In conclusion, despite the fact that this condition requires no treatment, it could lead to the recognition of clinical signs in patient with injection of local anesthesia into the artery. At the same time, the inoculation of anesthetic in the artery could be grounds for legal disputes for the dentist.

The role of hyperbaric oxygen therapy in the prevention and management of radiation-induced complications of the head and neck - a systematic review of literature.

Radiation therapy for the treatment of head and neck cancer can injure normal tissues and have devastating side effects. Hyperbaric oxygen (HBO) is known to reduce the severity of radiation-induced injury by promoting wound healing. While most of the research in literature has focused on its efficacy in osteonecrosis, HBO has other proven benefits as well. The aim of this review was to identify the various benefits of hyperbaric oxygen therapy in patients who have undergone radiation for head and neck cancer. An electronic database search was carried out to identify relevant articles and selected articles were reviewed in detail. The quality of evidence for each benefit, including preserving salivary gland function, preventing osteonecrosis, dental implant success, and overall quality of life, was evaluated. Evidence showed that HBO was effective in improving subjective symptoms of xerostomia, swallowing, speech and overall quality of life. There was no conclusive evidence to show that HBO improved implant survival, prevented osteonecrosis, or improved salivary gland function. The high costs and accessibility of HBO therapy must be weighed against the potential benefits to each patient.

Hypnosis as a Valuable Tool for Surgical Procedures in the Oral and Maxillofacial Area.

Hypnosis is a valuable tool in the management of patients who undergo surgical procedures in the maxillofacial complex, particularly in reducing and eliminating pain during surgery and aiding patients who have dental fear and are allergic to anesthesia. This case report demonstrates the efficacy of hypnosis in mitigating anxiety, bleeding, and pain during dental surgery without anesthesia during implant placement of tooth 14, the upper left first molar.

Manejo de tejidos blandos en regeneración/reconstrucción ósea mediante la técnica quirúrgica ‘Double Flap Incision Technique modificada’. Técnica de preservación del periostio / Oral surgery management of soft tissues with a new ‘Double Flap Incision Technique’ A periosteal preservation technique

Introducción: Las técnicas implantológicas demandan la existencia de unas estructuras óseas adecuadas en calidad y cantidad para alojar las fijaciones oseointegradas de un modo predecible. En ocasiones, el sustrato óseo es insuficiente, por lo que son necesarias técnicas de reconstrucción/regeneración ósea que precisan de un cierre primario completo para asegurarnos que los fenómenos que conducirán a la formación de nuevo tejido óseo se sucedan. El objetivo de este estudio es mostrar una serie de ocho casos clínicos donde la ‘Double Flap Incision Technique modificada’ nos sirve para reconstruir zonas de defecto óseo en la región mandibular posterior que limitaban la colocación de fijaciones oseointegradas. Métodos: Se realiza un estudio prospectivo de ocho casos clínicos procedentes de nuestra práctica privada, con déficit óseo en la zona posterior mandibular en pacientes demandantes de un tratamiento rehabilitador con prótesis fija implantosoportada. En todos los casos se utilizó la denominada ‘Double Flap Incision Technique modificada’ (DFITm). Resultados: En todos los casos conseguimos un cierre primario completo a los 15 días y fue posible la colocación de los implantes en la zona regenerada con criterio protésicamente guiado. Conclusión: La técnica de doble colgajo ‘Double Flap Incision Technique modificada’ nos permite llevar a cabo un adecuado cierre primario sin tensión en casos que requieran una reconstrucción o regeneración ósea, evitando la aparición de dehiscencias que conllevarían al fracaso del tratamiento (AU)

Introduction: Dental implants’ techniques needed to appropiate high-quality bones structures which can support osteointegration bindings in a predictable way. Occasionally, bone substrate is not the suitable one, it is for that reason that we need bone reconstruction and regeneration techniques in which we have to make a complete wound healing in order to guarantee bone regeneration in a correct way. The aim of this article is to comment eight case reports in which we used ‘Double flap incision technique’ to repair bone loss in posterior mandibular region. Methods: We have carried out a pilot study in about eight cases reports whose patients had bone loss in posterior mandibular region and treated with a dental implants’ repair treatment. ‘New Double Flap Incision Technique’ was used in all the cases we report. Results: We obtained an appropiate and complete wound healing in 15 days. In addition, dental implants were positionated in regenerated region correctly in all cases. Conclusion: This ‘New Double Flap Incision Technique’ provide us a way to obtain complete wound healing with no strain in cases which needed bone regeneration or reconstruction, avoid the presence of dehiscences which fail the treatment (AU)

Effect of a dietary supplement on peri-implant bone strength in a rat model of osteoporosis.

PURPOSE: Osteoporosis contributes to impaired bone regeneration and remodeling through an imbalance of osteoblastic and osteoclastic activity, and can delay peri-implant bone formation after dental implant surgery, resulting in a prolonged treatment period. It poses several difficulties for individuals with large edentulous areas, and decreases their quality of life. Consequently, prompt postoperative placement of the final prosthesis is very important clinically. Peri-implant bone formation may be enhanced by systemic approaches, such as the use of osteoporosis supplements, to promote bone metabolism. We aimed to confirm whether intake of synthetic bone mineral (SBM), a supplement developed for osteoporosis, could effectively accelerate peri-implant bone formation in a rat model of osteoporosis. METHODS: Thirty-six 7-week-old ovariectomized female Wistar rats were randomly assigned to receive a standardized diet with or without SBM (Diet with SBM group and Diet without SBM group, respectively; n=18 for both). The rats underwent implant surgery at 9 weeks of age under general anesthesia. The main outcome measures, bone mineral density (BMD) and pull-out strength of the implant from the femur, were compared at 2 and 4 weeks after implantation using the Mann-Whitney U test. RESULTS: Pull-out strength and BMD in the Diet with SBM group were significantly greater than those in the Diet without SBM group at 2 and 4 weeks after implantation. CONCLUSIONS: This study demonstrated that SBM could be effective in accelerating peri-implant bone formation in osteoporosis.

[Use of analgesia and sedation in dental implantology in patients with concomitant hypertension].

Dental implants surgery in patients with hypertension increases the risk of vascular complications. The aim of the study was to examine the effect of analgesia and sedation on blood pressure and postoperative pain in dental implantology. In 76 patients with hypertension implant surgery was performed under local anesthesia only (40 patients) or under local anesthesia with propofol sedation and pre-emptive analgesia with ketorolac (36 patients). Intraoperative systolic blood pressure in the second group was 20% less than in the first group while the intensity of pain in the postoperative period in the second group was three times less than in the first one. Propofol sedation in dental implantology provides hemodynamic stability in patients with concomitant hypertension and preemptive analgesia with ketorolac allows minimizing postoperative pain.

Influência do laser de baixa intensidadeem sítios de instalação de implantesdentários: revisão de literatura / Influence of low-level laser on dentalimplant sites: a literature review

A terapia com laser de baixa intensidade tem sido utilizada como coadjuvante na bioestimulação do reparo ósseo. Objetivo: o objetivo desse artigo é revisar estudos que avaliaram os efeitos do laser de baixa intensidade no processo de reparo ósseo em sítios de instalação de implantes dentários. Métodos: foi realizada busca eletrônica no PubMed, periódicos CAPES e Scopus, no período de 2002 a 2013, utilizando os descritores “Laser therapy, Low-level”, “Laser phototherapy”, “Laser therapy”, “Dental implants”. Publicações estruturalmente incompletas ou que não se adequaram aos critérios de inclusão foram excluídas. Resultados: dezesseis artigos relevantes foram selecionados, quinze realizados em modelo animal e um ensaio clínico randomizado. Catorze estudos in vivo mostraram melhor cicatrização óssea nos sítios irradiados com laser de baixa intensidade. Conclusão: a terapia com laser de baixa intensidade parece acelerar o processo de reparo ósseo em sítios de instalação de implantes dentários. Apesar dos resultados promissores obtidos a partir de estudos em modelo animal, evidências científicas obtidas em estudos clínicos ainda são limitadas.

Low-level laser therapy has been used as adjuvant in biostimulation of bone repair. Objective: The aim of this paper is to review studies assessing the effects of low-levellaser therapy on the process of bone repair at dental implants sites. Methods: an electronic search of papers published between 2002 and 2013 was conducted on PubMed, Scopus and CAPES databases using the keywords “Laser therapy, Low-level”, “Phototherapy”, “Laser therapy”, and“Dental implants”. Publications structurally incomplete or not meeting the inclusion criteria were excluded. Results: Sixteen relevant articles were selected, fifteen of which were conducted in ananimal model and one randomized clinical trial. Fourteen in vivo studies showed better bone healing in sites irradiated with low-level lasers. Conclusion: Low-level laser therapy seems to acceleratethe process of bone repair at dental implant sites. Despite promising results obtained in studieswith animal models, scientific evidence from clinical trials remains limited.

Non-randomized controlled prospective study on perioperative levels of stress and dysautonomia during dental implant surgery.

PURPOSE: The purpose of this study was to compare pre- and postoperative autonomic activities and changes in salivary stress biomarkers between patients who received only local anesthesia and those who received local anesthesia together with intravenous sedation in dental implant surgery. METHODS: A total of 21 patients were enrolled in this non-randomized controlled prospective study; 7 subjects underwent implant surgery under local anesthesia with intravenous sedation and 14 subjects underwent surgery under only local anesthesia. Stress was evaluated by measuring salivary levels of chromogranin A (CgA) and a spectral analysis of heart rate variability (HRV) at baseline (on a day other than the day of surgery), 1h preoperatively, and 1h postoperatively. HRV analysis yields low- (LF) and high-frequency (HF) components, the LF/HF ratio, and the component coefficient of variance (CCV[HF]), which provide indices of sympathetic and parasympathetic regulatory activity. RESULTS: CgA levels were significantly higher (p<0.05) at baseline in patients who received sedation than those who did not, but CgA levels did not differ prior to surgery. Also, the values of most parameters, including LF, HF, LF/HF (L/H), and CCV(HF), did not significantly differ between groups or among the three time points. Only ΔL/H and ΔCCV(HF) were significantly lower (p<0.05) at 1h preoperatively in patients who received sedation than those who received only local anesthesia. CONCLUSIONS: CgA levels were high in both groups immediately before surgery, and thus CgA values immediately before surgery may not be a reliable indicator of the need for intravenous sedation. Also, spectral analysis of HRV, especially ΔL/H and ΔCCV(HF), could be useful for assessing tension and anxiety.

Electroterapia para la regeneración ósea de implantes dentales / Electrotherapy for bone regeneration in dental implants

La oseointegración se ha optimizado favorablemente en los últimos años y tecnologías variadas se han aplicado para mejorar esta condición. El objetivo de esta investigación fue conocer la relación entre la aplicación de cargas eléctricas y su capacidad de mejorar la oseointegración en un modelo animal. 16 conejos de raza New Zealand, de 3 a 6 meses, fueron divididos en dos grupos. En ambos se realizo la instalación de 4 implantes de titanio especialmente diseñados para esta investigación, dos en cada tibia, utilizando técnicas de compresión. En el grupo experimental se aplico cargas eléctricas a nivel de extremidades inferiores durante 30 minutos por día mientras duraba el tiempo previo a la eutanasia de los animales realizada finalmente a los 21 y 42 días, momento en el cual fue realizada la prueba de torque de retiro con un torquímetro manual; posteriormente, los bloque con los implantes fueron retirados y se procesaron con técnicas histológicas de rutina para la tinción de Hematoxilina y Eosina; se realizo una observación descriptiva mediante microscopia óptica y los resultados numéricos fueron analizados con el análisis de varianza y posteriormente utilizando el test F con un nivel de significancia de 5%. Los resultados mostraron diferencias significativas en el torque de retiro de implantes a los 21 días y a los 42 días; no se observaron diferencias significativas entre el grupo control y el grupo experimental; histológicamente, no se observaron diferencias en el patrón de osificación, la disposición de elementos u otras condiciones histológicas de la reparación. Se puede concluir que la administración de cargas eléctricas en este modelo experimental no contribuye a la formación de tejido óseo perimplantar.

Osseointegration has been optimized in the last years; differents technologies has been applied to improve this condition. The aim of this research is to understand the relationship between the application of electric charges and their ability to improve osseointegration in an animal model. Sixteen New Zealand white male rabbits, 3 to 6 months of age, were divided into two groups. In both was inserted a 4 titanium implants designed for this research, two on each tibia; compression techniques was conducted for to install the implant. In the experimental group electric charges at the level of lower limbs was applied for 30 minutes per day; the euthanasia of the animals was performed at 21 and 42 days, at which time was obtained the measurement of the retirement torque with a manual torque wrench; subsequently, the blocks with implants were removed and processed with routine histological techniques with hematoxylin and eosin; a descriptive observation was performed by optical microscopy and the numerical results were analyzed by analysis of variance and then using the F test with a significance level of 5%. The results showed significant differences in removal torque of implants at 21 and 42 days; no significant differences between the control group and the experimental group were observed; Histologically, no differences in elements disposition or other histological repair conditions were observed. It can be concluded that the administration of electric charges in this experimental model does not contribute to the formation of perimplant bone tissue.

Developing implant dentistry education in Europe: the continuum from undergraduate to postgraduate education and continuing professional development.

INTRODUCTION: Implant dentistry is a treatment modality which has mainstream clinical practice of comprehensive care, which however is not adequately represented in the undergraduate dental curricula. A consensus workshop organised by ADEE in 2008, set the benchmarks for the knowledge and competences a modern dental practitioner must possess with regard to implant dentistry, as well as defined undergraduate and postgraduate pathways for the acquisition of these competences. Today, 5 years later, there exist several challenges for the implementation of these benchmarks in both undergraduate curricula but also post-graduation educational pathways. METHODS: A consensus workshop was organised by ADEE, bringing together 48 opinion leaders, including academic teachers of all disciplines related to implant dentistry, specialists, representatives of relevant scientific and professional associations, as well as industry delegates. The objectives of the workshop were to evaluate the existing scientific literature, reported experience and best practices in order to identify potential and limitations for the implementation of implant dentistry in the undergraduate curriculum, as well produce recommendations for the optimal educational structures for postgraduate programmes and continuing professional development. RESULTS: The scientific committee conducted two European-wide questionnaire surveys to better document the current state of education in implant dentistry. Upon completion of the surveys, reviewers were appointed to produce three scientific review papers, identifying current achievements and future challenges. Finally, during the 3 days of the workshop, all the evidence was reviewed and the main conclusions and recommendations that were adopted by all participants are reported in the present Consensus Paper. CONCLUSIONS: Implementation of implant dentistry in the undergraduate curriculum has improved significantly, but still lags behind the benchmarks set in 2008 and the diversity between institutions remains big. At the post-graduation level, there is currently a wide diversity of courses and pathways towards competences related to implant dentistry and there is at present a great need for quality assurance, as well as standardisation and transparency of the learning outcomes.