RESUMEN
BACKGROUND: The chin is the most prominent and median sector of the lower third of the face giving harmony to nose and lips. The authors present the application of piezoelectric scalpel for the correction of different chin deformities. The distinctive characteristics of this device allow us to avoid or reduce the immediate genioplasty complications. METHODS: Fifty-five patients with defective chin have been treated from January 2006 to April 2008. Intraoral chinplasty was performed during the correction of dentofacial dysmorphisms or associated with nasal surgery. The authors used a piezoelectric cutting device to perform different osteotomies and if necessary, interpositional graft was used to stabilize bony segments. RESULTS: Piezosurgery has been associated with a fewer number of postoperative complications, especially as regard intraoperative bleeding, nerve injuries (immediate and late), hematomas and seromas, and asymmetry (immediate and early). The mean time for completing the complete procedure of genioplasty with piezosurgery was almost the same compared with the saw and drill. CONCLUSIONS: Chinplasty represents one of the most common ancillary procedures and may be associated with corrective surgery of dentofacial dysmorphisms. Mental nerve injuries, asymmetries, intraoperative bleeding are the main immediate complications of genioplasty. Distinctive characteristics of ultrasonic piezoelectric osteotomy are selective cut of mineralized structure with less risk of vascular and nervous damage (microvibrations), intraoperative precision (thin cutting scalpel and no macrovibrations), blood free site (cavitation effect). In our experience, piezoelectric scalpel, compared with saw and drill, enables us to reduce or avoid immediate complications of chin surgery, helping the surgeon to reach patients' satisfaction. LEVEL OF EVIDENCE: IV.
Asunto(s)
Mentoplastia , Piezocirugía , Mentón/cirugía , Humanos , Osteotomía , Instrumentos QuirúrgicosRESUMEN
BACKGROUND/AIM: Autophagy is a macromolecular degradation process playing a pivotal role in the maintenance of stem-like features and in the morpho-functional remodeling of the tissues undergoing differentiation. In this work we investigated the involvement of autophagy in the osteogenic differentiation of mesenchymal stem cells originated from human gingiva (HGMSC). METHODS: To promote the osteogenic differentiation of HGMSCs we employed resveratrol, a nutraceutical known to modulate autophagy and cell differentiation, together with osteoblastic inductive factors. Osteoblastic differentiation and autophagy were monitored through western blotting and immunofluorescence staining of specific markers. RESULTS: We show that HGMSCs can differentiate into osteoblasts when cultured in the presence of appropriate factors and that resveratrol accelerates this process by up-regulating autophagy. The prolonged incubation with dexamethasone, ß-glycerophosphate and ascorbic acid induced the osteogenic differentiation of HGMSCc with increased expression of autophagy markers. Resveratrol (1 µM) alone elicited a less marked osteogenic differentiation yet it greatly induced autophagy and, when added to the osteogenic differentiation factors, it provoked a synergistic effect. Resveratrol and osteogenic inductive factors synergistically induced the AMPK-BECLIN-1 pro-autophagic pathway in differentiating HGMSCs, that was thereafter downregulated in osteoblastic differentiated cells. Pharmacologic inhibition of BECLIN-1-dependent autophagy precluded the osteogenic differentiation of HGMSCs. CONCLUSIONS: Autophagy modulation is instrumental for osteoblastic differentiation of HGMSCs. The present findings can be translated into the regenerative cell therapy of maxillary / mandibular bone defects.
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Autofagia , Células Madre Mesenquimatosas/citología , Osteoblastos/citología , Autofagia/efectos de los fármacos , Beclina-1/antagonistas & inhibidores , Beclina-1/metabolismo , Diferenciación Celular/efectos de los fármacos , Células Cultivadas , Humanos , Células Madre Mesenquimatosas/efectos de los fármacos , Células Madre Mesenquimatosas/metabolismo , Osteoblastos/efectos de los fármacos , Osteoblastos/metabolismo , Osteogénesis/efectos de los fármacos , Resveratrol/farmacología , Transducción de Señal/efectos de los fármacosRESUMEN
Medication-related osteonecrosis of the jaw are bone exposures in the maxillofacial region that does not heal after 8 weeks from the observation of a health care provider in patients with history of the intake of antiresorptive agents and no previous irradiation of the craniofacial region. Initially attributed only to the intake of bisphosphonates they have later been associated also with the intake of other classes of antiresorptive medications.This retrospective study analyzed records from patients with documented medication-related osteonecrosis of the jaws treated in our unit. Clinical data, comorbidities and concurrent medications, treatment outcome information such us number of repeated treatments needed, antibiotic used, type of treatment adopted were recorded. Baseline demographics for the included records of 15 patients (mean age: 64 years) revealed a treatment success rate of 73.3% (mean observation period: 42.2 months), failure rate of 26.6%, dental extraction trigger rate of 33.3%, and a spontaneous trigger rate of 40%.Zolendronate and denosumav were the medications most frequently associated with the upset of medication-related osteonecrosis of the jaw (60% of the sample). In 8 cases out of the 11 that were successful, the surgical treatment had to be repeated more than once. Leukocyte-platelet-rich fibrin led to the resolution of 11 of the 14 cases in which it was used.
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Osteonecrosis de los Maxilares Asociada a Difosfonatos/terapia , Fibrina Rica en Plaquetas , Anciano , Conservadores de la Densidad Ósea/efectos adversos , Difosfonatos/efectos adversos , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Insuficiencia del TratamientoRESUMEN
BACKGROUND: Dental implants and bone augmentation are well-established procedures used for oral rehabilitation. There is an increasing interest in biological mediators used topically for prevention of bone resorption maybe enhancement of osseointegration of dental implants. The purpose of the manuscript is to describe preliminarily the effect of bisphosphonates on the ossification pattern of bone grafts in a rat model. MATERIAL AND METHODS: Twenty Wistar-derived male rats were divided into 2 groups study and control. Bone substitute was added to mandibular defects and was covered by a resorbable collagen membrane. In the study group, the membrane was soaked with bisphosphonates suspension. In the control group, the membrane was soaked with saline solution. Radiographic and histomorphometric evaluation were performed. RESULTS: Radiographically, it was found that bone density was significantly higher in the study group. Histomorphometric analysis revealed a trend of higher bone volume fraction along with reduced bone substitute volume fraction in the study group, and increased number of osteoclasts and blood vessels in the control group. CONCLUSIONS: Within the limitations of our study it was found that there is a trend of increasing bone quantity and radiographic bone density by application of bisphosphonates.
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Resorción Ósea/prevención & control , Sustitutos de Huesos/farmacología , Difosfonatos/farmacología , Animales , Densidad Ósea/efectos de los fármacos , Colágeno , Implantación Dental Endoósea , Masculino , Mandíbula/citología , Mandíbula/diagnóstico por imagen , Modelos Animales , Oseointegración/efectos de los fármacos , Ratas , Ratas WistarRESUMEN
OBJECTIVES: The aim of this systematic review of the literature is to describe treatment options for bilateral coronoid process hyperplasia in pediatric patients, to describe etiologic and diagnostic correlations with the treatment, and to evaluate long-term follow-up treatment outcomes. METHODS: A systematic revision of the literature was performed in the Medline, PubMed, Cochrane library, and Embase database up to December 5, 2017. Predetermined Medical Subject Heading keywords were used: "bilateral" or "monolateral" and "coronoid" or "coronoid process" and "hyperplasia" and "temporomandibular joint" or "tmj" and "ankylosis" or "trismus" and "treatment." Results were recorded following PRISMA guidelines. RESULTS: The systematic research produced 1459 results excluding duplicates. Two additional studies from "Grey literature" were also considered. After application of inclusion and exclusion criteria, 38 articles were selected for a qualitative synthesis. Data regarding sex and age of presentation were collected and summarized in a study flow diagram. CONCLUSION: It is possible to conclude that early diagnosis is fundamental to restore stomatognathic multifunction. There is lack of longitudinal studies presenting long-term follow-up to determine treatment stability. Coronoidectomy might be considered gold standard treatment for this pathologic condition.
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Mandíbula/patología , Trastornos de la Articulación Temporomandibular/cirugía , Articulación Temporomandibular/patología , Niño , Diagnóstico Diferencial , Femenino , Humanos , Hiperplasia/complicaciones , Hiperplasia/diagnóstico , Hiperplasia/cirugía , Masculino , Mandíbula/cirugía , Osteotomía Mandibular , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico , Anquilosis del Diente/etiología , Resultado del Tratamiento , Trismo/etiologíaRESUMEN
AIM: The aim of this study was to analyze the clinical outcomes after using an innovative implant system characterized by a modern platform-switched Morse taper connection and an osteo growth induction titanium surface (a particular type of SLA surface). Peri-implant bone loss (PBL) and implant success rate were examined after a 1- to 3-year follow-up. METHODS: The study was conducted as a cross-sectional analysis on all patients treated from January 2011 to December 2014 using CLC CONIC implants. Implants were divided into 3 main groups, based on the duration of the follow-up (1 year, 2 years, and 3 years), then subgrouped by diameter, length, and type of prosthetic rehabilitation to compare differences in PBL. X-rays were taken at the time of surgery, at prosthetic loading, at 1 year, and then annually thereafter. Previously-established success criteria were used to assess the implants. Frequency analyses and comparisons between the means (with 95% CI) were conducted for the statistical analysis of the data collected. RESULTS: One hundred twenty patients met inclusion and exclusion criteria, and completed the follow-up, and were thus eligible for the study, with a total of 261 CLC CONIC implants. The mean follow-up was 22.45 months. No implants failed, giving an overall success rate of 100%. The average PBL at 1-year follow-up was 0.047âmm, at 2 years it was 0.128âmm, and at 3 years it was 0.236âmm. CONCLUSIONS: The CLC CONIC implant system had a high success rate after 1 to 3 years of follow-up, in line with previous reports in the scientific literature. Combining platform switching with the Morse taper connection enabled stable bone levels to be achieved in the short to medium term.
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Implantes Dentales , Diseño de Prótesis Dental , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Hueso Alveolar , Estudios Transversales , Implantes Dentales/efectos adversos , Prótesis Dental de Soporte Implantado , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: The overall success and predictability of dental implant treatment hinge on the primary stability, direct bone-to implant contact formation, and quantity and/or quality of residual bone. Pulsed electromagnetic field has been reported to increase bone regeneration in various clinical situations. Therefore, it was hypothesized that devices which could locally generate a Pulsed electromagnetic field would stimulate bone healing and increase bone density surrounding implants. OBJECTIVE: To retrospectively assess the effects of the miniaturized electromagnetic device (MED) on the implants stability for the first time in human subjects, in a prospective case controlled series. METHODS: Twelve consecutive patients (28 implants) were included in the study.Twelve MED healing caps and 16 regular control healing caps were inserted. Resonance frequency analysis (RFA) was performed at implant placement and abutment connection and an implant stability quotient value was given for each implant. RESULTS: Twenty-eight dental implants were included in the current study. Maxillary implants stability was significantly higher with MED healing cups compared with controls at 15 days postimplantation (66.2 vs 62.1, Pâ=â.0008). Resonance frequency analysis test performed at 30 days postimplantation demonstrated significantly increased stability in MED as compared with the control 73.5â±â3.2 vs 66.7â±â4.8 in mandibular implants and 74â±â1.7 vs 65â±â2.3 in maxillary implants. At the 50 days postimplantation, RFA tests revealed markedly higher stability of the maxillary implants with MED active healing caps compared with nonactive 75.4â±â5.1 vs 68.5â±â8.5, respectively. CONCLUSIONS: We conclude that MED-abutment implants demonstrated a superior stability during the early phase of healing as compared with standard implants.
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Implantes Dentales , Campos Electromagnéticos , Magnetoterapia/instrumentación , Adulto , Anciano , Densidad Ósea , Regeneración Ósea , Pilares Dentales , Implantación Dental Endoósea , Diseño de Prótesis Dental , Retención de Prótesis Dentales , Fracaso de la Restauración Dental , Femenino , Humanos , Persona de Mediana Edad , Análisis de Frecuencia de Resonancia , Estudios RetrospectivosRESUMEN
A retrospective study of 20 patients treated for vertical maxillary excess between 2009 and 2010, solely by superior surgical repositioning of the maxilla. Clinical and radiological cephalometric parameters were analyzed statistically and their impact on achieving the predicted postoperative mandibular autorotation and on relapse. According to our study, patients presenting with an anterior open bite and a low occlusal plane angle might fail to achieve the predicted mandibular autorotation and are prone to postoperative relapse. No correlation was found between the extent of maxillary impaction and the presence of autorotation.
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Mandíbula/diagnóstico por imagen , Maxilar/cirugía , Enfermedades Maxilares/cirugía , Osteotomía Le Fort/estadística & datos numéricos , Cefalometría , Humanos , Modelos Estadísticos , Estudios RetrospectivosRESUMEN
OBJECTIVE: The aim of this study was to evaluate the effect of mineralized plasmatic matrix (MPM), comprising a combination of synthetic graft and platelet concentrates, on bone regeneration. METHODS: Critical size defects of 6-mm diameter were created on the tibias of 6 male sheep, with the animals subsequently assigned into 2 groups. Of the 5 bone defects generated per animal, 4 were randomly filled with MPM, beta-tricalcium phosphate graft (ß-TCP), platelet-rich fibrin (PRF) + ß-TCP, and autogenous graft. One defect was left empty as a control group. Animals were killed at 3 weeks (early healing group) and 6 weeks (late healing group). The specimens underwent histologic and histomorphometric analysis to evaluate new bone formation. RESULTS: In both healing periods, new bone formation from autogenous bone was observed significantly more often than from biomaterials or the empty defect. The degree of new bone formation for MPM was significantly higher than that of the control group at all healing periods. In addition, it was significantly higher in both healing periods than that of ß-TCP albeit only in the late healing period than that of the PRF + ß-TCP combination. In all biomaterial groups, residual graft ratios decreased from early to late healing periods. CONCLUSION: The results indicated that MPM, representing growth factors in a fibrin network, increases new bone formation in surgically created defects in sheep tibia as confirmed by histologic assessment.
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Regeneración Ósea/efectos de los fármacos , Fosfatos de Calcio/farmacología , Fibrina Rica en Plaquetas/fisiología , Animales , Autoinjertos , Materiales Biocompatibles/farmacología , Regeneración Ósea/fisiología , Trasplante Óseo , Fosfatos de Calcio/uso terapéutico , Masculino , Modelos Animales , Distribución Aleatoria , Ovinos , Tibia/citología , Tibia/fisiología , Cicatrización de Heridas/efectos de los fármacosRESUMEN
PURPOSE: This prospective study is aimed at investigating clinically and histologically the effectiveness of a biomimetic magnesium-enriched-hydroxyapatite (MgHA)/collagen-based bone substitute for alveolar socket preservation. MATERIALS: Patients scheduled for posterior single tooth extraction were included. The alveolar socket was filled either with MgHA or deproteinized bovine bone matrix (DBBM). In DBBM group, a punch of mucosa was taken from the palate and used to cover the graft. Vertical and horizontal dimensional changes of the alveolar process were assessed clinically with a periodontal probe and with 3-dimensional (3D) analysis of a cast model. Postoperative quality of life was assessed through a questionnaire. After 6 months of healing, an alveolar tissue biopsy was taken for histologic and histomorphometric analysis of the newly formed tissue. After checking normality of the distributions, parametric or nonparametric tests were used for statistical comparisons. RESULTS: Twenty patients (12 males, 8 females, mean age 42.8â±â5.1 years, range 33-50 years) were treated. After 6 months, vertical and horizontal alveolar ridge resorption was similar in the 2 groups. The 3D analysis of the models showed a significantly higher resorption at the buccal side than at the palatal/lingual side. Histomorphometric analysis showed similar new bone formation for MgHA group (23.07â±â10.3%) and DBBM (22.77â±â6.95%), and a significantly higher residual material% for DBBM (15.77â±â1.95%) than MgHA (5.01â±â1.04%). Significantly less pain was reported in the first 3 days after surgery in patients of the MgHA group. CONCLUSION: The MgHA was as safe and effective as DBBM and may represent a feasible bone substitute for alveolar socket preservation.
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Proceso Alveolar/cirugía , Sustitutos de Huesos/uso terapéutico , Colágeno/uso terapéutico , Durapatita/uso terapéutico , Xenoinjertos/trasplante , Procedimientos Quirúrgicos Orales , Adulto , Animales , Materiales Biomiméticos/uso terapéutico , Bovinos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Orales/efectos adversos , Procedimientos Quirúrgicos Orales/métodos , Procedimientos Quirúrgicos Orales/estadística & datos numéricos , Estudios ProspectivosRESUMEN
The poly D,L-lactide-co-glycolic acid (PLGA) is a copolymer used in many therapeutic devices for its high rates of biodegradability and biocompatibility. The principal aim of the research was to evaluate the new bone formation, after 16 (T1) and 28 weeks (T2), in sheep maxillary sinus lift in vivo model using PLGA.Computerized tomography analysis, X-ray microanalysis, and scanning electron microscope analysis of secondary electrons (SE) and the backscattered electrons (BSE) of the samples were detected.After 28 weeks, the computed tomography analysis showed a 22% increase of UH density in the grafting areas. The X-ray microanalysis of the samples showed calcium and phosphorus increase at T1 and T2 follow-up period and the carbon and oxygen concentration decrease. The SE evaluation showed a rapid superficial resorption of the biomaterials at T1 and a completely bone reorganization of biomaterial at T2. The BSE analysis confirmed the SE data and showed the direct and intimate contact between bone and PLGA with a higher calcification in T2 compared to T1.Certainly, still other experiments and a larger number of samples will be necessary to be analyzed to determine the behavior of the PLGA in the bone regeneration; however, the PLGA used in maxillary sinus lift animal model, seem to promote new bone formation that continues increase at 28 weeks after grafting.
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Regeneración Ósea/efectos de los fármacos , Glicolatos/farmacología , Seno Maxilar/cirugía , Animales , Materiales Biocompatibles , Regeneración Ósea/fisiología , Calcificación Fisiológica , Implantes Dentales , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/fisiología , Modelos Animales , Ovinos , Elevación del Piso del Seno Maxilar , Tomografía Computarizada por Rayos XRESUMEN
Auto-fluorescence (AF) of healthy bone tissue has recently been described. Loss of AF (LAF) has, on the contrary, been reported in necrotic bone. Further, the use of LAF as a possible guidance to distinguish viable from necrotic bone during surgical treatment of osteonecrosis has been proposed. The aim of this study is to detail 8 patients of medication-related osteonecrosis of the jaws treated through an AF-guided surgical resection. The authors also provide the histopathologic description of hypo-fluorescent and hyper-fluorescent bone in each patient. After removal of necrotic bone block, Er:YAG laser was used for vaporizing further necrotic bone, up to the detection of strongly hyper-fluorescent bone. Samples of hyper-fluorescent bone were collected around areas of necrosis. Histopathologic evaluation revealed viable bone tissue in all hyper-fluorescent specimens. On the basis of these data, AF-guided surgical resection could be effective in highlighting surgical margins of necrotic bone tissue and it might have some utility in a range of applications of bone surgery.
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Fluorescencia , Terapia por Láser , Láseres de Estado Sólido/uso terapéutico , Mandíbula/patología , Osteonecrosis/cirugía , Anciano , Anciano de 80 o más Años , Conservadores de la Densidad Ósea/efectos adversos , Femenino , Humanos , Masculino , Maxilar/patología , Persona de Mediana Edad , Osteonecrosis/inducido químicamente , Osteonecrosis/diagnóstico por imagen , Osteonecrosis/patología , Factores de RiesgoRESUMEN
PURPOSE: The aim of this literature review was to provide an update on the current scientific knowledge in the field of 3D virtual patient science and to identify a possible easy, smart, and affordable method to combine different file formats obtained from different digital devices. METHODS: Electronic searches of the Medline database was performed, up to May 2017, for articles dealing with the construction of a 3D virtual patient; the matching of data acquired with different digital devices (cone beam computed tomography, CBCT; face scanner, FS; intraoral scanner, IOS; and desktop scanner, DS) was considered. The inclusion of studies was based on the superimposition of at least 2 different digital sources. RESULTS: Twenty-five studies were selected for subsequent examination. Only 3 studies analyzed the feasibility of superimposition of 3 different types of 3D data (CBCT + FS + IOS/DS). The most frequently used matching procedure was between CBCT and FS and CBCT and IOS/DS. CONCLUSION: The procedure of superimposition of data from CBCT, IOS, and FS is currently feasible and it is now possible to create a 3D "virtual patient" to better diagnose, plan the treatment, and communicate with patients.
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Tomografía Computarizada de Haz Cónico , Cara/diagnóstico por imagen , Imagenología Tridimensional , Odontología/métodos , Estética Dental , Humanos , Imagenología Tridimensional/instrumentaciónRESUMEN
Modern clinical protocols in implantology aim at shortening the treatment time and reducing duration and discomfort of the surgical phase, while maintaining optimal treatment outcomes. The purpose of this study was to evaluate clinical outcomes of implants immediately placed in extraction sites, using a single drilling step for implant site preparation. One-hundred thirty-three patients (mean age 55.3â±â12.7 [SD] years, range 20-83 years) were treated at 2 clinical centers. Two-hundred sixty-one implants were inserted in fresh postextraction sockets. One-hundred sixty-five implants were immediately loaded (IL) and 96 underwent delayed loading (DL). Implant survival, peri-implant bone level change and patients' satisfaction were assessed after at least 3 years of function. No patient dropout occurred. The mean follow-up was 63.61â±â11.52 months (range 39.71-85.71 months) from prosthesis delivery. Two IL and 1 DL implant failed in 3 patients. Implant survival was 98.8% and 99% for IL and DL group, respectively. The mean marginal bone loss after 1 year was 0.48â±â0.40âmm and 0.52â±â0.34âmm for IL and DL group. No biological nor mechanical complications occurred. All patients demonstrated full satisfaction. The present protocol with single burs for site preparation produced satisfactory clinical outcomes independent of the loading timing. Further long-term comparative studies are needed to confirm the present findings.
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Carga Inmediata del Implante Dental/métodos , Extracción Dental , Adulto , Anciano , Anciano de 80 o más Años , Implantes Dentales , Femenino , Estudios de Seguimiento , Humanos , Carga Inmediata del Implante Dental/efectos adversos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Factores de Tiempo , Alveolo Dental/cirugía , Resultado del Tratamiento , Adulto JovenRESUMEN
Scanning electron microscopy evaluation of root surfaces after ultrasonic instrumentation was performed with 2 different metallic tips on piezoelectric devices. Fresh extracted teeth were collected for experimental observation and randomly divided into 2 groups: Test Group, where the root surfaces were treated using an iron, rough, double nano-structural coated (T-Black), corindone-treated tip, and Control Group where the root surfaces were treated with a conventional iron smooth tip. A scanning electronic microscope analysis was performed and the surface roughness and the amount of residual debris were evaluated. Descriptive and inferential statistics were performed. Twenty specimens were analyzed, 10 per group and a total of 21.4â×â10âµm has been observed. On treated area percentage of debris after ultrasonic scaling in Test Group was 1.9â±â1.8%, while in Control Group it was 5.7â±â4.3%. Within the limits of the study, it seems that the efficacy of the novel iron, rough, double nano-structural coated (T-Black), corindone-treated structure tip showed greater performance in terms of root surface debridement than the conventional iron smooth tip. The possibility to use a single tool (ultrasonic device with a specific tip) for the root planing procedure within the nonsurgical mechanical therapy may represent a significant advantage for the clinicians. The tested novel tip seems to be able to show the requested ideal characteristics. However, further clinical studies are needed to demonstrate the in vitro results.
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Raspado Dental , Microscopía Electrónica de Rastreo , Raíz del Diente , Raspado Dental/instrumentación , Raspado Dental/métodos , Humanos , Distribución Aleatoria , Propiedades de Superficie , Raíz del Diente/fisiología , Raíz del Diente/cirugía , Raíz del Diente/ultraestructuraRESUMEN
Peripheral giant cell granuloma (PGCG) is a nonneoplastic lesion of the oral mucosa arising on the buccal or lingual attached gingiva or alveolar mucosa and the crest of the edentulous alveolar ridge and contains numerous giant cells. This case series describes 3 cases regarding the clinical and surgical management of PGCG associated with dental implants. MATERIALS AND METHODS: This case series presents 3 patients, mean age 36 years, who showed a pedunculated painless lesion associated with dental implants that radiographically appeared as an osseous rarefaction corresponding the implants. DISCUSSION: Histological examination provided the diagnosis of PGCG. The treatment approach consisted in a surgical complete resection of the lesion and implant removal. After 1-year-follow-up, all the investigated cases did not show signs of recurrence. CONCLUSION: A correct diagnosis and an appropriate surgical treatment of peri-implant giant cell granuloma are very important aspects for proper management of the lesion.
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Implantes Dentales , Granuloma de Células Gigantes/cirugía , Enfermedades de la Boca/cirugía , Adulto , Remoción de Dispositivos , Femenino , Granuloma de Células Gigantes/patología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/patologíaRESUMEN
OBJECTIVES: In the last decade, several studies have reported that short implants achieve excellent results with a 2-stage technique. According to the literature, short dental implants have often been used for the replacement of teeth. METHODS AND MATERIALS: A total of 69 short implants (Bone System) were inserted in the posterior mandibular area (41 in males, 28 in females, with a median age of 55 years and an age ranging from 41 to 70 years). RESULTS: Mean loss of bone levels at 1 year was 0.20â±â0.03âmm, mean changes in bone levels for periods longer than 1 year was 0.07âmm. Survival rate (SRR) of short implants was 98.5%. CONCLUSION: This study showed no complications in short implants and they could represent predictable solutions for the rehabilitation of atrophic posterior mandible to avoid complementary surgical procedures.
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Proceso Alveolar , Resorción Ósea/etiología , Implantación Dental Endoósea/métodos , Implantes Dentales , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Adulto , Anciano , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Mandíbula , Persona de Mediana EdadRESUMEN
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.
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Anestesia Dental/efectos adversos , Anestesia Local/efectos adversos , Anestésicos Locales/efectos adversos , Implantación Dental/efectos adversos , Dolor/etiología , Anciano , Anestésicos Locales/administración & dosificación , Blefaroptosis/etiología , Mejilla , Implantes Dentales , Párpados , Femenino , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Nariz , Músculos OculomotoresRESUMEN
PURPOSE: To evaluate the long-term cumulative implant survival rate (CISR%) and cumulative implant-crown success rate (CICSR%) of single-tooth Morse-taper connection implants, with particular attention to documenting the incidence of prosthetic complications. METHODS: The customized records of all patients who had been treated with single-tooth Morse-taper connection implants in 2 dental centers during the period between January 2002 and December 2012 were revisited. These records included patient-related (gender, age at surgery, smoking, bruxism), implant-related (date of insertion, site/location, and length/diameter of the implant, previous/concomitant bone regeneration), and restoration-related (date of delivery of the provisional and final crown) information. In addition, these records contained information about any implant failure and biologic and/or prosthetic complication that occurred during the follow-up period as well as the radiographic documentation. The follow-up period comprised between 5 and 15 years. The main outcomes were CISR% and CICSR%, with the latter being defined as the condition in which no complication had affected the surviving implant-supported crown during the entire follow-up. Life-table analysis was used for the analysis of CISR% and CICSR%. Peri-implant marginal bone resorption (PIMBR) at 5, 10, and 15 years was a secondary outcome of this study. RESULTS: In total, 578 patients who had received 612 implants were included in this study. The overall CISR% at 15 years was 94.8% (94.2% maxilla, 95.3% mandible). Among the surviving crowns, the overall CICSR% at 15 years was 94.5% (93.1% and 94.9% for anterior and posterior crowns, respectively), and the incidence of prosthetic complications was low (1.5%). The PIMBL amounted to 0.38â±â0.29âmm, 0.49â±â0.35âmm, and 0.94â±â0.58âmm at the 5-, 10-, and 15-year follow-ups, respectively. CONCLUSION: Morse-taper connection implants represent a reliable treatment procedure for the restoration of single-tooth gaps in the long term, with high CISR% (94.8%) at 15 years, a very low incidence of complications, and a high CICSR% (94.5%).
Asunto(s)
Coronas/efectos adversos , Implantes Dentales de Diente Único/efectos adversos , Prótesis Dental de Soporte Implantado/efectos adversos , Fracaso de la Restauración Dental/estadística & datos numéricos , Adulto , Anciano , Resorción Ósea/etiología , Prótesis Dental de Soporte Implantado/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Mandíbula , Maxilar , Persona de Mediana Edad , Análisis de SupervivenciaRESUMEN
OBJECTIVE: This article describes a virtual protocol designed to optimize surgical orthodontic diagnosis and treatment plan. METHODS: A total of 15 patients undergoing orthodontic-surgical treatment have been analyzed with a presurgical virtual three-dimensional (3D) treatment planning, which involves 9 steps. All the patients have been treated with the use of occlusal splint guides projected on the basis of the surgical and orthodontic visualized treatment objective . RESULTS: In all the analyzed patients, a precise and optimal orthodontic presurgical preparation has been obtained. CONCLUSIONS: The 3D analysis seems more precise to interpret than two-dimensional; it provides information and images of craniofacial structures free from perspective distortion and it reduces the steps of the presurgical diagnosis. The simplicity of the protocol described in this paper makes possible to apply it in everyday practice.The study described here allows high-precision planning of orthodontic-surgical therapy and optimization of each treatment phase, with consequent advantages in clinical practice: a more accurate orthognathic surgery with predictable results.