Frequency of surgical bone augmentation methods complementary to dental implant placement: A study evaluated with cone beam computed tomography.

Background: The success of dental implants largely depends on the quantity and quality of available bone. Occasionally, it is necessary to perform additional surgical techniques alongside implant placement to increase the available bone volume and ensure the success and survival of treatments. The objective of this study was to evaluate, through cone beam computed tomography, the need for supplementary bone augmentation methods in implant placement. Additionally, the study aimed to assess the frequency of such techniques based on gender, anatomical sectors, and types of bone augmentation procedures. Material and Methods: The analysis included 106 cone beam computed tomography images obtained from 77 patients over the age of 18 who sought oral rehabilitation with implants at the University Clinic of the Master's Program in Oral Implantology at the European University of Valencia. Results: A total of 201 edentulous sextants were analyzed. It was observed that 63.68% of the sextants required a bone augmentation technique, and there was a statistically significant difference (p=0.039) regarding the need for supplementary techniques in women. The need for bone augmentation by sectors was most prevalent the horizontal type (48.11%) and in the mandible (29.41%). About crestal and lateral approaches for sinus elevation, there was a higher need for the lateral technique (49.38%), and a statistically significant difference was evident (p=0.015). Conclusions: A high frequency of bone augmentation need for implant placement was demonstrated. It was shown that some form of supplementary surgical method was required in implant placement (63.68%). The highest need for bone augmentation was observed in the posterior maxillary sector, primarily in the vertical type (29.27%), accompanied by lateral window sinus elevation technique (49.38%). Key words:Bone graft, Dental implant, Guided bone regeneration, Sinus floor augmentation, Cone beam computed tomography.

A review of temporomandibular joint disease (TMJD). Part II: Clinical and radiological semiology. Morbidity processes.

The clinical signs and symptoms of greatest semiologic value in temporomandibular joint disease (TMJD) are muscle pain, joint pain, limitations in mandibular movement, and joint sounds. Imaging studies of the joint are very useful for establishing the diagnosis and for discarding other disease processes, though in many cases diagnostic error results from the detection of a large proportion of patients with alterations in the imaging studies but with no associated clinical manifestations. Panoramic X-rays and magnetic resonance imaging are the most commonly used complementary techniques for diagnosing TMJD. MRI may be regarded as the imaging technique of choice, particularly when studying the soft tissues. Biochemical evaluation of the joint synovial fluid has improved our understanding of TMJD pathogenesis, though to date such parameters have not been extended to clinical practice. Myofascial pain with positive painful palpation of the masticatory muscles; joint disc displacements with reduction characterized by the presence of opening or opening and closing clicks; disc displacements without reduction characterized by limitations in oral aperture; and osteoarthritis / osteoarthrosis characterized by the auscultation of friction sounds during mandibular movement, are the morbidity processes most often seen in the context of TMJD. The present study offers a review of the semiology and morbidity processes of the temporomandibular joint.

Review of temporomandibular joint pathology. Part I: classification, epidemiology and risk factors.

Pathology of the temporomandibular joint (TMJ) affects an important part of the population, though it is not viewed as a public health problem. Between 3-7% of the population seeks treatment for pain and dysfunction of the ATM or related structures. The literature reports great variability in the prevalence of the clinical symptoms (6-93%) and signs (0-93%), probably as a result of the different clinical criteria used. In imaging studies it is common to observe alterations that have no clinical expression of any kind. Radiographic changes corresponding to osteoarthrosis are observed in 14-44% of the population. Age is a risk factor, though with some particularities. In elderly patients there is an increased prevalence of clinical and radiological signs, though also a lesser prevalence of symptoms and of treatment demands than in younger adults. Approximately 7% of the population between 12 and 18 years of age is diagnosed with mandibular pain-dysfunction. Temporomandibular dysfunction (TMD) is more frequent in females. No clear relationship has been established between occlusal alterations and TMJ disease. Only disharmony between centric relation and maximum intercuspidation, and unilateral crossbite, have demonstrated a certain TMJ disease-predictive potential. Both local and systemic hyperlaxity has been postulated as a possible cause of TMD. Parafunctional habits and bruxism are considered risk factors of TMD with odds ratios (ORs) of up to 4.8. Psychophysiological theory holds stress as a determinant factor in myofascial pain. Genetic factors and orthodontic treatment have not been shown to cause TMD.

Basal cell nevus syndrome. Presentation of six cases and literature review.

Basal cell nevus syndrome, also known as Gorlin-Goltz syndrome, is an autosomal dominant inherited disorder which is characterised by the presence of multiple maxillary keratocysts and facial basal cell carcinomas, along with other less frequent clinical characteristics such us musculo-skeletal disturbances (costal and vertebrae malformations), characteristic facies, neurological (calcification of the cerebral falx, schizophrenia, learning difficulties), skin (cysts, lipomas, fibromas), sight, hormonal, etc. On occasions it can be associated with aggressive basal cell carcinomas and malignant neoplasias, for which early diagnosis and treatment is essential, as well as family detection and genetic counselling. Currently there are new lines of investigation based on biomolecular studies, which aim at identifying the molecules responsible for these cysts and thus allowing an early diagnosis of these patients. In its clinical management and follow up, the odonto-stomatologist, the maxillofacial surgeon and several other medical specialists are involved. In this paper a review of the literature, and six cases of patients affected by multi-systemic and varied clinical expression of basal cell nevus syndrome, are presented.

A Stafne's cavity with unusual location in the mandibular anterior area.

The typical Stafne's cavity, located on the posterior portion of the mandible, is a relatively uncommon entity. However, when the defect is located in the anterior region of the mandible, it is quite rare, having thus far been described in only 36 cases in the scientific literature. Most of these defects appear in the fifth and sixth decades of life, are localized to the area of the canines and premolars, and have a predilection for males. The inferior dental canal, one of the anatomical-radiographic landmarks that aid in the diagnosis of Stafne's cavity in the posterior region, is rarely present anterior the mental foramen. For this reason, because of its more variable radiographic appearance compared to the posterior defect, its tendency to be superimposed over the apices of the teeth, and the rarity of its localisation to the anterior mandible, it is much more difficult to establish a definitive diagnosis of a Stafne's cavity in this location. It is therefore more likely that a diagnostic error can occur, especially early on. We present a new case in a 68-year-old male in which the diagnosis was serendipitous, and we review in particular the aetiology and pathogenesis, clinical aspects, and differential diagnoses for this condition.