ABSTRACT
OBJECTIVE: To compare collected bone weight and the frequency of autologous bone harvesting from the flutes of surgical drills used for implant bed preparation using two different drilling techniques. A comparative evaluation of radiographic bone density and bone quality was also made. MATERIALS AND METHODS: A randomized clinical trial was made of 66 dental implants in patients with a single posterior edentulous site. The compared drilling techniques were high-speed drilling with irrigation (control group) and low-speed drilling without irrigation (test group). The bone collected in both groups was dried and weighed with a precise electronic balance. The frequency of harvesting was calculated. The median radiographic bone density of each implant site was measured using cone-beam computed tomography (CBCT) pixel values. Patient sex, age, implant position and dimensions, as well as the last drill diameter were analyzed as independent variables. The level of significance was 5%. RESULTS: The harvesting of bone chips from drill flutes proved possible in 51.5% of the procedures in the control group and in 100% in the test group (p < 0.001). There were also statistically significant differences in bone weight between the control group (6.7 ± 10.6 mg) and the test group (41.9 ± 30.3 mg) (p < 0.001). The CBCT pixel values were directly correlated with the collected bone weight in both groups. The median radiographic bone density, arch and last drill diameter were significantly associated with harvesting bone frequency and collected bone weight (p < 0.05). CONCLUSIONS: Our findings suggest that the frequency and weight of autologous bone harvested from drills are greater with low-speed drilling without irrigation than with high-speed drilling with irrigation. Radiographic bone density, arch and last drill diameter also significantly influenced the harvesting outcomes.
Subject(s)
Bone Density , Bone Transplantation , Cone-Beam Computed Tomography , Therapeutic Irrigation , Tissue and Organ Harvesting , Humans , Male , Female , Middle Aged , Therapeutic Irrigation/instrumentation , Therapeutic Irrigation/methods , Bone Transplantation/methods , Tissue and Organ Harvesting/methods , Tissue and Organ Harvesting/instrumentation , Dental Implantation, Endosseous/methods , Adult , Aged , Dental Implants , Transplantation, AutologousABSTRACT
Background: Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique. Material and Methods: A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well. Results: Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations...(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Molar, Third/surgery , Paresthesia , Tooth, Impacted/diagnostic imaging , Mandibular Nerve/diagnostic imaging , Trigeminal Nerve Injuries , Tooth Extraction , Oral Medicine , Pathology, Oral , Oral Health , Retrospective Studies , Prospective Studies , Follow-Up StudiesABSTRACT
Background: A study is made of the findings of high-magnification rigid endoscopy at the root end surface following apicoectomy of teeth subjected to periapical surgery.Material and Methods: A cross-sectional study was made of patients subjected to periapical surgery at the Unitof Oral Surgery and Implantology (University of Valencia, Valencia, Spain) between 2011 and 2019. Followingapicoectomy, the root end surfaces were inspected, with the evaluation of untreated canals, isthmuses, craze lines,crack lines, opaque dentin and gaps. Likewise, an analysis was made of the association between patient age andthe tooth type and restoration and the presence of craze lines, cracks, opaque dentin and gaps.Results: The final sample consisted of 168 patients subjected to periapical surgery, with 177 operated teeth and206 roots. Untreated canals were observed in 14 roots (6.8%). Isthmuses were identified in 74 roots (35.9%),particularly in the mesial root of the lower first molar (94.1%). In turn, craze lines were identified in 8.3% of theroots, cracks in 3.9%, and gaps in 53.4%. The prevalence of opaque dentin was 78.3%, with a greater presence inposterior teeth (90.3% in premolars and 86.2% in molars) than in anterior teeth (50.6%) (p<0.001). Patient age andtooth restoration showed no correlation to the studied parameters.Conclusions: Craze lines and crack lines were observed in less than 10% of the roots, though opaque dentin wasidentified in 73% of the roots, particularly in posterior teeth, and gaps were found in over half of the canals. (AU)
Subject(s)
Humans , Apicoectomy/methods , Dental Pulp Cavity/surgery , Molar , Tooth Root/surgery , Cross-Sectional StudiesABSTRACT
Background: An analysis was made of the correlation between root width, the thickness of the remaining dentinalwall as determined by endoscopy, and the outcome of periapical surgery.Material and Methods: A retrospective cohort study was carried out involving patients subjected to periapicalsurgery between 2017 and 2019 at the University of Valencia (Valencia, Spain).One year after surgery, cone-beam computed tomography (CBCT) was used to evaluate healing against the preoperative volumes. The maximum root width was measured on the postoperative CBCT scan at the apical section ofthe treated root. This measurement was transferred to the intraoperative endoscopic image, where the minimumroot width, peripheral dentin thickness, and minimum dentin thickness were recorded. Root measurements, andthe position (maxillary or mandibular) and type of tooth (roots of incisors, canines, premolars or molars) werefurther correlated to periapical surgery outcome.Results: A total of 51 patients, comprising 52 teeth and 62 roots, were included in the study. The mean measurements were: maximum root width (4.13±0.84 mm), minimum root width (2.46±0.72 mm), peripheral dentin thickness (0.77±0.2 mm) and minimum dentin thickness (0.4±0.2 mm). The success rate was 82.2%. Premolar roots showed a greater minimum dentin thickness (0.58±0.25 mm) (p<0.003) than incisor roots. No significant association was found between the different measurements and the healing rate at one year, though the roots that failed to heal showed smaller minimum dentin thickness values than the roots that healed correctly. The position and type oftooth did not influence healing outcome.Conclusions: The root width and thickness of the remaining dentin wall did not significantly influence healing.However, the roots that failed to heal showed smaller minimum dentin thickness values than the roots that healed correctly. (AU)
Subject(s)
Humans , Cone-Beam Computed Tomography/methods , Dentin , Endoscopy , Tooth Root/diagnostic imaging , Tooth Root/surgery , Cohort Studies , Retrospective StudiesABSTRACT
Background : To review systematically the bone gain and superficial resorption rate of the onlay block bone grafts versus the cortical tenting technique, as well as secondarily study the postoperative complications, implant survival and success rates, and peri-implant marginal bone loss. Material and Methods: Following the recommended methods for systematic reviews and meta-analyses (PRISMA), an electronic search was performed in the PubMed (MEDLINE), EMBASE and the Cochrane Library of the Cochrane Collaboration (CENTRAL) databases to identify all relevant articles published up to March 2021 on onlay block bone grafts and cortical tenting technique. Results: Eighteen papers complied with the inclusion criteria. In onlay grafts, the vertical bone gain mean was 4.24 mm, and resorption 20.91%; and 4.29 mm in the horizontal augmentation with a resorption of 10.28%. The complication rate was 14.8%. The implant survival and success rates were 100% and 92%; and the mean peri-implant bone loss ranged from 0.6 to 1.26 mm. In cortical tenting technique, the vertical bone gain mean was 6.17 mm and the resorption of 9.99%; and 5.55 mm in the horizontal augmentation with a 6.12% of resorption. The complication rate was 24.6%. The implant survival and success rates were 96.63% and 100%; and the mean peri-implant bone loss ranged from 0.27 to 0.77mm. Conclusions: Despite the limitations, both techniques offer a predicTable way to reconstruct atrophic alveolar ridges, though the cortical tenting technique seems to achieve a greater bone gain and a lower surface resorption. Current evidence is still limited due to the inadequate follow-up, lack of information referred to methodological quality and sample attrition.(AU)
Subject(s)
Humans , Alveolar Process , Alveolar Ridge Augmentation , Bone Transplantation , Dental Implantation , Dental Implantation, Endosseous/methodsABSTRACT
Background: Two-dimensional (2D) radiographic techniques are commonly used for assessing lesion prognosisafter endodontic surgery. The present retrospective cohort study analyzes the sensitivity and ability of differentradiographic techniques in obtaining area and volume measurements of periapical lesions.Material and Methods: Preoperative and follow-up (6-48 months) periapical and panoramic radiographs (indextest) and cone-beam computed tomography (CBCT) images (reference standard) were selected from an endodonticmicrosurgery database. Sensitivity was analyzed independently by two examiners. The areas of the 2D radio-graphic images and CBCT volumes were studied using Itk-Snap software and Romexis viewer.Results: The sample comprised 105 patients and 105 teeth, with a mean follow-up of 21 months (range 6-48). Preop-eratively, CBCT detected all the periapical areas, periapical radiography detected 67, and panoramic radiographydetected 60. Postoperatively, of the 52 cases in which CBCT detected remains of the periapical area, periapical ra-diography detected 22, and panoramic radiography detected 17. The measurements of the areas obtained by the 2Dmethods, and the volumes obtained by CBCT, had to be transformed into linear measures for comparison purpos-es. The measurements were found to be significantly different in both the preoperative and the follow-up images. Conclusions: Periapical radiography showed greater sensitivity than panoramic radiography, both preoperatively andat follow-up. The lesions measured with CBCT were larger, with significant differences than as evidenced by theperiapical and panoramic radiographs.(AU)
Subject(s)
Humans , Periapical Diseases/surgery , Radiography, Panoramic , Periapical Diseases/diagnostic imaging , Cone-Beam Computed Tomography , Cohort Studies , Retrospective StudiesABSTRACT
BACKGROUND: Hemostasis is of critical importance in endodontic surgery. Studies on bleeding control in maxillary molars are scarce. The present study compares the efficacy of two hemostatic techniques in controlling bleeding in endodontic surgery. MATERIAL AND METHODS: A randomized two-arm pilot study involving 30 patients with peri-radicular lesions in maxillary molars (first and second molars) was carried out including the following hemostatic agents: polytetrafluoroethylene (PTFE) strips as an adjunct to epinephrine impregnated gauze (test group; n = 15) and aluminum chloride (Expasyl(TM)) (control; n = 15). Bleeding control was independently assessed by the surgeon and by two blinded observers before and after application of the hemostatic agent, and was classified as either adequate (complete bleeding control) or inadequate (incomplete bleeding control). RESULTS: Bleeding control was similar in both groups. Simple binary logistic regression analysis failed to identify variables affecting bleeding control. Only the height of the keratinized mucosal band (≥ 2 mm) suggested a decreased risk of inadequate bleeding control of up to 89% (OR = 0.11; p = 0.06). CONCLUSIONS: No difference in the efficacy of bleeding control was observed between PTFE strips as an adjunct to epinephrine impregnated gauze and aluminum chloride in maxillary molars
No disponible
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Hemostasis, Surgical/methods , Tooth Root/surgery , Dental Pulp Cavity/surgery , Hemostatics/therapeutic use , Molar/surgery , Polytetrafluoroethylene/therapeutic use , Epinephrine/therapeutic use , Aluminum Chloride/therapeutic use , Root Canal Therapy/methods , Blood Loss, Surgical/prevention & control , Logistic Models , Treatment Outcome , Maxilla/surgeryABSTRACT
BACKGROUND: The main objective of this study is to examine the quality of the information available for patients online with regards to the apicoectomy surgical procedure, both on general and critically selected websites. The hypothesis is that general websites has less quality than other that have been pre-selected. MATERIAL AND METHODS: A search for the English term "apicoectomy" was performed online. The first 100 websites that appeared in both Google and Yahoo were analysed. Seven validated instruments were used for these two dimensions: quality (DISCERN, JAMA and EQIP), and readability (FRES, Fog Scale, FKRGL and SMOG). RESULTS: A total of 21 websites (10.5%) were selected. The readability of the websites in both groups was difficult or very difficult. With regards to the quality of the websites, the DISCERN instrument indicated an average value of 2.28 [2.14-2.39] for all of the websites, therefore indicating very low quality with serious defects; however, in the selected websites, the average quality was 3.16 [2.84-3.48], indicating potential, but not serious defects (p < 0.001). There were statistically significant differences for the FRES values (p = 0.030), with a greater readability in the selected group of websites. CONCLUSIONS: We believe that it is very important for the population to become aware of and learn how to use certain exclusion criteria when selecting medical consultation websites, as in doing so, they will be able to obtain a higher quality of information from these websites
No disponible
Subject(s)
Humans , Apicoectomy , Patient Portals/standards , Internet , Information Seeking Behavior , Information Dissemination , Statistics, Nonparametric , Comprehension , Patient Portals/statistics & numerical data , Reference StandardsABSTRACT
BACKGROUND: To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction. MATERIAL AND METHODS: An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized clinical trials. The Cochrane risk of bias assessment tool was used for methodological appraisal. A random-effects meta-analysis was conducted of pain perception and trismus. RESULTS: From the initially 1314 screened studies, only 11 were included in the qualitative synthesis, and 5 in the meta-analysis. There were no statistically significant differences in pain between the envelope and triangular flap designs over time, except on the sixth postoperative day, when the envelope flap proved more painful. Regarding trismus, statistically significant differences were observed on the seventh postoperative day, with greater mouth opening in the envelope flap group than in the triangular flap group. There were no clear differences in swelling and osteitis among the flap designs. CONCLUSIONS: Despite its limitations, the present meta-analysis found no clear differences in patient morbidity between the different flap designs
No disponible
Subject(s)
Humans , Tooth, Impacted/surgery , Tooth Extraction/methods , Surgical Flaps , Molar, Third/surgery , Tooth, Impacted/complications , Tooth Extraction/adverse effects , Morbidity , Treatment Outcome , Pain Perception , Trismus/etiology , Dry Socket/etiologyABSTRACT
BACKGROUND: Epidermolysis bullosa (EB) comprises a group of hereditary disorders characterized by mechanical fragility of the skin and mucous membranes, with the development of blisters and vesicles in response to minimum tissue friction. Recessive dystrophic epidermolysis bullosa (RDEB) with generalized involvement is the most common subtype in the oral cavity. The present study was carried out to investigate dental implant survival, peri-implant tissue condition, patient satisfaction, and the impact of treatment upon the quality of life of patients with RDEB rehabilitated with implants and full-arch implant-supported prostheses. MATERIAL AND METHODS: Thirteen patients with RDEB underwent dental implant treatment between September 2005 and December 2016. A retrospective study was made to analyze implant survival, peri-implant tissue health and patient satisfaction. RESULTS: A total of 80 implants were placed (42 in the maxilla and 38 in the mandible) in 13 patients between 20-52 years of age and diagnosed with RDEB. All the implants were rehabilitated on a deferred basis with 20 full-arch prostheses. Fifteen fixed prostheses and 5 implant-supported overdentures were placed. The implant survival rate was 97.5% after a mean follow-up of 7.5 years after prosthetic loading. Fifty percent of the implants showed mucositis at the time of evaluation. Probing depth was maintained at 1-3 mm in 96.2% of the implants, and bleeding upon probing was observed in 67.5% of the implants. There was a high prevalence of bacterial plaque (85%). CONCLUSIONS: The treatment of edentulous patients with RDEB by means of implants and implant-supported prostheses is predictable as evidenced by the high success rate, and improves patient self-esteem and quality of life
No disponible
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Epidermolysis Bullosa Dystrophica/physiopathology , Mouth Rehabilitation/methods , Dental Prosthesis, Implant-Supported , Retrospective Studies , Follow-Up Studies , Patient Satisfaction , Quality of Life , Treatment Outcome , Visual Analog ScaleABSTRACT
Background: To evaluate the effect of two different implant macro-designs on the sequential osseointegration at bicortically installed implants in the rabbit tibia. A further aim is to compare the osseointegration at different topographic zones. Material and Methods: 27 New Zealand rabbits were implemented. Two implants, one for each macro-design (Ticare Inhex(R) or Ticare Quattro(R), Mozo-Grau, Valladolid, Spain), were randomly implanted in the diaphysis or metaphysis of each tibia. The flaps were sutured to allow a submerged healing. The animals were sacrificed after 2, 4 or 8 weeks. Ground sections were prepared and analyzed. Results: No statistically significant differences were found between the two groups for newly formed bone in contact with the implant surface, being about 16%, 19% and 33% in both groups, after 2, 4, and 8 weeks of healing. Bone apposition was slightly higher in the diaphysis, reaching values of 36.4% in the diaphysis, and 29.3% in the metaphysis at 8 weeks of healing. It was observed that the implant position showed a statistical significance regarding BIC values at 4 and 8 weeks (p < 0.05). Multivariate analysis fails to detect statistical significant differences for the interaction between implant designs and topographic site. Ticare Quattro(R) design had a slight better BIC values at diaphysis sites across healing stages, but without reaching a statistical significance. Conclusions: The both implant macro-designs provided similar degrees of osseointegration. Bone morphometry and density may affect bone apposition onto the implant surface. The apposition rates were slightly better in diaphysis compared to metaphysis
No disponible
Subject(s)
Animals , Rabbits , Dental Implants , Osseointegration , Dental Implantation, Endosseous , Surface Properties , Tibia , TitaniumABSTRACT
Background: To determine whether saliva is a good means of evaluating concentrations of oxidative stress bio-markers, analyzing the correlation between concentrations in saliva and in follicular tissue, and to compare bio-marker concentrations in patients with one asymptomatic mandibular impacted third molar (MITM) (before ex-traction) with a healthy control, and to determine how biomarkers are modified by extraction. Material and Methods: 80 patients with one asymptomatic MITM and 80 healthy controls were included. Saliva samples were collected from all subjects (before extraction in the study group) to evaluate Myeloperoxidase (MPO) and Malondialdehyde (MDA) concentrations. Follicular tissues were obtained during surgery to measure biomarkers. One month after extraction, saliva samples were collected to assess changes of oxidative stress. Results: Salivary MPO and MDA showed positive correlation with concentrations in follicular tissue (MPO: correlation coefficient = 0.72, p = 0.025; MDA: = 0.92, p = 0.001). Patients with asymptomatic MITMs showed higher salivary concentrations of oxidative stress biomarkers than healthy control subjects, with statistical significance for both MPO (p < 0.001) and MDA (p < 0.001). One month after extraction, salivary biomarkers decreased significantly in the study group (p < 0.001)
No disponible
Subject(s)
Humans , Peroxidase , Tooth, Impacted , Biomarkers , Malondialdehyde , Molar, Third , SalivaABSTRACT
Background: The purpose of this cross-sectional study was to evaluate radiologically, the relation between the distance from the cement enamel junction (CEJ) to the facial bone crest (FBC), and the facial alveolar bone (FAB) width at maxillary anterior teeth. A further aim was to assess if the CEJ-FBC distance had an impact in the prevalence to find a FAB thickness greater than one mm. Study design: CBCT images were retrospectively obtained from the database of the Oral Surgery Unit of the University of Valencia. The teeth were divided in 3 groups according to the CEJ-FBC distance: Shorter (≤ 3mm), Middle (>3 ≤ 4.5 mm) and Larger (> 4.5 mm). FAB thickness was measured by two different examiners at 1, 2 and 3 mm apical to the FBC. Normality of means were evaluated by Kolmogorov-Smirnov test and an ANOVA-type linear model was performed. Results: 82 patients were included in the study, with 156 central incisors, 149 lateral incisors and 152 canines analyzed. A significant greater FAB thickness in Shorter (≤ 3 mm CEJ-FBC) than Middle and Larger group was observed in all distances measured apical to the FBC. There was a significant inverse relation between the distance CEJ-FBC and FAB thickness at all distances measured. The prevalence of a FAB thickness equal or greater than one mm was 35.9% of all teeth analyzed from Shorter, 17.4% of Middle and 8.9% of Larger group at 1 mm apical to the FBC
No disponible
Subject(s)
Humans , Alveolar Process , Tooth Cervix , Cone-Beam Computed Tomography , Cross-Sectional Studies , Maxilla , Retrospective StudiesABSTRACT
BACKGROUND: To compare the radiological parameters and success of posterior maxillary direct sinus lift with simultaneous or delayed implant placement, or implant placement in native bone, after a minimum follow-up period of 5 years. MATERIAL AND METHODS: A retrospective cohort study was carried out in a university clinic, selecting patients subjected to implant treatment in the posterior maxilla between the years 2005 and 2011. The patients were divided into three groups: 1) implants placed in native bone; 2) direct sinus lift with simultaneous implant placement; and 3) direct sinus lift with delayed implant placement. Bone crest level, bone loss, vertical bone gain, and implant success and survival after a minimum follow-up period of 5 years after prosthetic loading were analyzed. RESULTS: A total of 163 patients and 329 implants were included in the study. The mean duration of follow-up was 7.0 ± 1.9 years. Bone loss and implant success and survival were very similar in all three groups, with no significant differences among them. Graft reabsorption was greatest during the first 12 months, though graft stabilization was confirmed after 5 years of follow-up. CONCLUSIONS: Bone loss and percentage success and survival proved very similar for the implants placed in native bone and for sinus lift with simultaneous or delayed implant placement. The height of the graft material decreased mainly in the first 12 months, and continued until stabilization after 5 years, with no significant variations there-after
Subject(s)
Sinus Floor Augmentation/methods , Treatment Outcome , Retrospective Studies , Follow-Up Studies , Cohort StudiesABSTRACT
Background: To compare the technique of high speed drilling with irrigation and low speed drilling without irrigation in order to evaluate the success rate and peri-implant bone loss at 12 months of follow-up. Material and Methods: A randomized, controlled, parallel-group clinical trial was carried out in patients requiring dental implants to rehabilitate their unitary edentulism. Patients were recruited from the Oral Surgery Unit of the University of Valencia (Spain) between September 2014 and August 2015. Patients who met the inclusion criteria were randomized to two groups: group A (high-speed drilling with irrigation) and group B (low-speed drilling without irrigation). The success rate and peri-implant bone loss were recorded at 12 months of follow-up. Results: Twenty-five patients (9 men and 16 women) with 30 implants were enrolled in the study: 15 implants in group A and 15 implants in group B. The mean bone loss of the implants in group A and group B was 0.83 ± 0.73 mm and 0.62 ± 0.70 mm, respectively (p> 0.05). In the maxilla, the bone loss was 1.04 ± 0.63 mm in group A and 0.71 ± 0.36 mm in group B (p> 0.05), while bone loss in the mandible was 0.59 ± 0.80 mm in group A and 0.69 ± 0.77 mm in group B (p> 0.05). The implant success rate at 12 months was 93.3% in group A and 100% in group B. Conclusions: Within the limitations of the study, the low-speed drilling technique presented peri-implant bone loss outcomes similar to those of the conventional drilling technique at 12 months of follow-up (AU)
No disponible
Subject(s)
Humans , Oral Surgical Procedures, Preprosthetic/methods , Therapeutic Irrigation/methods , Prosthodontics/methods , Dental Implants , Osseointegration , 28599 , Bone Substitutes/therapeutic useABSTRACT
Purpose: The aim of this study was to systematically review the evidence for periapical implant lesion, which makes a patient more susceptible to the periapical lesion, frequency, symptoms, signs (including radiological findings) and possible treatment options. Material and Methods: A systematic literature review and analysis of publications included in PubMed, Embase and Cochrane; articles published until March 2016; with a populations, exposures and outcomes (PEO) search strategy was performed, focused on the issue: 'In patients with periapical lesion to the implant during the osseointegration, what symptoms, signs, and changes in complementary examination manifested, for according to that stage, be intervened with the appropriate approach? '. The set criteria for inclusion were peer-reviewed articles. Results: From a total of 212 papers identified, 36 studies were included in this systematic review, with 15461 implants evaluated and 183 periapical implant lesions. Which 8 papers included more than 5 cases and 28 included equal or less than 5 cases. Analysis of the papers revealed that periapical implant lesion is classified according to evolution stages into acute (non-suppurated and suppurated) and subacute (or suppurated-fistulized). In the acute stage and in the subacute if there is no loss of implant stability, the correct treatment approach is implant periapical surgery. In the subacute stage associated with implant mobility the implant must be removed. Conclusions: Evidence on the subject is very limited, there are few studies with small sample, without homogeneity of criteria for diagnosing the disease and without design of scientific evidence. Currently etiology lacks consensus. The early diagnosis of periapical implant periapical lesions during the osseointegration phase and early treatment, will lead to a higher survival rate of implants treated, hence preventing the need for implant extraction (AU)
No disponible
Subject(s)
Humans , Periapical Diseases , Periapical Tissue , Dental Implants/adverse effects , Osseointegration , Prognosis , Periapical Tissue/surgery , BibliometricsABSTRACT
Background: Dental implant placement using flapless surgery is a minimally invasive technique that improves blood supply compared with flapped surgery. However, the flapless technique does not provide access to allow bone regeneration. Objective: The aim of this systematic review was to evaluate the clinical parameters following implant surgery in healed sites, using two procedures: flapped vs. flapless surgery. Material and Methods: A detailed electronic search was carried out in the PubMed/Medline, Embase and Cochrane Library databases. The focused question was, "How do flapped and flapless surgical techniques affect the clinical parameters of dental implants placed in healed sites?". All the studies included with a prospective controlled design were considered separately, depending on whether they had been conducted on animals or humans. The following data were recorded in all the included studies: number of implants, failures, location (maxilla, mandible), type of rehabilitation (partial or single), follow-up and flap design. The variables selected for comparison in the animal studies were the following: flap design, gingival index, mucosal height, recession and probing pocket depth. In humans studies the variables were as follows: flap design, plaque index, gingival index, recession, probing pocket depth, papilla index and keratinized gingiva. Results: Ten studies were included, six were experimental studies and four were clinical studies. Studies in animals showed better results using the flapless technique in the parameters analyzed. There is no consensus in the clinical parameters analyzed in human studies, but there is a trend to better results using flapless approach. Conclusions: The animal studies included in the present review show that implants placed in healed sites with a flapless approach have better clinical parameters than the flapped procedure in a short-term follow-up. In human studies, there is no consensus about which technique offer better results in terms of clinical parameters. Therefore, more research in humans is required in order to overcome the limitations and contrast these results (AU)
No disponible
Subject(s)
Humans , Animals , Dental Implantation, Endosseous/statistics & numerical data , Free Tissue Flaps , Treatment Outcome , Postoperative Complications/epidemiology , Bone Substitutes/therapeutic use , Gingival Recession/epidemiology , Periodontal IndexABSTRACT
La ránula intraoral es una enfermedad benigna seudoquística de extravasación que tiene su origen en las glándulas salivales sublinguales. Es una entidad poco prevalente. Es más frecuente en niños y adolescentes, con características clínicas propias que la diferencian de otras entidades de la boca. Su tratamiento es quirúrgico y varias técnicas han sido descritas en la literatura: marsupialización simple y modificada, enucleación de la lesión, extirpación de la glándula junto con enucleación de la ránula. Si bien la extirpación de la glándula junto con la enucleación de la lesión es el tratamiento definitivo radical y más aceptado, la marsupialización modificada puede ser útil como alternativa de tratamiento quirúrgico conservador en casos de ránulas intraorales gigantes, disminuyendo los riesgos de morbilidad quirúrgica y presentando bajos índices de recurrencia, mientras su aplicación sea cuidadosa. El siguiente reporte de caso describe el manejo clínico de forma quirúrgica conservadora mediante marsupialización modificada, con un seguimiento de 12 meses sin signos de recidiva.
The intraoral ranula is a benign pseudo-cystic extravasation with its origin in the sublingual salivary glands. It is an infrequent disease. It is more common in children and adolescents, with its own clinical characteristics that differentiate it from other entities in the mouth. The treatment for this condition is surgical, and several techniques have been described in the literature: simple and modified marsupialisation, enucleation of the lesion, and removal of the gland with enucleation of the ranula. While the removal of the gland with enucleation of the lesion is the widely accepted radical and definitive treatment, marsupialisation may be useful as an alternative to conservative surgical treatment in cases of giant intraoral ranula, reducing the risk of surgical morbidity, and presenting with low rates of recurrence, while its application should be performed with care. The case is presented that describes the conservative surgical treatment with marsupialisation in its clinical management, with a 12 months follow up without signs of recurrence.
Subject(s)
Humans , Male , Adolescent , Ranula/surgery , Salivary Gland Diseases/surgery , Sublingual Gland/surgery , Treatment OutcomeABSTRACT
BACKGROUND: One of the main aims of orthodontists is to reduce the treatment time as much as possible, particularly in view of the rise in demand for orthodontic treatment among adult patients. The objective of this systematic review was to examine the effectiveness of corticotomy as a surgical procedure that accelerates orthodontic tooth movement, together with its possible adverse effects. MATERIAL AND METHODS: A systematic review of articles in 4 databases, Pubmed, Cochrane, Scopus and Embase, complemented by a manual search, identified 772 articles. The duplicates were eliminated and a critical reading of titles and abstracts led to the rejection of articles that did not meet the objectives of the review, leaving 69. After reading the full text of these articles, 49 were excluded because they did not meet the inclusion criteria. On applying the CONSORT criteria as a quality filter, a further 4 were eliminated due to low quality. Finally, 16 articles (4 systematic reviews and 12 controlled trials) were reviewed. RESULTS: All the studies agree that corticotomy prior to orthodontic treatment accelerates dental movement, reducing the treatment time. With regard to side-effects, no periodontal damage was found, although this was only studied in the short term. CONCLUSIONS: The evidence regarding the results of corticotomy is limited, given the small number of quality clinical studies available. Before this procedure is included as a routine practice in dental surgeries, studies of higher methodological quality are required, studying a greater number of individuals and examining the possible long-term adverse effects and the cost/benefit of the procedure
Subject(s)
Humans , Adult , Tooth Movement Techniques/methods , Orthodontics, Corrective/methods , Osteotomy , Treatment OutcomeABSTRACT
BACKGROUND: Coronectomy is an alternative to complete removal of an impacted mandibular third molar. Most authors have recommended coronectomy to prevent damage to the inferior alveolar nerve during surgical extraction of lower third molars. The present study offers a systematic review and metaanalysis of the coronectomy technique. MATERIAL AND METHODS: A systematic review and meta-analysis was performed based on a PubMed and Cochrane databases search for articles published from 2014 and involving coronectomy of mandibular third molars located near the inferior alveolar nerve canal, with a minimum of 10 cases and a minimum follow-up period of 6 months. After application of the inclusion and exclusion criteria, a total of 12 articles were included in the study. Results and DISCUSSION: Coronectomy results in significantly lesser loss of sensitivity of the inferior alveolar nerve and prevents the occurrence of dry socket. No statistically significant differences were observed in the incidence of pain and infection between coronectomy and complete surgical extraction. After coronectomy, the remaining tooth fragment migrates an average of 2 mm within two years. CONCLUSIONS: Coronectomy is indicated when the mandibular third molar is in contact with the inferior alveolar nerve and complete removal of the tooth may cause nerve damage