Effect of the buccal fat pad in the prevention of zygomatic implant surgery postoperative complications: A pilot study

Background: Zygomatic implants have been used to treat severe atrophy maxilla. Since its description, the technique has been improved in order to reduce patient morbidity as well as prosthesis rehabilitation time. Despite the improvements in the procedure, zygomatic implant treatments still have complications related to the peri-implant soft-tissue; a probing depth greater than 6 millimeter (mm) and a prevalence of bleeding on probing of 45% have been described. The mobilization of the buccal fat has been used to manage different oral and maxillofacial soft-tissue pathologies. The aim of this study was to assess whether the buccal fat pad might prevent mucosal dehiscence and avoid potential postoperative complications when is placed covering the body part of the zygomatic implants. Material and methods: In this pilot study, 7 patients were enrolled and a total of 28 zygomatic implants were placed and evaluated during a 12-month follow-up period. Surgical sites were randomly divided into two groups before implant placement: control group (A; in which no buccal fat pad was applied) and experimental group (B). Peri-implant soft tissue thickness difference, pain using a Visual Analog Scale (VAS), swelling, hematoma, buccal soft tissue healing and sinusitis, were evaluated. The implant survival rate was determined according the Aparicio success criteria and compared between the control and experimental procedure. Results: A nonstatistical difference was found between groups regarding to pain. The experimental group showed higher soft-tissues thickness (p= 0.03) and the implant survival rate was 100% in both groups. Conclusions: The mobilization of the buccal fat pad to cover the body of the zygomatic implants increases peri-implant soft-tissue thickness, without increasing the postoperative pain. (AU)

Evaluación de la ansiedad en los estudiantes de Odontología durante la pandemia de la COVID-19 / Assessment of anxiety in dental students during the Covid-19 pandemic

La pandemia por COVID-19 ha tenido un gran impacto en la actividad dental, y grandes repercusiones en la educa ción dental. El objetivo de este estudio fue analizar la presencia de ansiedad en los estudiantes de odontología durante el primer confinamiento por la COVID-19, y estudiar su relación con factores sociode mográficos, la sintomatología relacionada con la enfermedad, la realización de cua rentena y el miedo a contraer la enferme dad.Se realizó un estudio observacional y transversal con un cuestionario donde se registraron los datos marcados en los objetivos y se realizó la escala de ansie dad generalizada (GAD-7). El análisis estadístico se realizó mediante la prue ba Chi-cuadrado de Pearson, la prueba exacta de Fisher y un análisis de regre sión lineal multivariante.Los resultados mostraron unos niveles elevados de ansiedad, siendo los estudiantes ≥26 años, las mujeres y los que guardaron cuarentena los que presentaron mayor ansiedad. La realización de pruebas diagnósticas supuso una disminución del nivel de ansiedad.Los estudiantes de odontología se vieron directamente afectados durante el confinamiento, siendo necesario implementar medidas como la realización de estudios que valoren su evolución a lo largo de los siguientes cursos, desde el punto de vista de su salud mental y desarrollo curricular (AU)

Dental activity and education have been severely affected by the COVID-19 pandemic. The aim of the present study was to evaluate the anxiety levels in dental students during the first confinement due to COVID-19, and to analyze its relationship with sociodemographic factors, disease-related symptoms, the carrying out of quarantine and fear of contracting the disease. An observational and cross-sectional study was carried out through a questionnaire, which the previously mentioned data were recorded and anxiety was evaluated using the generalized anxiety scale (GAD-7). Statistical analysis was performed using Pearson’s Chi-square test, Fisher’s exact test, and multivariate linear regression analysis. The results showed high levels of anxiety, furthermore, the students ≥26 years old, women and those who were in quarantine had the highest anxiety. Diagnostic testing led to a decrease in the level of anxiety. Dentistry students were directly affected during the confinement, and it is necessary to implement measures such as studies to assess their evolution throughout the following courses, from the point of view of their mental health and curricular development (AU)

Plasma rich in growth factors (PRGF) and leukocyte-platelet rich fibrin (L-PRF): comparative release of growth factors and biological effect on osteoblasts.

PURPOSE: To compare the release of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF-I) and interleukin 1ß (IL-1ß) of plasma rich in growth factors (PRGF) and leucocyte platelet-rich fibrin (L-PRF) and to evaluate their biological implication in osteoblasts. METHODS: Blood from 3 healthy volunteers was processed into PRGF, immediate L-PRF (L-PRF 0') and L-PRF 30 min after collection (L-PRF-30') and a control group. Growth factors release were analyzed at 7 times by ELISA. Cell proliferation, collagen-I synthesis and alkaline phosphatase activity were assessed in primary cultures of human osteoblasts. RESULTS: A slower controlled release of IGF-I, VEGF and PDGF was observed in the PRGF group at day 14. A higher synthesis of type I collagen was also quantified in PRGF. L-PRF released significantly higher amounts of IL-1ß, that was almost absent in the PRGF. CONCLUSIONS: The addition of leukocytes dramatically increases the secretion of proinflammatory cytokines, which are likely to negatively influence the synthesis of type I collagen and alkaline phosphatase (ALP) by osteoblasts.

Evaluación de la cantidad de hueso neoformado al emplear materiales de relleno en elevación de seno maxilar con abordaje lateral / Evaluation of the amount of new bone formed using graft materials in maxillary sinus augmentation with lateral window technique

Introducción: La cirugía de elevación de seno es un procedimiento realizado en cirugía bucal para conseguir aumentar el volumen óseo en sectores posteriores de maxilares atróficos y así poder rehabilitar la zona con implantes dentales. El objetivo de esta revisión es conocer la cantidad de hueso neoformado, en función del tipo de biomaterial empleado, en la técnica de elevación de seno mediante técnica abierta. Material y métodos: Para cumplir con dicho objetivo se ha llevado a cabo una búsqueda bibliográfica en las principales bases de datos (PubMed/MEDLINE, Cochrane Library, Scopus y Web of Science). Resultados: 18 artículos han sido incluidos para su comparación y discusión en esta revisión. En todos ellos, el estudio histomorfométrico de los materiales de injerto en la elevación de seno fue llevado a cabo, permitiendo conocer la cantidad (%) de hueso nuevo formado con cada biomaterial. Los materiales de injerto empleados son diversos, encontrando hueso autólogo, aloinjerto, xenoinjerto y materiales sintéticos; combinación de algunos de estos materiales entre sí e incluso con concentrados plaquetarios, proteína morfogenética ósea y células madre mesenquimales. Conclusiones: El empleo de hueso autólogo como biomaterial en la cirugía de elevación de seno maxilar mediante técnica abierta, obtiene el mayor porcentaje de hueso nuevo formado. Sin embargo, los resultados obtenidos son también satisfactorios empleando materiales de injerto de diferente naturaleza. (AU)

Introduction: Sinus augmentation is a common procedure performed in dental practice to increase bone volume in atrophic posterior maxilla in order to rehabilitate this area with dental implants. The aim of this review is to know the amount of new bone formation in sinus lift surgery by open technique depending of the biomaterial used. Material and methods: A comprehensive literature search was conducted in the main databases (PubMed/MEDLINE, Cochrane Library, Scopus and Web of Science). Results: The search yielded 18 results that met the inclusion criteria. In all of them, the histomorphometric study of the materials grafted was studied, allowing to know the amount of new bone formed with each biomaterial. The graft materials used are diverse, finding autologous bone, allograft, xenograft and alloplastic materials. Furthermore, it is used the combination of some of these materials with each other and even with platelet concentrates, bone morphogenetic proteins and mesenchymal stem cells. Conclusions: The use of autologous bone as biomaterial in maxillary sinus lift surgery by open technique obtains the highest percentage of new bone formed. However, the results obtained in sinus lift surgery are satisfactory using graft materials of different nature. (AU)

Socket shield technique: A systematic review of human studies.

BACKGROUND AND PURPOSE: Alveolar bone resorption after dental extraction frequently leads to situations in which long-term function and esthetic success of rehabilitations with dental implants is a challenge. Socket shield has been described as an alternative technique to maintain the alveolar ridge when placing immediate implants. The aim of this review is to evaluate the medium- and long-term clinical outcomes of the socket shield technique in human studies. MATERIAL AND METHODS: This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Cochrane Collaboration tool, the Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. RESULTS: Six articles were included in this review. The studies analysed showed lower rates of horizontal and vertical alveolar bone resorption, better maintenance of the buccal plate, less marginal bone loss and better esthetic results than simple placement of immediate implants. However, a lack of homogeneity was found in evaluation methods of the different outcomes, surgical procedures and prosthetic management. CONCLUSIONS: Based on the results of this review, it is possible to suggest that socket shield technique could be a good alternative in terms of alveolar bone maintenance, marginal bone stability and aesthetic outcomes in immediate implant treatment. However, it is not possible to recommend this technique as an alternative treatment with the same long-terms predictability as conventional immediate implants.