Proposal and Validation of a New Index to Assess the Difficulty of Lower Third Molar Extraction.

There is no current consensus on the parameters that determine the difficulty of mandibular third molar extraction in terms of the time required, which is essential to prevent complications and optimize the time of the intervention. This study aims to obtain, using the mathematical method of multiple linear regression, an equation that allows estimating the extraction time of a lower third molar according to its complexity, as well as to validate this equation in a sample of external wisdom teeth. METHODS: A prospective cohort study on a sample of patients of the Master of Oral Surgery of the University of Seville in which multiple linear regression coefficients were calculated with a subsequent validation study of the results in the sample of patients operated in the Hospital Palmaplanas of Mallorca. RESULTS: The regression line obtained after applying the statistical methodology to the cohort of patients from the University of Seville obtained significant dependent variables such as depth, roots, and odontosection. Once applied to the cohort of patients from the Palmaplanas Hospital in Mallorca, a regression coefficient was obtained between the data received and the estimated 0.770. CONCLUSIONS: The formula proposed in this article presents significant validity in the prediction of the surgical time of extraction of the lower third molars included.

Satisfaction in complete denture wearers with and without adhesives: A randomized, crossover, double-blind clinical trial.

BACKGROUND: The purpose of this study was to compare the satisfaction of patients regarding retention, stability and accumulation of particles with a randomized, double-blind crossed method in users with complete dentures with and without adhesive. MATERIAL AND METHODS: Seventeen edentulous individuals were randomized and received new upper and lower complete dentures. After a period of adaptation, they participated in some masticatory tests and clinical revisions, after use the protheses with and without the use of two denture adhesives: Adhesive A (Fittydent, Fittydent International GmbH) and adhesive B (Corega, GlaxoSmithKline) at 0, 7 and 14 days. Satisfaction was measured immediately after each test through a survey using a VAS scale (0-10) and data were analyzed with McNemar's test with Bonferroni correction. RESULTS: The results showed significant differences (p<.01) between the study groups with adhesive A - B and the group without adhesive, but no significant differences were found between the two stickers for any of the variables studied. CONCLUSIONS: Complete denture adhesives significantly improved the satisfaction of patients because a better retention, stability and less accumulation of particles of the food substitute between the denture and the mucosa is obtained compared with non-use of complete denture adhesives. Key words:Complete dentures, patient satisfaction, denture adhesives, clinical trials.

Three steps to maintain predictable interdental papilla and gingiva emergence profiles in immediate implant placement. A 3-year follow-up case report.

We present a case that describes a three-step clinical technique to provide guidelines to replace fractured teeth with immediate implant placement using the same dental structure as a temporary crown and a regenerative approach. This approach predictably maintains the interdental papilla and gingiva emergence profile to ensure a favorable cosmetic result. A 3-year follow-up has shown good clinical outcomes and stability in crestal bone levels. Consequently, this is an innovative way to do temporary crown and design restorations in everyday clinical practice. Key words:Interdental papilla, dental implant, inmmediate implant, gingival aesthetics, dental aesthetics.

Comparison of masticatory efficacy among complete denture wearers with two adhesives and dentate individuals: A randomized, crossover, double-blind clinical trial.

STATEMENT OF PROBLEM: The masticatory efficacy between dentate and edentulous individuals with and without the use of dental adhesives has been little studied. A comparative study of the addition of various agents of synthetic adhesion (vinyl methyl ether versus polyvinyl acetate) to these adhesives is needed. PURPOSE: The purpose of this randomized, crossover, double-blind clinical trial was to compare the masticatory efficacy of wearers of complete dentures with and without dental adhesives of 2 different compositions and that of dentate controls. MATERIAL AND METHODS: Seventeen participants with edentulism (edentulous control and 2 experimental groups) received new maxillary and mandibular complete dentures. After an adjustment period, they participated in masticatory tests with and without the use of 2 denture adhesives (Fittydent; Fittydent International GmbH and Corega; GlaxoSmithKline). The participants with edentulism were compared with 17 dentate controls. Masticatory efficacy was evaluated while the participants were masticating a substitute for irreversible hydrocolloid (20 g) and performing a single test of mastication (with 20 masticatory strokes) at 0, 7, and 14 days. Masticatory efficiency was measured immediately after each test with the sieving method and was calculated according to the weight of the particles of the substitute in each of the sieve filters. Data were analyzed using 1-way ANOVA for simple pairs, and a multiple comparison was made using the Wilcoxon test with Bonferroni correction (α=.05). RESULTS: Significant differences were found between the 2 adhesives (P<.05) in the masticatory efficacy for filters 2 and 3, and nonsignificant differences occurred for filter 1. Compared with the edentulous control group, significant differences between the use or nonuse of adhesives were found in the edentulous group for the 3 filters (P<.05). Compared with the dentate control group, significant differences were found in masticatory efficiency between the dentate control group and the other groups for all comparisons (P<.05). CONCLUSIONS: Masticatory efficacy was higher with the use of Corega denture adhesive. The masticatory efficacy was significantly higher in dentate participants compared with participants with edentulism who had complete dentures, with or without denture adhesives. A significant increase of masticatory efficacy was observed among edentulous participants with denture adhesives in relation to those not using denture adhesives.

Outcome of single immediate implants placed in post-extraction infected and non-infected sites, restored with cemented crowns: a 3-year prospective study.

OBJECTIVES: To compare the survival of immediate implants placed in postextraction infected and non-infected sites, restored with cemented crowns. METHODS: Thirty-six implants were immediately placed in non-infected sockets (control group (CG), n=18), and in infected alveoli (test group (TG), n=18) that had been debrided, curetted, cleaned with 90% hydrogen peroxide, irradiated with yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser, and irrigated with a sterile solution. Guided bone regeneration was performed under antibiotic coverture. All study patients had both a CG and a TG site. The implant osteotomy sites were extended 3-4 mm beyond the apical extent of the sockets to achieve primary stability for the implants. The prosthetic phase occurred 4.5 months after surgery. Success criteria were accepted as the presence of implant stability, absence of a radiolucent zone around the implants, absence of mucosal suppuration, and lack of pain. Clinical evaluations were performed at baseline, and at 12, 24, and 36 months of follow-up. RESULTS: All of the implants were osseointegrated 3 months after surgery. The 3-year survival rate was 94.44% for TG, and 100% for CG. The clinical and radiographic variables tested yielded no significant differences among groups at 36 months. CONCLUSIONS: Under the tested conditions, immediate implant placement can be considered a predictable treatment option for the restoration of fresh postextraction infected sockets. CLINICAL SIGNIFICANCE: Immediate implants may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history when appropriate preoperative procedures are taken to clean and decontaminate the surgical sites.

Fracture resistance of endodontically treated teeth restored with glass fiber reinforced posts and cast gold post and cores cemented with three cements.

STATEMENT OF PROBLEM: Dental fractures can occur in endodontically treated teeth restored with glass fiber reinforced posts and cast gold posts. PURPOSE: The objective of this study was to record the fracture strength of endodontically treated teeth restored with glass fiber reinforced or cast gold post and cores cemented with 3 cements. MATERIAL AND METHODS: Forty-two single-rooted premolars with standardized weakened roots were endodontically treated and allocated to 6 experimental groups (n=7) defined by the 2 factors investigated: post system and cement. Three groups were restored with glass fiber posts and resin-modified glass ionomer cement, dual-polymerizing resin cement, or chemically active autopolymerizing resin cement. The other 3 groups were restored with cast gold post and cores and the same 3 cements. The cores of the glass fiber post groups were fabricated with composite resin core material. Metal crowns were cemented on the cores in the 6 groups. The entire system was subjected to continuous compression in a universal testing machine, and fracture limit and location (cervical third, middle third, or apical third) were noted. Two-way ANOVA and the Scheffé test were used to analyze the data and compare the groups (α=.05). RESULTS: Two-way ANOVA showed significant differences in the post type (P<.001) and the cements (P<.001). The interaction between them (P<.001) was statistically significant in the fracture resistance of the endodontically treated teeth. The greatest interaction between post and cement was the glass fiber post with resin-modified glass ionomer cement, followed by the cast gold post and core with resin-modified glass ionomer cement. CONCLUSIONS: The use of a glass fiber reinforced post and resin-modified glass ionomer cement increased the fracture resistance of endodontically treated teeth.