Comportamiento clínico, radiográfico e histomorfométrico del diente autólogo como biomaterial en elevación de seno maxilar de acceso lateral. Caso clínico con seis mese de seguimiento post-carga protésica / Clinical, radiographic and histomorphometric behaviour of the autologous tooth as a biomaterial in lateral access maxillary sinus elevation. Case report with six months of post-prosthetic loading follow-up

Introducción: la pérdida ósea tras las extracciones puede requerir en el maxilar posterior la realización de una elevación de seno para la correcta colocación de implantes. El hueso autólogo se considera el gold estándar, pero tiene una alta tasa de reabsorción y morbilidad, haciendo que haya otras alternativas como el diente autólogo, con buenos resultados en procedimientos regenerativos. Este caso clínico evalúa a nivel clínico, radiográfico e histomorfométrico el empleo del diente autólogo en elevación de seno maxilar y el comportamiento de dos implantes colocados de manera diferida. Caso clínico: se presenta el caso de una mujer de 48 años, que acudió a consulta para reponer el sector posterior derecho. Se realizó la exodoncia del 4.8 como diente donante para utilizarlo como biomaterial en una elevación de seno de acceso lateral, colocando dos implantes seis meses tras la intervención, y evaluándolos seis meses tras su carga protésica. Discusión: el diente autólogo en el presente caso clínico presentó un 30,56% de hueso neoformado tras seis meses de espera, con mejores resultados que al emplear aloinjertos y xenoinjertos. Además, diferentes aspectos culturales y étnicos respaldan la aceptación del diente autólogo por parte de los pacientes, aunque se necesitan más estudios a largo plazo para evaluar la estabilidad de este tipo de injerto en elevación de seno maxilar. Conclusiones: el diente autólogo en la elevación de seno ofrece biocompatibilidad, baja incidencia de complicaciones y buena aceptación por parte del paciente, con un buen comportamiento clínico y radiográfico de los implantes, a pesar del poco tiempo transcurrido en este caso tras la carga. (AU)

Introduction: Bone loss after extractions may require a sinus elevation to be performed in the posterior maxilla for the correct placement of implants. Autologous bone is considered the gold standard, but has a high rate of resorption and morbidity, leading to other alternatives such as autologous tooth, with good results in regenerative procedures. This case report evaluates at the clinical, radiographic and histomorphometric level the use of the autologous tooth in maxillary sinus elevation and the behaviour of two implants placed in a delayed manner. Case report: The case is presented of a 48-year-old woman who came for consultation to replace the right posterior sector. The extraction of 4.8 as a donor tooth was performed to use it as a biomaterial in a lateral access sinus elevation, placing two implants six months after the intervention, and evaluating them six months after their prosthetic loading. Discussion: The autologous tooth in this case report showed 30.56% of newly formed bone following a six-month wait, with better results than when allografts and xenografts were used. In addition, different cultural and ethnic aspects support the acceptance of the autologous tooth by patients. However, more longterm studies are needed to evaluate the stability of this type of graft in maxillary sinus elevation. Conclusions: The autologous tooth in the sinus elevation offers biocompatibility, low incidence of complications and good patient acceptance, with good clinical and radiographic behaviour of the implants, despite the short time elapsed in this case after loading.(AU)

Is it possible to predict neurosensory alterations in impacted lower third molar removal based on preoperative imaging procedures? A prospective cohort study / ¿Es posible predecir alteraciones neurosensoriales en la extracción del tercer molar inferior impactado basándose en procedimientos de imagen preoperatorios? Un estudio de cohorte prospectivo

Background: Surgical extraction of the lower third molar (LTM) may trigger neurosensory injury of the inferioralveolar nerve, making extraction a real challenge. This study set out to assess whether is it possible to predictneurosensory alterations from preoperative imaging.Material and Methods: A total of 99 patients underwent 124 impacted lower third molar (ILTM) surgeries. Priorto surgery, panoramic and CBCT images were evaluated in an attempt to predict a neurosensory disturbance.Preoperative data (ILTM position, panoramic radiograph signs, inferior alveolar nerve (IAN) location and its con-tact with the ILTM roots) and intra/postoperative findings (extraction difficulty and sensitivity alterations) wererecorded. Descriptive and bivariate data analysis was performed. Statistical comparison applied the chi-squaretest, Fisher test, and one-way ANOVA test. Statistical significance was established with a confidence interval (CI)of 95%.Results: In 4.03% of cases, patients experienced neurosensory alterations. Of 124 ILTM positions in panoramicradiographs, 76 cases were considered to exhibit a potential neurosensory risk as they presented two or more typesof superimposed relationships between ILTM and mandibular canal. Of these, alterations were reported in onlythree cases (3.95%). Of the 48 remaining ILTM images presenting only one sign, neurosensory alterations wereobserved in two cases (4.17%). No permanent alterations were recorded in any of the five cases observed.Conclusions: Within the limitations of the present study, prediction of neurosensory alterations prior to ILTMextraction by means of preoperative imaging did not show a significant statistical correlation with post-surgicalincidence. Nevertheless, interruption of the canal´s white line (ICWL) or a diversion of the canal (DC) may predictan increased risk of IAN injury.(AU)

Comparison of the effectiveness of two manual toothbrushes: Conventional design versus double-sided toothbrush design. A pilot study.

OBJECTIVES: Dental hygiene is the most effective method in the prevention of oral diseases. However, most patients do not use the recommended teeth brushing techniques and/or time brushing is insufficient. With this objective, modifications in conventional toothbrushes have been developed to deal with these findings. The aim of this study was to compare plaque removal effectiveness of a manual toothbrush with a modified head (MTMH) with a wrap-around design versus a conventional manual toothbrush. METHODS: This pilot prospective clinical study was designed according to STROBE guidelines. The patients suspended oral hygiene habits for 24 h (baseline). Subsequently, the teeth were brushed for 60 s. Both toothbrushes followed the same study procedure, separated by 1 month. Plaque-removing effectiveness was measured before and after tooth brushing using the modified O'Leary Plaque Index (PI). RESULTS: Seven patients were included in this pilot study. The mean age was 37.66 ± 10.68 years. PI mean differences between baseline and after brushing were 51.99% ± 16.43 for MTMH and 27.93 ± 6.85, for conventional toothbrush (p = 0.0013). After brushing, mean PI values were 18.36% ± 6.95%, and 37.61% ± 10.57% respectively (p < 0.001). CONCLUSION: Within the limitations of the present study, it can be concluded that the effectiveness of plaque removal by using MTMH is significantly higher than the conventional manual toothbrush.

Manejo odontológico del paciente con frenillo lingual corto: a propósito de un caso / Dental management of the patient with short lingual frenulum: a case report

Introducción: El frenillo lingual corto puede provocar dificultades en la lactancia durante los primeros meses de vida en el neonato. A partir del desarrollo del lenguaje puede ser la causa de una fonética inadecuada. El tratamiento quirúrgico del frenillo debe ir acompañado por un adecuado tratamiento multidisciplinar para favorecer la corrección de las dificultades en la pronunciación. El objetivo del presente artículo es presentar un caso clínico representativo del diagnóstico, tratamiento quirúrgico y rehabilitación miofuncional del frenillo lingual corto, así como analizar la evidencia científica disponible. Caso clínico: Se presenta un paciente varón de 6 años diagnosticado de anquiloglosia severa que acude por dificultad en la pronunciación del fonema “RR”. Se realiza el tratamiento quirúrgico del frenillo mediante electrobisturí y su seguimiento por un logopeda. Conclusiones: El diagnóstico de la patología y la planificación quirúrgica y miofuncional deben tener en cuenta la clasificación del frenillo, la edad del paciente y la anatomía de la región. El tratamiento de la patología asociada al frenillo lingual corto requiere de un equipo multidisciplinar para evitar la recidiva. (AU)

Introduction: The short lingual frenulum can cause breastfeeding difficulties during the first months of life in the neonate. From language development they can be the cause of inadequate phonetics. Surgical treatment of the frenulum must be accompanied by adequate multidisciplinary treatment to improve the correction of pronunciation difficulties. The objective of this article is to present a representative clinical case of the diagnosis, surgical treatment and myofunctional rehabilitation of the short lingual frenulum, as well as to update the available scientific evidence. Case Report: A 6-year-old male patient is presented, diagnosed with severe ankyloglossia who came due to difficulty in pronouncing the phoneme “RR”. Surgical treatment of the frenulum was performed using electrocautery and its follow-up by a speech therapist. Conclusions: The diagnosis of the pathology and the surgical and myofunctional planning must take into account the classification of the frenulum, the age of the patient and the anatomy of the region. The treatment of the pathology associated with short lingual frenulum requires a multidisciplinary team to avoid recurrence. (AU)

Retratamiento multidisciplinar de una agenesia de un incisivo lateral superior con un implante cerámico monobloque. A propósito de un caso clínico / Multidisciplinary re-treatment of an agenesis of an upper lateral incisor with an one-piece ceramic implant. A clinical report

Introducción: Los implantes dentales de circona son una buena opción terapéutica que surge como alternativa a los implantes dentales convencionales de titanio, dadas sus excelentes propiedades de biocompatibilidad, baja acumulación de placa bacteriana y escaso infiltrado inflamatorio. El objetivo del presente caso clínico es describir la colocación de un implante monobloque de circona para reponer un incisivo lateral superior izquierdo en un paciente de 34 años de edad, para la posterior realización de una corona implantosoportada monolítica de circona. Descripción del caso: Se presenta un paciente varón de 34 años de edad, no fumador y sin antecedentes médico-quirúrgicos de interés (ASA I), que acudió a la consulta demandando una mejora en la estética de su sonrisa. El paciente presentaba una agenesia congénita en el incisivo lateral superior izquierdo que había sido tratada previamente con ortodoncia para cerrar dicho espacio. Tras el examen intraoral del paciente y el estudio radiográfico, se plantea la opción de tratamiento de abrir nuevamente el espacio mediante ortodoncia para rehabilitar la ausencia con un implante de circona, asegurando la estética que demandaba el paciente. Conclusiones: La rehabilitación mediante implantes de circona para el tratamiento de agenesias congénitas en incisivos laterales superiores, es una opción válida y efectiva, obteniendo resultados óptimos a nivel estético y funcional. Sin embargo, se necesitan más estudios clínicos con tamaños muestrales suficientes que comparen implantes de titanio y cerámicos con el fin de tener datos más concluyentes. (AU)

Introduction: Zirconia dental implants are a good therapeutic option emerging as an alternative to conventional titanium dental implants, given their excellent properties of biocompatibility, low bacterial plaque accumulation and low inflammatory infiltrate. The aim of the present clinical case is to describe the placement of a zirconia implant to replace an upper left lateral incisor in a 34-year-old patient, for the subsequent restoration of a monolithic implant-supported zirconia crown. Case description: A clinical case of a 34-year-old man is presented, nonsmoker and with no previous registered medical records (ASA I) who came to the dental clinic demanding an improvement in the aesthetics of his smile. The patient had a congenital agenesis of the left lateral incisor that had previously been treated with orthodontics to close the space. After the radiographic study and intraoral examination of the patient, the treatment option of reopening the space with a new phase of corrective orthodontics to rehabilitate the absence with a zirconia implant was proposed, ensuring the aesthetics demanded by the patient. Conclusions: Restoration using zirconia implants for the treatment of congenital agenesis in upper lateral incisors is a valid and effective option, obtaining optimal aesthetic and functional results. However, more clinical studies with sufficient sample sizes comparing titanium and ceramic implants are needed in order to have more conclusive data. (AU)

Manejo odontológico del paciente con frenillo lingual corto: a propósito de un caso / Dental management of the patient with short lingual frenulum: a case report

Introducción: El frenillo lingual corto puede provocar dificultades en la lactancia durante los primeros meses de vida en el neonato. A partir del desarrollo del lenguaje puede ser la causa de una fonética inadecuada. El tratamiento quirúrgico del frenillo debe ir acompañado por un adecuado tratamiento multidisciplinar para favorecer la corrección de las dificultades en la pronunciación. El objetivo del presente artículo es presentar un caso clínico representativo del diagnóstico, tratamiento quirúrgico y rehabilitación miofuncional del frenillo lingual corto, así como analizar la evidencia científica disponible. Caso clínico: Se presenta un paciente varón de 6 años diagnosticado de anquiloglosia severa que acude por dificultad en la pronunciación del fonema “RR”. Se realiza el tratamiento quirúrgico del frenillo mediante electrobisturí y su seguimiento por un logopeda. Conclusiones: El diagnóstico de la patología y la planificación quirúrgica y miofuncional deben tener en cuenta la clasificación del frenillo, la edad del paciente y la anatomía de la región. El tratamiento de la patología asociada al frenillo lingual corto requiere de un equipo multidisciplinar para evitar la recidiva. (AU)

Introduction: The short lingual frenulum can cause breastfeeding difficulties during the first months of life in the neonate. From language development they can be the cause of inadequate phonetics. Surgical treatment of the frenulum must be accompanied by adequate multidisciplinary treatment to improve the correction of pronunciation difficulties. The objective of this article is to present a representative clinical case of the diagnosis, surgical treatment and myofunctional rehabilitation of the short lingual frenulum, as well as to update the available scientific evidence. Case Report: A 6-year-old male patient is presented, diagnosed with severe ankyloglossia who came due to difficulty in pronouncing the phoneme “RR”. Surgical treatment of the frenulum was performed using electrocautery and its follow-up by a speech therapist. Conclusions: The diagnosis of the pathology and the surgical and myofunctional planning must take into account the classification of the frenulum, the age of the patient and the anatomy of the region. The treatment of the pathology associated with short lingual frenulum requires a multidisciplinary team to avoid recurrence. (AU)

Retratamiento multidisciplinar de una agenesia de un incisivo lateral superior con un implante cerámico monobloque. A propósito de un caso clínico / Multidisciplinary re-treatment of an agenesis of an upper lateral incisor with an one-piece ceramic implant. A clinical report

Introducción: Los implantes dentales de circona son una buena opción terapéutica que surge como alternativa a los implantes dentales convencionales de titanio, dadas sus excelentes propiedades de biocompatibilidad, baja acumulación de placa bacteriana y escaso infiltrado inflamatorio. El objetivo del presente caso clínico es describir la colocación de un implante monobloque de circona para reponer un incisivo lateral superior izquierdo en un paciente de 34 años de edad, para la posterior realización de una corona implantosoportada monolítica de circona. Descripción del caso: Se presenta un paciente varón de 34 años de edad, no fumador y sin antecedentes médico-quirúrgicos de interés (ASA I), que acudió a la consulta demandando una mejora en la estética de su sonrisa. El paciente presentaba una agenesia congénita en el incisivo lateral superior izquierdo que había sido tratada previamente con ortodoncia para cerrar dicho espacio. Tras el examen intraoral del paciente y el estudio radiográfico, se plantea la opción de tratamiento de abrir nuevamente el espacio mediante ortodoncia para rehabilitar la ausencia con un implante de circona, asegurando la estética que demandaba el paciente. Conclusiones: La rehabilitación mediante implantes de circona para el tratamiento de agenesias congénitas en incisivos laterales superiores, es una opción válida y efectiva, obteniendo resultados óptimos a nivel estético y funcional. Sin embargo, se necesitan más estudios clínicos con tamaños muestrales suficientes que comparen implantes de titanio y cerámicos con el fin de tener datos más concluyentes. (AU)

Introduction: Zirconia dental implants are a good therapeutic option emerging as an alternative to conventional titanium dental implants, given their excellent properties of biocompatibility, low bacterial plaque accumulation and low inflammatory infiltrate. The aim of the present clinical case is to describe the placement of a zirconia implant to replace an upper left lateral incisor in a 34-year-old patient, for the subsequent restoration of a monolithic implant-supported zirconia crown. Case description: A clinical case of a 34-year-old man is presented, nonsmoker and with no previous registered medical records (ASA I) who came to the dental clinic demanding an improvement in the aesthetics of his smile. The patient had a congenital agenesis of the left lateral incisor that had previously been treated with orthodontics to close the space. After the radiographic study and intraoral examination of the patient, the treatment option of reopening the space with a new phase of corrective orthodontics to rehabilitate the absence with a zirconia implant was proposed, ensuring the aesthetics demanded by the patient. Conclusions: Restoration using zirconia implants for the treatment of congenital agenesis in upper lateral incisors is a valid and effective option, obtaining optimal aesthetic and functional results. However, more clinical studies with sufficient sample sizes comparing titanium and ceramic implants are needed in order to have more conclusive data. (AU)

Medium-term clinical behaviour of one-piece zirconia implants supporting single crowns or fixed dental prostheses: A systematic review and meta-analysis.

PURPOSE: This systematic review aimed to evaluate the medium-term (3-year) overall survival and success rates, marginal bone loss and different biological parameters displayed with one-piece zirconia implants. MATERIALS AND METHODS: Electronic searches were conducted of the MEDLINE (via PubMed), Scopus (Elsevier), Cochrane Library (Wiley) and Web of Science (Clarivate Analytics) databases and manual searching was also performed for relevant articles published up to 14 November 2022. The review included human studies with a minimum of 10 subjects and/or 20 implants and with a follow-up period of at least 3 years after implant placement. RESULTS: Twelve studies met the inclusion criteria and were included for analysis, giving a total of 1,621 one-piece zirconia implants. Eleven studies were included to perform a meta-analysis of survival rates, and six for success rates and marginal bone loss. The survival and success rates at the 3-year follow-up were 94.4% (95% confidence interval 90.4%-98.4%; P < 0.001) and 91.6% (95% confidence interval 84.2%-98.9%; P < 0.001), respectively, and marginal bone loss was 0.231 mm (95% confidence interval 0.190-0.272; P < 0.001). CONCLUSIONS: One-piece zirconia implants appear to be a reliable option for restoring missing teeth, obtaining an implant survival rate of 94.4% and a success rate of 91.6% after a follow-up period of at least 3 years. Moreover, the results showed acceptable rates of marginal bone loss and adequate biological parameters.

Comportamiento del injerto autólogo de diente en preservación alveolar: evaluación clínica, radiográfica e histomorfométrica de un caso clínico tras un año de seguimiento / Behavior of the autologous tooth graft in alveolar preservation: clinical, radiographic and histomorphometric evaluation of a clinical case after one year of follow-up

Introducción: tras las extracciones, se producen una serie de cambios dimensio nales en sentido horizontal y vertical de la cresta alveolar, los cuales pueden ser minimizados mediante algunas técnicas quirúrgicas, como la preservación alveo lar, que utiliza diferentes sustitutos óseos, entre los que se encuentra actualmente el injerto autólogo de diente. Caso clínico: se presenta el caso clínico de una mujer de 61 años, que acudió a consulta presentando dolor intenso en la zona del segundo premolar superior de recho (1.5). Se realizó la exodoncia del 1.5, usándose como diente donante para realizar una preservación del alveolo tras la extracción. Cuatro meses tras el proce dimiento, se colocó un implante y se tomó una biopsia para realizar un análisis histo morfométrico. Un año tras la carga del im plante se observaron buenos resultados clínicos y radiográficos. Discusión: el diente y el tejido óseo tie nen similitudes en su composición quími ca, tanto en sus componentes inorgáni cos y orgánicos como en la cantidad de agua. En cuanto al contenido orgánico destacan los factores de crecimiento, la proteína morfogenética ósea 2 (BMP-2) y el colágeno tipo 1, dotando al diente como biomaterial de la propiedad de os teoinducción. El empleo del diente como sustituto en preservación alveolar consi gue porcentajes altos de hueso neofor mado, variando entre 37,55% cuando se usa el diente completo, al 48,40% usando dentina desmineralizada. Además de los buenos resultados histomorfométricos, goza de una buena aceptación por parte de los pacientes, fundamentalmente en determinadas ra zas o culturas, y consigue una reducción de las dimensio nes óseas evaluadas mediante escáner de haz cónico. Sin embargo, requiere un tiempo de preparación, que aumenta si el diente tiene restauraciones o tratamientos de conduc tos asociados (AU)

Introduction: following tooth extraction, horizontal and vertical resorption of bone volume occurs, but they can be reduced by many surgical procedures, such as alveolar ridge preservation, which uses different bone substitutes, being one of them autogenous tooth-graft. Clinical case: a 61-year-old woman is presented, who came to private dental clinic presenting intense pain in the area of an upper bicuspid of the first quadrant (1.5). Exodontia of the 1.5 was performed, using it as a donor tooth to obtain the biomaterial to preserve its alveolus. After 4 months re-entry was performed and an implant was placed, harvesting a bone biopsy for histomorphometric analysis. One year post-loading, good clinical and radiographic results were shown. Discussion: human bone and tooth have similarities in their chemical composition, both in their inorganic and organic components and in the amount of water. The organic content, growth factors, bone morphogenetic protein 2 (BMP-2) and type 1 collagen stand out, give the tooth the property of osteoinduction. The use of the tooth as a substitute in alveolar preservation achieves high percentages of neoformed bone, varying between 37.55% when the whole tooth is used, to 48.40% using demineralized dentin. In addition, it is well accepted by patients, especially in certain races or cultures, and achieves a reduction in bone dimensions evaluated by cone beam computed tomography. However, it has a drawback, requiring a long preparation time, which increases if the tooth has associated restorations or root canals. Conclusions: Autologous tooth-graft has a high biocompatibility, a low rate of intraoperative complications and good patient acceptance. It requires 25 minutes for preparation, which increases if there are restorations, root canals and caries. The percentage of vital bone obtained in the present clinical case shows new bone formation of 20% 4 months after alveolar ridge preservation (AU)

Preservación alveolar con colgajo vs sin colgajo. Revisión bibliográfica / Socket preservation with flap versus flapless. A literature review

Introducción: La extracción dentaria desencadena una serie de cambios di mensionales en la altura y anchura de la cresta alveolar que se traducen en la pérdida de tejidos blandos y duros, afec tando de forma directa a la calidad de vida de los pacientes. Por ello, se han estudiado diferentes técnicas para la pre servación de la cresta alveolar (PCA) tras las extracciones, con el fin de optimizar los resultados funcionales y estéticos de la futura rehabilitación prostodóncica. El objetivo fue evaluar los resultados de la PCA utilizando un enfoque con colgajo en comparación con un enfoque sin colgajo en términos de cambios óseos en anchu ra y altura. Material y Métodos: Se realizó una búsqueda bibliográfica en tres bases de datos The National Library of Medicine (MEDLINE/PubMed), Scielo y Cochrane Library. Se incluyeron ensayos clínicos aleatorizados en humanos que compara ran la PCA con colgajo y sin colgajo, en los que se analizaran pacientes sanos, mayores de edad, sin hábitos nocivos, en los que era necesaria la exodoncia de un diente mandibular o maxilar. Resultados: Se incluyeron 5 ensayos clí nicos de los últimos 15 años en los que se realizó un total de 74 procedimientos quirúrgicos de PCA con colgajo y 77 sin colgajo en 138 pacientes entre 18 y 75 años, cuyo género sólo se describió en 3 estudios. Los cambios óseos en anchu ra al realizar una PCA con colgajo varían entre –4,18 mm y 3 mm, mientras que al realizar una PCA sin colgajo los cambios son entre 1,74 mm y 3,42 mm. Por otro lado, los cambios óseos en altura al realizar una PCA con colgajo varían entre –0,99 mm y 0,8 mm, mientras que al realizar una PCA sin colgajo los cambios son entre 0,3 mm y 1,42 mm (AU)

Introduction: Tooth extraction triggers a series of dimensional changes in the height and width of the alveolar ridge, which result in the loss of soft and hard tissues, directly affecting patients’ quality of life. Therefore, different techniques for the preservation of the alveolar ridge (PCA) after extractions have been studied in order to optimize the functional and esthetic results of future prosthodontic rehabilitation. The aim was to evaluate the results of PCA using a flap approach compared to a flapless approach in terms of bone changes in width and height. Material and Methods: A literature search was performed in three databases The National Library of Medicine (MEDLINE/ PubMed), Scielo and Cochrane Library. Randomized human clinical trials comparing flap and flapless PCA were included in which healthy patients, over the age of majority, without harmful habits, who needed to have a mandibular or maxillary tooth extraction, were analyzed. Results: A total of 5 clinical trials from the last 15 years were included in which a total of 74 flap and 77 flapless PCA surgical procedures were performed in 138 patients between 18 and 75 years of age and whose gender was only described in 3 studies. Bone changes in width when performing a flapless PCA varied between –4.18 mm and 3 mm, while when performing a flapless PCA the changes were between 1.74 mm and 3.42 mm. On the other hand, bone changes in height when performing a PCA with flap vary between –0.99 mm and 0.8 mm, while when performing a PCA without flap the changes are between 0.3 mm and 1.42 mm (AU)

Mandibular third molar extraction: perceived surgical difficulty in relation to professional training.

BACKGROUND: Establishing the level of surgical difficulty pre-operatively is an essential step in ensuring correct treatment planning. This study set out to determine whether the knowledge and experience acquired by dentists who had received different levels of training influenced, firstly, the perceived levels of difficulty of a variety of cases of mandibular third molar (MTM) extraction and, secondly, the perceived difficulty deriving from a series of factors (patient-related factors, anatomical and radiographic factors, operative factors). METHODS: This cross-sectional, descriptive, observational study took the form of a survey. Using a visual analog scale (VAS), participants evaluated both the perceived difficulty of 30 cases of MTM extraction described by means of digital panoramic radiographs and the perceived difficulty deriving from a series of factors conditioning MTM extraction. The results underwent statistical analysis with SPSS Statistics 28.0 software. Non-parametric tests (Mann Whitney test for independent samples and the Kruskal-Wallis test) were applied. RESULTS: A total of 389 surveys were available for analysis. Dental practioners with no surgical training saw the intervention as presenting greater difficulty. Professionals with postgraduate training in oral surgery considered patient-related factors more important than operative factors, in contrast to dentists who had not received oral surgery training. CONCLUSIONS: Dental training has a signficant influence on the perceived difficulty of MTM extraction and also affects opinions about which factors have greater or lesser influence on surgical difficulty.

Relación entre los anticonceptivos orales y la incidencia de alveolitis. Revisión bibliográfica / Relationship between oral contraceptives and alveolitis incidence. A literature review

Introducción: La alveolitis es una complicación tras una exodoncia dental quecursa con dolor intenso, trismo y mal olor.Esta complicación se relaciona con el hábito tabáquico, la higiene oral, no seguirlas normas post extracción o la edad yel género del paciente. Otras causas potenciales que podrían desencadenar esteproceso son el ciclo menstrual en el casode las pacientes de género femenino o eltratamiento con anticonceptivos orales. Elobjetivo de esta revisión es comparar, según la literatura, la incidencia de alveolitisen mujeres en tratamiento con anticonceptivos orales respecto a las que no lostoman y respecto a los hombres.Métodos: Se realizó una búsqueda bibliográfica en las bases de datos PubMed/Medline, Science Direct, GoogleScholar y Scopus y se incluyeron artículos en inglés y en español relacionadoscon el tema a tratar. Las palabras claveutilizadas fueron: “alveolar osteitis” OR “fibrinolytic alveolitis” OR “localized osteomyelitis” OR “delayed extraction woundhealing” AND “contraceptives” OR “OC”OR “contraceptive pill”. Se incluyeron estudios sobre exodoncias en pacientes entratamiento con anticonceptivos o sin anticonceptivos o varones, según los gruposde control que se han propuesto estudiar,que registrasen casos de alveolitis.Resultados: Se observó una mayor incidencia media de alveolitis post extracciónen las pacientes en tratamiento con anticonceptivos (18,52%), respecto a otraspacientes que no lo estaban (6,78%) yrespecto a la población de género masculino (6,4%)...(AU)

Introduction: Alveolitis is a complicationafter dental extraction which courses withintense pain, trismus, and halitosis. This complication is associated with smoking,oral hygiene, not following post-extraction rules or the age and gender of the patient. However, other potential causes could trigger this process, such as the menstrual cycle in the case of female patients or the fact that they are under treatment with oral contraceptives. The objective of this review was to compare the incidence of alveolitis among patients treated with oral contraceptives with those who do not take them. Methods: A bibliographic search was carried out in the databases PubMed/Medline, Science Direct, Google Scholar and Scopus and articles in English and Spanish related to the topic were included.Keywords used were: “alveolar osteitis ”OR “fibrinolytic alveolitis” OR “localized osteomyelitis” OR “delayed extraction wound healing” AND “contraceptives”OR “OC” OR “contraceptive pill”. Studies on exodontia in patients treated with contraceptives with registered cases of alveolitis were included.Results: A higher mean incidence of alveolitis was observed in patients treated with contraceptives (18.52%),with respect to other patients who were not (6.78%) and with respect to male population (6.4%)...(AU)

Current status of split-mouth controlled clinical trials comparing cyanoacrylate vs. conventional suture after lower third molar surgeries: a systematic literature review.

Objetive. During the last few years, cyanoacrylate has been used for wound closure in oral and maxillofacial surgery with growing frequency. When comparing cyanoacrylate with sutures, some authors report similar experiences, while others have found differences. Some agree on the similar outcomes obtained between cyanoacrylate and sutures, others have registered better effects with cyanoacrylate, and others with sutures. Therefore, the aim of this systematic review (SR) was to evaluate postoperative parameters - pain, swelling, trismus, healing and complications (bleeding and infection) - after lower third molar (LTM) removal using cyanoacrylate compared with sutures. Materials and methods. Electronic and manual literature searches were conducted independently by two reviewers up to March 2022. Results. Four studies met the pre-established inclusion criteria and were included for descriptive analysis. These were controlled clinical trials comparing the effects of cyanoacrylate with sutures in 116 patients and 232 split-mouth cases. Pain and haemostasis were significantly reduced on the cyanoacrylate group, swelling showed the same results on two of the studies analysed, trismus and healing had no significant differences between both groups. Conclusions. Both techniques were found to be effective in terms of wound closure, proposing cyanoacrylate as an effective resource that should be investigated in future research. Nevertheless, the literature on cyanoacrylate is scarce and lacks comparative studies of its outcomes and effects.

Autogenous particulated dentin for alveolar ridge preservation. A systematic review.

PURPOSE: This review aimed to investigate the clinical outcomes of autogenous particulated dentin (APD) used for alveolar ridge preservation (ARP), evaluating volume gain, histologic/histomorphometric data, and associated complications. MATERIAL AND METHODS: The review followed PRISMA guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An automated search was made in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library) supplemented by a manual search for relevant clinical articles published before March 10th, 2022. The review included human studies of at least four patients in which extraction and subsequent ARP were performed in a single surgery. Both comparative studies and studies that assessed ARP with APD exclusively were admitted. The quality of evidence was assessed with the Cochrane bias assessment tool, the Newcastle-Ottawa Quality Assessment Scale, and the Joanna Briggs Institute Critical Appraisal tool. RESULTS: Eleven studies fulfilled the inclusion criteria and were included for descriptive analysis, with a total of 215 patients, and 337 alveoli preserved by APD, spontaneous healing (blood clot), or other bone substitutes, obtaining comparatively less vertical and horizontal resorption when APD was used. CONCLUSIONS: After dental extraction, autogenous dentin was effective in terms of volume maintenance, showing promising results in histologic/histomorphometric analysis, and a low complication rate. Nevertheless, few comparative studies with comparable parameters have been published and so more research providing long-term data is needed to confirm these findings.

Utilización de dentina autógena para relleno del gap en el implante inmediato postextracción: a propósito de un caso clínico con seis meses de seguimiento / Autogenous dentin graft in the immediate post-extractive implant gap: six-month follow up of a clinical report

Introducción: las extracciones dentarias producen una reabsorción horizontal y vertical de la cresta alveolar, que se puede minimizar con algunas técnicas quirúrgicas, como la colocación de implantes inmediatos post-extracción, asociados al empleo de biomateriales. Caso clínico: se presenta el caso clínico de una mujer de 48 años, que acudió a consulta presentando dolor intenso en la zona del incisivo lateral superior izquierdo, asociado a una profundidad de sondaje de 12 mm. Se realizó la exodoncia del 2.2, y la colocación de un implante inmediato post-extracción, utilizando la dentina de la raíz extraída, para rellenar el gap entre el implante y la cortical vestibular, mostrando buenos resultados clínicos y radiográficos a los 6 meses tras la intervención. Discusión: aunque en la actualidad se utilizan multitud de biomateriales para reducir la reabsorción ósea en los implantes inmediatos post-extracción, ninguno de ellos parece tener mejores resultados que el resto, suponiendo en este sentido la dentina autógena una alternativa útil al tratarse de un material autólogo, con buenas tasas de aceptación por parte de los pacientes, y teniendo unas propiedades adecuadas de osteoconducción y osteoinducción.Conclusiones: la dentina autógena presenta buenos resultados clínicos y radiográficos para rellenar el gap en implantes inmediatos post-extracción (AU)

Introduction: Tooth extraction produces an horizontal and vertical resorption of the alveolar ridge, which can be reduced by many surgical techniques, such as immediate post-extractive implants, in combination with bone substitutes. Clinical case: A clinical case of a 48-year-old woman is presented, who went to dental clinic referring pain in her upper lateral incisor, associated to high probing depth. An immediate post extractive implant was placed, employing autogenous dentin from the root extracted, to fill the gap between the implant and the buccal plate, showing good clinical and radiographic evolution 6 months after surgery. Discussion: Although nowadays there are different bone substitutes to reduce bone resorption when immediate implants are placed, they have similar results, becoming autogenous dentin an useful alternative, which is an autologous material, with good patient acceptation rates and osteoconductive and osteoinductive properties.Conclusion: Autogenous dentin shows promising clinical and radiographical results when it is used to fill the gap in the post-extractive immediate implant (AU)

Influence of Serum Vitamin D Levels on Survival Rate and Marginal Bone Loss in Dental Implants: A Systematic Review.

This systematic literature review set out to investigate the relationship between serum vitamin D levels and dental implants in terms of survival rates, marginal bone loss, and associated complications. The review was conducted according to PRISMA guidelines, performing an electronic search in four databases (Pubmed, Web of Science, Cochrane, and Scopus), complemented by a manual search up to April 2022. Four articles were selected for analysis. The Newcastle-Ottawa Quality Assessment Scale tool was used to assess the quality of evidence of cohort studies, and the Cochrane bias assessment tool was used to assess the quality of evidence of randomized clinical trials. The study included 1089 patients restored with 1984 dental implants, with follow-up periods ranging from 20-240 months. Cases presenting lower serum vitamin D levels obtained slightly worse results in terms of marginal bone loss. Longer follow-up periods are needed in order to determine whether serum vitamin D levels affect implant survival rates and osseointegration over time.

Brain complications from odontogenic infections: A systematic review.

PURPOSE: Odontogenic infections can spread through different routes to more remote anatomical areas, such as the brain. Brain abscesses have an incidence of 0.3-1.3 / 100,000 population and only 2-5% are of dental origin. The main objective is to research brain complications derived from odontogenic infections. Secondary objectives were to identify the most common symptoms in brain abscess, to describe the microbiology involved in these infectious processes, report which parts of the brain complex are most commonly affected and report the sequelae of this patients. METHODS: A systematic review following the PRISMA Guide and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports was carried out in PubMed, Scopus and Web of Science. The search terms were: Brain infection, brain abscess, oral health oral origin, odont* infect*. RESULTS: The database search identified a total of 1000 articles. A total of 18 publications were identified after applying inclusion and exclusion criteria. A total of 38 patients were analyzed. Mean age was 49.64±18.80 years. CONCLUSION: The most common symptoms of patients with brain abscess are neurological affectations first and then fever and headache second, without necessarily presenting as a symptomatological triad. Microbiological diagnosis is key to determining the origin of the infection. Anaerobic pathogens such as Streptococcus (F. Milleri), Fusobacterium Nucleatum and Porfiromonas Gingivalis families are common bacterial agents. The frontal lobe is the most frequently affected, followed by the parietal and temporal lobe. The most frequent brain complications are neurological disorders. However, most patients with brain abscesses recover without sequelae.

Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review.

Introduction and Objective: Zygomatic implants (ZI) offer a good and predictable alternative to reconstructive procedures of atrophic maxillae. The main objetive of this systematic review was to assess the effect of rehabilitation with zygomatic implants on patient's quality of life (QLP) using Patient Reported Outcomes Measures (PROMs).Materials and Methods: This review followed PRISMA guidelines. An automated electronic search was conducted in four databases supplemented by a manual search for relevant articles published until the end of January 2021. The Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Quality Assessment Scale were used to assess the quality of evidence in the studies reviewed.Results: General findings of this systematic review showed substantial increases in Oral health-related quality of life (OHRQoL) among patients restored with ZI and high scores in terms of general satisfaction, especially in chewing ability and esthetics. An overall survival rate of ZI was 98.3% after a mean follow-up time of 46.5 months was observed. Occurrence of 13.1% biological complications and 1.8% technical complications were reported.Conclusions: Patients rehabilitated with zygomatic implant-supported complete dental prostheses showed substantial improvements in OHRQoL and general satisfaction with the treatment received.

Utilización de dentina autóloga como material de regeneración. Rehabilitación de un paciente mediante tratamiento quirúrgico y prostodóncico con flujo digital / Utilization of autologous dentin as regeneration material. A patients’ rehabilitation by surgical and prosthodontic treatment with digital workflow

Introducción: Existen numerosos procedimientos para conseguir un lecho óseo adecuado para colocar implantes tras la pérdida de dientes naturales. En los últimos años se han propuesto técnicas para la preservación del lecho tras la extracción dental. Los injertos de dentina autóloga ofrecen un sustrato conveniente con propiedades osteoinductivas y osteogénicas óptimas para la regeneración alveolar. Objetivo: Se presenta un caso clínico de un paciente rehabilitado mediante un tratamiento quirúrgico y prostodóntico, y una actualización de la bibliografía en relación con los injertos de dentina autóloga. Caso clínico: Varón de 64 años sin antecedentes médicos ni hábitos patológicos, que presenta desgastes severos, inestabilidad oclusal y problemas estéticos. Se realiza una rehabilitación integral del paciente combinando una técnica quirúrgica de preservación alveolar con injerto de dentina autóloga, tras la cual se procede a la colocación de implantes, con un tratamiento protésico de coronas de zirconio, incrustaciones de disilicato de litio y reconstrucciones de composite. El tratamiento protésico se realiza en dos fases, pasando por una fase de provisionalización previa a la colocación de las restauraciones definitivas, empleando el flujo digital. A los 6 meses el paciente se encuentra satisfecho y con una función y estética óptima. Conclusiones: El injerto de dentina autóloga parece una alternativa eficaz y predecible como material de regeneración alveolar. Combinando esta técnica de preservación con una planificación digital, se puede maximizar el resultado del tratamiento rehabilitador, consiguiendo una mayor satisfacción del paciente. (AU)

Introduction: There are multiple procedures to achieve an adequate bone site for implant placement after teeth loss. In the last years, numerous techniques have been proposed for alveolar preservation. Dentin autologous grafts offer a convenient substrate with osteoinductive and osteogenic properties, which are optimum for alveolar regeneration. Objective: In this article, a clinical case of a patient rehabilitated by surgical and prosthodontic treatment, and a review of the literature regarding autologous dentin grafts is presented. Case report: 64 years old male, with no medical records or parafunctional habits, presents severe wear, occlusal instability and aesthetic problems. An integral rehabilitation is performed combining a surgical preservation technique with autologous dentin graft, after which the placement of the implants takes place, and a prosthodontic treatment with zirconium crowns, lithium disilicate inlays and composite restorations. The prosthodontic treatment is accomplished in two phases, going through a provisionalization phase previous to the placement of the definitive restorations, and digital workflow is used. 6 months later, the patient is satisfied, and function and aesthetic are optimum. Conclusions: Dentin autologous graft offers a predictable and effective alternative as a material for alveolar regeneration. Combining this preservation technique, with a good digital planification, results can be maximized and satisfaction for the patient can be increased. (AU)

Material de injerto en elevación de seno de acceso lateral: ¿es necesario? Parte II / Graft material in lateral sinus lift, is it necessary?: Part II

Introducción: Las extracciones dentarias producen una reabsorción del proceso alveolar en sentido horizontal y vertical además de la neumatización del seno. Estos cambios óseos en la zona posterior del maxilar pueden comprometer la colocación de implantes. La técnica convencional o de acceso lateral sigue siendo la técnica más utilizada para realizar elevaciones de seno maxilar. Estas elevaciones se realizan tanto sin injertos óseos como con diferentes biomateriales. Existe cierto debate sobre si es necesario colocar o no injerto. Objetivo: Analizar y comparar la ganancia ósea en elevaciones de seno de acceso lateral con injerto y sin injerto. Material y método: Se realizó una búsqueda electrónica para la actualización del tema en tres bases de datos y una serie de libros relacionados. Resultados: Se obtiene una ganancia de 4,0-6,14 mm cuando no se emplea material de injerto y entre 3,11-13,1 mm cuando se emplean biomateriales. Los estudios reflejan una pérdida ósea marginal entre 1,01-1,9 mm cuando no se emplea material de injerto y 2,3 mm de media cuando se emplean biomateriales. La técnica de elevación de seno de acceso lateral sin empleo de biomaterial presenta unas tasas de supervivencia elevadas pero las tasas de supervivencia son ligeramente superiores cuando se emplean biomateriales. La tasa de complicaciones es baja para ambas técnicas, siendo la más frecuente la perforación de la membrana de Schneider, que no parece suponer un impedimento para la colocación de implantes. Conclusión: la técnica de elevación convencional con relleno obtiene mayor ganancia ósea, pero mayor pérdida ósea marginal y presenta una tasa de supervivencia alta de implantes en comparación con la técnica que no emplea material de injerto, por lo que se debe individualizar cada caso para decidir si es necesario o no la utilización de un sustituto óseo. (AU)

Introduction: dental extractions produce a resorption of the alveolar process, horizontally and vertically in addition to pneumatization of the sinus. These bone changes in the posterior area of the maxilla can compromise implant placement. The conventional or lateral access technique is still the most used technique to perform maxillary sinus elevations. These elevations are performed without bone grafts and with different graft biomaterials where there is some discussion whether or not it is necessary to place a graft. Objective: Analyze and compare bone gain in graft and non-graft lateral access sinus lifts. Material and method: An electronic search was carried out to update the subject in three databases and a series of related books. Results: A gain of 4.0-6.14 mm is obtained when no graft material is used and between 3.11-13.1 mm when biomaterials are used. Studies show a marginal bone loss between 1.01-1.9 mm when no graft material is used and 2.3 mm on average when biomaterials are used. Lateral access sinus elevation technique without the use of biomaterial has high survival rates but survival rates are slightly higher when biomaterials are used. Rate of complications is low for both techniques, the most frequent being the perforation of Schneider’s membrane, which doesn’t seem to be an impediment to the placement of implants. Conclusion: conventional lift technique with filling obtains greater bone gain, but greater marginal bone loss and presents a high implant survival rate compared to the technique that doesn’t use graft material, so each case must be individualized to decide if it’s necessary or not the use of a bone substitute. (AU)