Effect of the lack of primary stability in the survival of dental implants.

BACKGROUND: The survival of dental implants has been linked to primary stability. The aim of this study is to analyse the factors that influence the survival of dental implants placed without primary stability. MATERIAL AND METHODS: A cohort study of implants placed without primary stability was carried out between September 2011 and July 2016. All cases with registered information on the patient and surgical intervention were used. Cases that did not have a 12-month follow-up after implant placement were excluded. RESULTS: Out of 2,400 analysed implants, 92 were placed without primary stability. The absence of primary stability was classified as B in 49 cases, C in 38 cases and D in 5 cases. No statistically significant influence of the patient's age, primary stability, brand, or implant size in terms of implant survival was established. A tendency towards greater early implant loss was observed in implants whose absence of primary stability was classified as C. CONCLUSIONS: Poor primary stability is not statistically significant in the loss of dental implants of the characteristics studied. Any of the factors studied are related with early implant loss as a main factor. Key words:Primary stability, survival, dental implants.

Prosthetic hygiene and functional efficacy in completely edentulous patients: satisfaction and quality of life during a 5-year follow-up.

OBJECTIVES: The aim of this study was to compare satisfaction with function and hygiene maintenance in completely edentulous elderly patients rehabilitated with implant-supported fixed prostheses, overdentures, and conventional prostheses. MATERIALS AND METHODS: A total of 150 geriatric patients were divided into three groups: Group 1 (CD) patients rehabilitated with complete dentures; Group 2 (FP) patients with implant-supported fixed prostheses; Group 3 (OD) patients with overdentures. The patients responded to a questionnaire based on the Oral Health Impact Profile and the Dental Impact Profile to evaluate satisfaction with their prostheses. Data were analyzed using ANOVA F and the Kruskal-Wallis nonparametric test, with significance established as P < 0.05. RESULTS: Significant differences were found between the three groups. For oral hygiene, the group with overdentures showed better results, and the group with fixed prostheses was more satisfied with function. CONCLUSIONS: Satisfaction among these completely edentulous patients varied in relation to prosthetic type. The level of general satisfaction among patients with implant-supported prostheses was greater than the group using conventional dentures. Patients rehabilitated with fixed prostheses enjoyed a higher level of satisfaction than patients with overdentures.

Retrospective long-term evaluation of dental implants in totally and partially edentulous patients: part II: periimplant disease.

PURPOSE: This retrospective longitudinal study aims to assess long-term outcomes of osseointegrated dental implants placed in partially and totally edentulous patients. MATERIAL AND METHODS: Patients who were willing to sign the informed consent and attend a check-up were included. The prevalence of periimplant disease was calculated. Cases were further divided into mucositis or periimplantitis. Uni- and multi-variate statistical analyses were conducted to determine the influence of various factors. RESULTS: A total of 105 patients who had received 342 implants were included. Mean follow-up was 13.19 ± 3.70 years. The prevalence of periimplant disease was 14.2% of the analyzed implants and 21% of patients. An additional 4.8% of patients reported a previous presence of periimplant disease without current disease. The prevalence of mucositis and periimplantitis was 11.2% and 1.7%, respectively, of analyzed implants. Factors with possible influence on the presence of periimplant disease were gender, alcohol consumption, chemotherapy and/or head and neck radiotherapy, history of periodontal disease, and years of function. CONCLUSION: In our sample, periimplant disease was not infrequent, being present in 1 of 5 patients at the final check-up.

Retrospective long-term evaluation of dental implants in totally and partially edentulous patients. Part I: survival and marginal bone loss.

PURPOSE: This retrospective longitudinal study aims to assess long-term outcomes of osseointegrated dental implants in partially and totally edentulous patients. MATERIALS AND METHODS: Patients willing to sign the informed consent and attend a check-up were included. Implant failures were recorded, and marginal bone level and bone loss were evaluated on intraoral radiographs. Univariate and multivariate statistical analyses were conducted to determine the influence of various factors. Complications and patient satisfaction were recorded. RESULTS: One hundred five patients who received 342 implants were included. Mean follow-up was 13.19 ± 3.70 years. 9.4% of implants were lost, and 78.1% of patients retained all implants placed. Mean marginal bone loss was 0.77 ± 1.10 mm, being greater than 3 mm in 2.5% of analyzed implants. Factors with possible influence on implant survival and marginal bone loss were smoking, osteopenia or osteoporosis, check-up frequency, implant surface, length and position, and type of prosthesis. 24.8% of patients remained free of complications. Patient satisfaction was high. CONCLUSIONS: In our sample, which included both totally and partially edentulous patients, long-term implant survival was more than 90% with a mean marginal bone loss of 0.77 mm and an implant survival at patient level of 78%; patient satisfaction was high despite the fact that complications were frequent.

Satisfacción de los pacientes con tratamientos implantológicos. Revisión de la literatura / Patient satisfaction with implant treatments. Review of the literature

La pérdida de dientes, definida por la Organización Mundial de la Salud como una discapacidad, conlleva cambios físicos y psicológicos en el paciente. El profesional puede diagnosticar el estado físico, pero no puede analizar la situación psicológica si no utiliza instrumentos que midan la salud oral y la influencia que esta tiene en el modo de vida de los pacientes. Lo cual, ha derivado en múltiples estudios que analizan la calidad de vida relacionada con la salud oral. Se realizó una revisión bibliográfica de la literatura científica publicada sobre el tema. La literatura aporta un consenso entre los autores, en que la satisfacción de los pacientes tras un tratamiento implantológico, mejora sustancialmente. Entre los factores que pueden condicionar el grado de satisfacción de estos pacientes, están el tipo de prótesis, los años de rehabilitación, la edad, el sexo, el estado de salud general, factores socioeconómicos, la dieta y la ansiedad preoperatoria. El tratamiento implantológico de los pacientes desdentados, deriva en resultados funcionales, estéticos y psicológicos, altamente satisfactorios. El tipo de prótesis, así como las características de cada paciente, condicionarán el grado de satisfacción (AU)

The loss of teeth, defined by the World Health Organization as a disability, entails physical and psychological changes in the patient. The professional can diagnose the physical state, but he cannot analyze the psychological situation if he does not use instruments that measure the oral health and the influence that this has on the patient’s lifestyle. This has led to many studies that analyze the quality of life related to oral health. A bibliographical review was conducted of the scientific literature published on the subject. The literature provides a consensus among the authors, in which patient satisfaction after an implant treatment improves substantially. Among the factors that may condition the degree of satisfaction of these patients are the type of prosthesis, the years of rehabilitation, age, gender, state of general health, socioeconomic factors, diet and preoperative anxiety. The implant treatment of the edentulous patients leads to highly satisfactory functional, aesthetic and psychological results. The type of prosthesis, as well as the characteristics of each patient, condition the degree of satisfaction (AU)

Comparative study of two local anesthetics in the surgical extractionof mandibular third molars: Bupivacaine and articaine

Objective: The third molar extraction is one of the most common surgical procedures in oral surgery and is usuallyaccompanied by postoperative discomfort. It has been suggested that the longer duration of action of bupivacaineassociated with the residual analgesia and the gradual onset of pain, could decrease the need for analgesics duringthe postoperative period. This study aims to compare the efficacy and safety of bupivacaine and articaine as localanesthetics for the extraction of mandibular third molars and to check whether bupivacaine produced residualanalgesia.Study design: We compared bupivacaine 0.5% and articaine 4% with an epinephrine concentration of 1:200 000in a crossover design model of extraction of bilaterally symmetrical mandibular third molars.Results: Regarding efficacy, patients experienced less postoperative pain at 6 and 12 hours and shorter durationof soft tissue anesthesia with articaine. With respect to safety, no differences were found between the anestheticscompared, showing a similar local and systemic toxicity. With regard to the preference of patients, it was higherfor articaine, the main reasons being the greater postoperative pain and swelling with bupivacaine.Conclusion: It can be concluded that articaine seems to be a more appropriate anesthetic for the extraction of mandibularthird molars due to the shorter duration of the anesthetic effect in the soft tissues, lower pain reported bypatients during the immediate postoperative period and the personal preference of patients for this drug (AU)

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Comparative study of two local anesthetics in the surgical extraction of mandibular third molars: bupivacaine and articaine.

OBJECTIVE: The third molar extraction is one of the most common surgical procedures in oral surgery and is usually accompanied by postoperative discomfort. It has been suggested that the longer duration of action of bupivacaine associated with the residual analgesia and the gradual onset of pain, could decrease the need for analgesics during the postoperative period. This study aims to compare the efficacy and safety of bupivacaine and articaine as local anesthetics for the extraction of mandibular third molars and to check whether bupivacaine produced residual analgesia. STUDY DESIGN: We compared bupivacaine 0.5% and articaine 4% with an epinephrine concentration of 1:200 000 in a crossover design model of extraction of bilaterally symmetrical mandibular third molars. RESULTS: Regarding efficacy, patients experienced less postoperative pain at 6 and 12 hours and shorter duration of soft tissue anesthesia with articaine. With respect to safety, no differences were found between the anesthetics compared, showing a similar local and systemic toxicity. With regard to the preference of patients, it was higher for articaine, the main reasons being the greater postoperative pain and swelling with bupivacaine. CONCLUSION: It can be concluded that articaine seems to be a more appropriate anesthetic for the extraction of mandibular third molars due to the shorter duration of the anesthetic effect in the soft tissues, lower pain reported by patients during the immediate postoperative period and the personal preference of patients for this drug.

Langerhans cell histiocytosis: Literature review and descriptive analysis of oral manifestations

Langerhans cell histiocytosis (LCH) is a rare disease, of unknown pathogenesis, characterized by intense and abnormal proliferation of bone marrow-derived histiocytes (Langerhans cells). It can present both local and systemic manifestations involving bone, skin and mucosal tissue, and internal organs. Three basic clinical forms develop: Letterer-Siwe disease (subacute or acute disseminated form), Hand-Schüller-Christian disease (disseminated chronic form) and eosinophilic granuloma (localized chronic form). LCH may manifest orally with single or multiple lesions of the alveolar or basal bone, ulcerated mucosal lesions accompanied by adenopathies and/or periodontal lesions, presenting gingival inflammation, bleeding, recession, necrosis, odontalgia, dental hypermobility and premature loss of teeth. The principal differential diagnoses include advanced periodontal disease or a periapical process of dental or periodontal origin. The odontologist plays a vital role in the diagnosis and multidisciplinary treatment of such patients, by performing routine examinations for periodic follow-up of the disease and its possible oral manifestations, bearing in mind that these may be the first or only signs of LCH (AU)

Langerhans cell histiocytosis: literature review and descriptive analysis of oral manifestations.

Langerhans cell histiocytosis (LCH) is a rare disease, of unknown pathogenesis, characterized by intense and abnormal proliferation of bone marrow-derived histiocytes (Langerhans cells). It can present both local and systemic manifestations involving bone, skin and mucosal tissue, and internal organs. Three basic clinical forms develop: Letterer-Siwe disease (subacute or acute disseminated form), Hand-Schüller-Christian disease (disseminated chronic form) and eosinophilic granuloma (localized chronic form). LCH may manifest orally with single or multiple lesions of the alveolar or basal bone, ulcerated mucosal lesions accompanied by adenopathies and/or periodontal lesions, presenting gingival inflammation, bleeding, recession, necrosis, odontalgia, dental hypermobility and premature loss of teeth. The principal differential diagnoses include advanced periodontal disease or a periapical process of dental or periodontal origin. The odontologist plays a vital role in the diagnosis and multidisciplinary treatment of such patients, by performing routine examinations for periodic follow-up of the disease and its possible oral manifestations, bearing in mind that these may be the first or only signs of LCH.

Distracción Alveolar Histogénica: Estado actual y caso clínico / Alveolar distraction Histogenesis: Actual moment and clinical case

La distracción alveolar vertical fue inicialmente descrita por Chin y Toth en 1996, demostrándose en diferentes estudios que esta técnica es una alternativa a los métodos tradicionales utilizados para el aumento óseo vertical en la corrección de defectos óseos alveolares congénitos o adquiridos. Se realizó una revisión de los resultados con distracción alveolar publicados en los últimos 5 años, así como la valoración de algunos diseños de distractor alveolar, observándose resultados alentadores, pudiendo considerarse como una alternativa terapéutica a la clásica regeneración ósea guiada o los injertos óseos (AU)

Alveolar distraction described at first instance by Chin and Toth in 1996, became an alternative to traditional methods used for vertical bone augmentation in the congenital or adquired alveolar bone defects correction. A review of the results using alveolar distraction published in the last 5-years was made, as well as an valuation of some of the alveolar distractor desings. Encouraging results are observed, becaming an alternative to the classic guided bone regeneration or bone grafts (AU)

Riesgos y complicaciones de anestesia local en la consulta dental. Estado actual / Risks and complications of local anaesthesia in dental office. Current situation

Se realiza una revisión sobre las complicaciones más frecuentes que se presentan en la consulta dental a la luz de la propia experiencia y de los artículos publicados en la literatura internacional en los últimos años, enfatizando la necesidad de que el odontólogo esté preparado para reconocer dichos problemas, prevenirlos y, en algunos casos, tratarlos. (AU)