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1.
Methods Protoc ; 4(1)2021 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-33672499

RESUMEN

The aim of this study is to propose a 3D skeletal classification and relative normal values of reference. Method: from a pool of 271 cone-beam computerized tomography images 108 chin-summit examinations of the skull were selected and divided into 3 traditional skeletal classes. The same Cone-beam Computerized Tomography (CBCT) images were then assessed using the cephalometric multiplanar analysis following the total face approach protocol. Results: the results of this study indicate standard 3D cephalometric norms for the vertical and sagittal evaluation of the skull. Conclusion: data obtained from our measurements allowed the creation of intervals supplying nosological classification that could be used in orthodontics, orthognatic surgery and implant surgery in fully edentulous patients.

2.
Artículo en Inglés | MEDLINE | ID: mdl-33528448

RESUMEN

The aim of this article is to propose a simplified digital protocol for the treatment of the fully edentulous patient, using an immediate implant and immediate loading protocol to deliver a polymethyl methacrylate metal-reinforced hybrid prosthesis. Ten consecutive patients were treated with this approach. At the end of 1 year, there was an implant survival rate of 97.8% and a prosthetic success rate of 100%. Based on the responses to the quality of life questionnaire, patients had a high acceptance rate for this treatment protocol. Within the limits of this case series, the proposed simplified digital protocol could be utilized for reconstruction in the fully edentulous patient and for delivering an implant-supported prosthesis immediately after implant placement.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Arcada Edéntula , Boca Edéntula , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Boca Edéntula/cirugía , Calidad de Vida , Resultado del Tratamiento
3.
BMC Oral Health ; 21(1): 87, 2021 Feb 25.
Artículo en Inglés | MEDLINE | ID: mdl-33632190

RESUMEN

BACKGROUND: The aim of this study is to compare the biomechanical effects of the conventional 0.019 × 0.025-in stainless steel archwire with the dual-section archwire when en-masse retraction is performed with sliding mechanics and skeletal anchorage. METHODS: Models of maxillary dentition equipped with the 0.019 × 0.025-in archwire and the dual-section archwire, whose anterior portion is 0.021 × 0.025-in and posterior portion is 0.018 × 0.025-in were constructed. Then, long-term tooth movement during en-masse retraction was simulated using the finite element method. Power arms of 8, 10, 12 and 14 mm length were employed to control anterior torque, and retraction forces of 2 N were applied with a direct skeletal anchorage. RESULTS: For achieving bodily movement of the incisors, power arms longer than 14 mm were required for the 0.019 × 0.025-in archwire, while between 8 and 10 mm for the dual-section archwire. The longer the power arms, the greater the counter-clockwise rotation of the occlusal plane was produced. Frictional resistance generated between the archwire and brackets and tubes on the posterior teeth was smaller than 5% of the retraction force of 2 N. CONCLUSIONS: The use of dual-section archwire might bring some biomechanical advantages as it allows to apply retraction force at a considerable lower height, and with a reduced occlusal plane rotation, compared to the conventional archwire. Clinical studies are needed to confirm the present results.

4.
Artículo en Inglés | MEDLINE | ID: mdl-33548069

RESUMEN

OBJECTIVES: To present the results of guided bone regeneration (GBR) of atrophic edentulous ridges with customized CAD/CAM titanium meshes. MATERIAL AND METHODS: Forty-one patients, presenting with 53 atrophic sites, were enrolled between 2018 and 2019. GBR was obtained with titanium meshes filled with autogenous bone chips and bovine bone mineral (BBM). After a mean of 7 months (range: 5-12 months), meshes were removed and 106 implants placed. After a mean of 3.5 months (range: 2-5 months), implants were uncovered and prosthetic restorations started. The outcomes were vertical and horizontal bone augmentation changes, biological complications and implant survival. RESULTS: Out of 53 sites, 11 underwent mesh exposure: eight of them were followed by uneventful integration of the graft, while three by partial bone loss. The mean vertical and horizontal bone gain after reconstruction was 4.78 ± 1.88 mm (range 1.00-8.90 mm) and 6.35 ± 2.10 mm (range 2.14-11.48 mm), respectively. At the time of implant placement, mean changes of initial bone gain were -0.39 ± 0.64 mm (range -3.1 to + 0.80 mm) and -0.49 ± 0.83 mm (range -3.7 to +0.4 mm), in the vertical and horizontal dimensions, respectively. Reduction of bone volume was significantly higher (p < .001 for both dimensions) in the exposed sites. The mean follow-up of implants after loading was 10.6 ± 6.5 months (range: 2-26 months). The survival rate of implants was 100%. CONCLUSION: Customized titanium meshes can represent a reliable tool for GBR of severely atrophic sites, with simplification of the surgical phases.

5.
Cochrane Database Syst Rev ; 2: CD003811, 2021 02 24.
Artículo en Inglés | MEDLINE | ID: mdl-33624847

RESUMEN

BACKGROUND: The most frequent indications for tooth extractions, generally performed by general dental practitioners, are dental caries and periodontal infections. Systemic antibiotics may be prescribed to patients undergoing extractions to prevent complications due to infection. This is an update of a review first published in 2012. OBJECTIVES: To determine the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health Trials Register (to 16 April 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2020, Issue 3), MEDLINE Ovid (1946 to 16 April 2020), Embase Ovid (1980 to 16 April 2020), and LILACS (1982 to 16 April 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomised, double-blind, placebo-controlled trials of systemic antibiotic prophylaxis in patients undergoing tooth extraction(s) for any indication. DATA COLLECTION AND ANALYSIS: At least two review authors independently performed data extraction and 'Risk of bias' assessment for the included studies. We contacted trial authors for further details where these were unclear. For dichotomous outcomes, we calculated risk ratios (RR) and 95% confidence intervals (CI) using random-effects models. For continuous outcomes, we used mean differences (MD) with 95% CI using random-effects models. We examined potential sources of heterogeneity. We assessed the certainty of the body of evidence for key outcomes as high, moderate, low, or very low, using the GRADE approach. MAIN RESULTS: We included 23 trials that randomised approximately 3206 participants (2583 analysed) to prophylactic antibiotics or placebo. Although general dentists perform dental extractions because of severe dental caries or periodontal infection, only one of the trials evaluated the role of antibiotic prophylaxis in groups of patients affected by those clinical conditions. We assessed 16 trials as being at high risk of bias, three at low risk, and four as unclear.  Compared to placebo, antibiotics may reduce the risk of postsurgical infectious complications in patients undergoing third molar extractions by approximately 66% (RR 0.34, 95% CI 0.19 to 0.64; 1728 participants; 12 studies; low-certainty evidence), which means that 19 people (95% CI 15 to 34) need to be treated with antibiotics to prevent one infection following extraction of impacted wisdom teeth. Antibiotics may also reduce the risk of dry socket by 34% (RR 0.66, 95% CI 0.45 to 0.97; 1882 participants; 13 studies; low-certainty evidence), which means that 46 people (95% CI 29 to 62) need to take antibiotics to prevent one case of dry socket following extraction of impacted wisdom teeth. The evidence for our other outcomes is uncertain: pain, whether measured dichotomously as presence or absence (RR 0.59, 95% CI 0.31 to 1.12; 675 participants; 3 studies) or continuously using a visual analogue scale (0-to-10-centimetre scale, where 0 is no pain) (MD -0.26, 95% CI -0.59 to 0.07; 422 participants; 4 studies); fever (RR 0.66, 95% CI 0.24 to 1.79; 475 participants; 4 studies); and adverse effects, which were mild and transient (RR 1.46, 95% CI 0.81 to 2.64; 1277 participants; 8 studies) (very low-certainty evidence).  We found no clear evidence that the timing of antibiotic administration (preoperative, postoperative, or both) was important. The included studies enrolled a subset of patients undergoing dental extractions, that is healthy people who had surgical extraction of third molars. Consequently, the results of this review may not be generalisable to all people undergoing tooth extractions. AUTHORS' CONCLUSIONS: The vast majority (21 out of 23) of the trials included in this review included only healthy patients undergoing extraction of impacted third molars, often performed by oral surgeons. None of the studies evaluated tooth extraction in immunocompromised patients. We found low-certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction when compared to placebo, and very low-certainty evidence of no increase in the risk of adverse effects. On average, treating 19 healthy patients with prophylactic antibiotics may stop one person from getting an infection. It is unclear whether the evidence in this review is generalisable to patients with concomitant illnesses or patients at a higher risk of infection. Due to the increasing prevalence of bacteria that are resistant to antibiotic treatment, clinicians should evaluate if and when to prescribe prophylactic antibiotic therapy before a dental extraction for each patient on the basis of the patient's clinical conditions (healthy or affected by systemic pathology) and level of risk from infective complications. Immunocompromised patients, in particular, need an individualised approach in consultation with their treating medical specialist.


Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Tercer Molar/cirugía , Complicaciones Posoperatorias/prevención & control , Extracción Dental/efectos adversos , Diente Impactado/cirugía , Antibacterianos/efectos adversos , Profilaxis Antibiótica/efectos adversos , Infecciones Bacterianas/prevención & control , Sesgo , Ensayos Clínicos Controlados como Asunto , Alveolo Seco/prevención & control , Humanos , Dolor Postoperatorio/prevención & control
6.
Clin Implant Dent Relat Res ; 23(1): 149-155, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33438293

RESUMEN

This case report describes the management of a lesion involving the Canalis Sinuosus (CS), that is a bone channel originating from the infraorbital canal below the orbital margin and posterior to the infraorbital foramen and coursing in an anterolateral direction to the anterior wall of the nasal cavity. A female patient, 62y, ASA 1, wearing full mobile dentures, came to our clinic asking for upper jaw rehabilitation. Due to a severe bone atrophy, a graft procedure was performed and the placement of eight implants was planned. One week after implants were positioned, the patient referred pain in the upper right central incisor region, that was compatible with a normal post-operative healing. After 15 days, since the symptoms worsened and became localized and persistent, a more detailed CBCT analysis was carried out. The images demonstrated that a CS on the right side was compressed by the apex of the implant in position #11. The implant was replaced with a shorter one and adequate pharmacological therapy was prescribed. All the symptoms completely disappeared after 30 days.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Maxilar , Dentadura Completa , Femenino , Humanos , Incisivo , Cavidad Nasal
7.
Artículo en Inglés | MEDLINE | ID: mdl-33277160

RESUMEN

PURPOSE: This study compared two transferring methods for virtually planned orthognathic surgery - the CAD/CAM intermediate splint and the customized surgical guide with fixation plates. METHODS: This was a prospective clinical study in which participants were consecutively recruited and underwent bimaxillary orthognathic surgery. They were divided into two groups based on the transferring method used. The pre- and postoperative CBCTs were aligned using voxel-based landmark-free registration, and the discrepancies for selected points were compared with the planned displacement of the virtually planned surgery. The maxilla and mandible were analyzed separately, and translation and rotation movements were considered. RESULTS: A total of 16 patients, divided into two groups of eight patients each, were included in this study. The splintless group was significantly more accurate for the translation movement along the x-axes for points A (p = 0.008; mean absolute error 0.527 ± 0.387 for the splint group and 0.137 ± 0.067 for the splintless group) and Ans (p = 0.045; mean absolute error 0.535 ± 0.446 for the splint group and 0.156 ± 0.002 for the splintless group). For the mandible there was a significant difference in accuracy along the x-axes for points B (p = 0.049; mean absolute errors 1.728 ± 1.181 and 0.697 ± 0.519 for the splint and splintless groups, respectively), LL3 (p = 0.049; mean absolute error 1.629 ± 0.912 and 0.851 ± 0.797 for the splint and splintless groups, respectively), LR3 (p = 0.049; mean absolute error 1.711 ± 0.906 and 0.844 ± 0.780 for the splint and splintless groups, respectively), with the splintless group being more accurate. For the rotation the splintless group was significantly more accurate along the y-axes (p = 0.04; mean absolute error 1.62 ± 0.78 and 0.49 ± 0.31 for the splint and splintless groups, respectively) and z-axes (p = 0.04; mean absolute error 0.63 ± 0.45 and 0.17 ± 0.05 for the splint and splintless groups, respectively) for the maxilla, while no significant difference was found for the mandible. CONCLUSIONS: Overall, the customized fixation plate system is more accurate than the intermediate CAD/CAM splint for transferring the virtual plan into the operation room.

8.
Materials (Basel) ; 13(22)2020 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-33187350

RESUMEN

AIM: To evaluate the hypothesis of a correlation between the preoperative residual alveolar bone height (RBH) and graft maturation after maxillary sinus floor augmentation procedures using two different bone substitutes. METHODS: A total of 20 patients who underwent unilateral maxillary sinus floor augmentation with either mineralized deproteinized bovine bone (DBBM) or a xenograft enriched with polymer and gelatin (NBS) were included in this prospective study. Six months after sinus surgery, bone biopsies were harvested with a 3.2 mm diameter trephine bur, prior to dental implant placement. Histomorphometric analysis was performed, and the results were correlated with the individual RBH. Implants were loaded after 5 months of insertion, and 1-year implant success and marginal bone level change were assessed. RESULTS: RBH was 2.17 ± 1.11 mm (range 0.5-3.5 mm) and 2.14 ± 0.72 mm (range 0.5-3.0 mm) in the NBS and DBBM group, respectively. The biopsy analyses for the DBBM group showed woven bone increases by 5.08% per 1-mm increment of RBH; medullary spaces decreased by 9.02%, osteoid decreased by 4.4%, residual biomaterial decreased by 0.34%, and lamellar bone increased by 5.68% per 1-mm increase of RBH. In the NBS group, samples showed woven bone increases by 8.08% per 1-mm increase of RBH; medullary spaces decreased by 0.38%; osteoid increased by 1.34%, residual biomaterial decreased by 0.58%, and lamellar bone decreased by 5.50% per 1-mm increase of RBH. There was no statistically significant difference in the correlation between RBH and lamellar bone, woven bone, and osteoid, independently of the material used. Implant success was 100% in both groups, and marginal bone loss was 1.02 ± 0.42 mm in DBBM and 0.95 ± 0.31 mm in the NBS group after the 1-year follow-up. CONCLUSION: In spite of the absence of significance, the observed trend for woven bone to increase and medullary spaces to decrease when RBH increases deserves attention. Residual bone dimension might be a determinant in the bone graft maturation after maxillary sinus augmentation.

9.
Materials (Basel) ; 13(21)2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33172215

RESUMEN

In the present study, the cytotoxicity and the antimicrobial activity of two silver citrate-based irrigant solutions were investigated. Cytotoxicity of various concentrations (0.25%, 0.5%, 1%, 2.5%, 5%) of both solutions (BioAKT and BioAKT Endo) was assessed on L-929 mouse fibroblasts using the MTT assay. For the quantitative analysis of components, an infrared (I.R.) spectroscopy was performed. The minimum inhibitory and minimal bactericidal concentrations (M.I.C. and M.B.C., respectively) were ascertained on Enterococcus faecalis strain ATCC 4083. For biofilm susceptibility after treatment with the irrigating agent, a minimum biofilm eradication concentration (M.B.E.C.) and confocal laser scanning microscope (C.L.S.M.) assays were performed. Quantification of E. faecalis cell biomass and percentage of live and dead cells in the biomass was appraised. Normality of data was analyzed using the D'Agostino & Pearson's test and the Shapiro-Wilk test. Statistical analysis was performed using one-way analysis of variance (ANOVA) and Tukey's test. Both silver citrate solutions showed mouse fibroblasts viability >70% when diluted to 0.25% and 0.5%. Conversely, at higher concentrations, they were extremely cytotoxic. F.T.-IR spectroscopy measurements of both liquids showed the same spectra, indicating similar chemical characteristics. No substantial contrast in antimicrobial activity was observed among the two silver citrate solutions by using broth microdilution methods, biofilm susceptibility (MBEC-HTP device), and biomass screening using confocal laser scanning microscopy (C.L.S.M.) technique. Both solutions, used as root canal irrigants, exhibited significant antimicrobial activity and low cytocompatibility at dilutions greater than 0.5%.

10.
J Dent ; 103: 103494, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33031887

RESUMEN

OBJECTIVES: This study aimed to morphologically investigate the distribution of the adhesive layer when placed prior, or subsequent, to matrix positioning in direct-bonded Class II RBC restorations. Additional aim was to evaluate possible differences when using two-steps (CSE, Clearfil SE Bond2) or one-step adhesive system (CU, Clearfil Universal Bond Quick). METHODS: Standardized mesio-occlusal and disto-occlusal cavities were prepared on 20 human molars. Teeth were randomly allocated to two protocols according to the positioning of contoured sectional metal matrices before (M->A, n = 10), or after adhesive application (A->M, n = 10). Both adhesive systems were additioned with crystal violet dye (CV, 10 vol%). Specimen sections were evaluated using optical and scanning electron microscopy (SEM). Dynamic viscosity, pH, microshear bond strength test (µ-SBS) on enamel and dentin, and three-point bend test (3PB) of polymerized adhesive rods, were performed on both pristine and CV-additioned adhesives. RESULTS: M->A produced a layer of adhesive both on tooth-restoration interface and on external restoration surfaces in contact with the matrix. A->M produced a thin layer of adhesive on external tooth surfaces, well beyond cavity and RBC restoration margins. In all restorations, excess RBC material with uneven margins was observed protruding over the cervical margin. CV addition slightly increased pH and decreased viscosity. µ-SBS: CU + CV showed a 10-fold reduction in adhesion forces on dentine. 3PB: CSE yielded higher flexural strength values than CU. CV addition reduced flexural strength of CSE. CONCLUSIONS: Both M > A and A > M generated adhesive placement disadvantages with adhesive materials being expressed in difficult to reach locations that may jeopardize complete adhesive polymerization. CLINICAL SIGNIFICANCE: All cervical margins of RBC restorations should be carefully finished to improve longevity, no matter the clinical protocol adopted. CV addition labelled the tested adhesives without compromising their performances considerably.

11.
Int J Oral Maxillofac Implants ; 35(5): 974-981, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32991648

RESUMEN

PURPOSE: The aim of this retrospective clinical case series report was to evaluate the outcomes of patients who underwent zygomatic implant surgery with a recent technical modification of the extrasinus surgical protocol. MATERIALS AND METHODS: The implant system presented in this study had a novel designed unthreaded body with a 12.5-mm sharp threaded apical end for obtaining maximum retention to the zygomatic bone. A total of 92 patients with severely atrophic maxillae were included in this study. All the patients were treated with a modification of the extrasinus protocol for insertion of 261 zygomatic implants. The mean follow-up of the patients was 34.5 ± 17.1 (SD) months (range: 6 to 72 months). The implant survival rate was the primary outcome. The intraoperative and postoperative complications were evaluated as additional criteria for success. RESULTS: The cumulative implant survival rate was 97.99%. Definitive or provisional prostheses were delivered on the same day of surgery, which resulted in an improvement in the quality of life of the patients. Five implants failed in four patients. No sinusitis or mucositis was seen in any of the patients. Eleven postoperative complications occurred in seven patients. CONCLUSION: The novel zygomatic surgery protocol introduced in this study can be an effective alternative to augmentation procedures and conventional implants, especially in cases of extremely atrophic posterior maxillae.


Asunto(s)
Implantación Dental Endoósea , Implantes Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Calidad de Vida , Estudios Retrospectivos
12.
Materials (Basel) ; 13(19)2020 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-32992613

RESUMEN

AIM: This systematic review and meta-analysis aims to assess the additive effect of leukocyte and platelet-rich fibrin (L-PRF) on coronally advanced flap (CAF) procedures in root coverage of Miller's class I and II gingival recession defects. Review methodology: A comprehensive search in MEDLINE (PubMed), Scopus and CENTRAL (the Cochrane Central Register of Controlled Trials), along with an additional hand search, provided eight randomized clinical trials to be included in this review. A total of 167 patients with 470 gingival recession defects were analyzed. A meta-analysis was carried out to assess the change in gingival thickness (GT), width of keratinized gingiva (WKG), root coverage percentage (%RC), clinical attachment level (CAL) and recession depth (RD) at all follow-ups between CAF alone and CAF + L-PRF groups for all included studies. A subgroup analysis was carried out based on recession type (single/multiple). RESULTS: Overall, a significant improvement in GT, CAL and RD was found when treated with CAF + L-PRF. There was a trend for a positive effect in terms of an increase in WKG when using L-PRF, especially in the treatment of single recession, though significance was not achieved (p = 0.08 overall). The results of heterogeneity among the subgroups were varied and were found to be greater than 91.3% for GT and 32.8% for WKG. CONCLUSION: L-PRF when used in addition to CAF showed favorable results for the treatment of class I and II gingival recession defects.

13.
Materials (Basel) ; 13(18)2020 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-32962279

RESUMEN

The present study aimed to perform a systematic critical appraisal of the methodological quality of systematic reviews (SRs) on the effect of autologous platelet concentrates (APCs) in the treatment of periodontal intraosseous defects and to provide a synthesis of the main clinical findings available. An electronic and hand search was performed up to February 2020; 14 systematic reviews of randomized controlled trials (RCTs), of which 11 were meta-analyses, were included. Only one SR fully satisfied all 11 items of the AMSTAR ("A Measurement Tool to Assess Systematic Reviews") checklist for methodological quality evaluation, 3 SRs were classified of high quality, 8 of medium quality, and 2 of low quality. There is some evidence on the beneficial additive effect of APCs in the surgical treatment of intraosseous defects when used alone or in combination with bone grafts. APCs did not show any advantage when used together with guided tissue regeneration (GTR) or enamel matrix derivative (EMD). Undertaking SRs which adhere to rigorous standards and protocols is strongly recommended. There are increasing data on the positive adjunctive effect of APCs in the surgical treatment of intraosseous defects but, due to the heterogeneity of the available primary studies, the quality of evidence remains rather low and further long-term well-designed RCTs are encouraged.

14.
Int J Oral Implantol (Berl) ; 13(3): 241-252, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32879929

RESUMEN

PURPOSE: Implant primary stability has long been considered a prerequisite for successful osseointegration. However, achieving stability may be difficult when placing implants in wide postextractive bone defects. The purpose of this study was to conduct a clinical and radiographic investigation of bone modifications at porous-structured implants inserted with or without primary stability. MATERIALS AND METHODS: Fifty porous-structured implants were inserted in the posterior sockets of 50 consecutive patients 2 months after tooth extraction, combined with allogeneic bone and a resorbable membrane. The implants were divided into two groups according to insertion torque: spinner (spinning at 35 Ncm, n = 23) and stable (stable at 35 Ncm, n = 27). Implant stability was assessed by resonance frequency analysis from baseline to 6-month function. Follow-up took place 3 years after implant placement. RESULTS: At baseline, the implant stability quotient was undetectable in the spinner group and averaged 75.07 ± 5.84 in the stable group. At uncovering, the implant stability quotient increased to 71.33 ± 4.42 and 77.97 ± 3.30 in the spinner and stable group, respectively (P < 0.001). After 6 months of loading, no between-group difference in implant stability quotient was found (P = 0.13). Marginal bone level changes were similar between groups at all follow-ups, averaging -0.41 ± 0.77 mm and -0.15 ± 0.53 mm at 36-month follow-up in the spinner and stable group, respectively (P = 0.35). No implant failed throughout the observation period. Neither biological nor mechanical complications occurred. CONCLUSION: Implants with a moderately rough surface and a porous-structured body may osseointegrate even without primary stability.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Implantación Dental Endoósea , Estética Dental , Humanos , Porosidad , Alveolo Dental/cirugía
15.
Artículo en Inglés | MEDLINE | ID: mdl-32926001

RESUMEN

Clinical records of patients who underwent implant-supported rehabilitation according to the biologically oriented preparation technique (BOPT) principles were retrospectively analyzed. Records of 189 nonconsecutive patients who received 502 implants were reviewed. At the last follow-up visit (occurring on average 5.11 years after prosthesis delivery), 466 (92.8%) implants had a Gingival Index of 0, and 491 (97.8%) presented no bleeding on probing. Four hundred eighty-nine crowns on as many implants (97.4%) showed no sign of gingival recession. Technical complications occurred with 10 implants (2.0%) and 6 patients (3.2%). Biologic complications were detected with 14 implants (2.8%) and 6 patients (3.2%). When the BOPT approach is applied to rehabilitate patients using implant-supported prostheses, excellent medium-term results concerning soft tissue health may be achieved.


Asunto(s)
Implantes Dentales , Prótesis Dental de Soporte Implantado , Coronas , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Estudios Retrospectivos , Resultado del Tratamiento
16.
Clin Implant Dent Relat Res ; 22(5): 552-566, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32902123

RESUMEN

PURPOSE: To compare clinical and radiographic outcomes of <7 mm short (SH) implants inserted in native bone vs longer (ST) implants placed in vertically augmented partially edentulous posterior jaws. A further aim was to evaluate if the residual bone dimension plays a role in the outcomes of SH and extra-SH implants. MATERIALS AND METHODS: This review was registered with PROSPERO. An electronic literature search was performed on PubMed, Scopus and Web of Science. Randomized controlled trials (RCTs) with at least 1-year follow-up, comparing fixed prostheses supported by SH vs ST implants in augmented sites were included. Marginal bone level (MBL) changes, implant survival rate, and complications were evaluated through a meta-analysis. Subgroup analysis was performed dividing the SH implants according to length at each follow-up (1-, 3-, 5-year of function). RESULTS: Twenty-five articles fulfilled the inclusion criteria, featuring a total of 650 SH implants placed in 415 patients and 685 ST implants placed in 403 patients. There was a trend for a significantly lower MBL associated with SH implants respect to ST implants at each follow-up, whilst there was no evidence of a difference in failure rates between SH and ST implants, for any SH length considered and at any follow-up. There was evidence for a lower incidence of complications in favor of SH implants at both 1-year (P < .0001) and 3-year follow-up (P = .01), while at 5-year follow-up there was no evidence of a difference between SH and ST groups (P = .30). CONCLUSION: SH implants supporting partial fixed rehabilitations represent a valuable alternative to augmentation procedures in the medium term. While the performance of implants at least 5-mm long is well documented, more studies with at least 5-year follow-up are needed to confirm the promising outcomes observed with <5 mm-long fixtures.

17.
Dent J (Basel) ; 8(3)2020 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-32756300

RESUMEN

The aim of this multicenter cross-sectional study was to determine the prevalence of peri-implantitis and to assess its association with several patient- and implant-related factors. Patients with at least one implant, who came for a recall visit to one of the four centers over a period of five months, were enrolled. Presence of peri-implantitis (defined as bleeding on probing, exudate/suppuration, bone loss > 0.2 mm/year and increased pocket depth) and several other variables (e.g., smoking habits, history of periodontitis, diabetes) were recorded. Out of 248 enrolled patients (1162 implants), 10 patients had at least one implant with peri-implantitis (4.03%); a total of 14 implants were affected (1.20%). A statistically significant association between peri-implantitis and diabetes was found (OR 8.65; CI: 1.94-38.57). Smoking more than 10 cigarettes per day (OR: 0.53; CI 0.03-9.45) and history of periodontitis (OR: 2.42; CI: 0.49-11.89) were not found to be statistically associated with peri-implantitis. Even if implant therapy is a consolidated treatment, biological complications do happen. Strict supportive therapy recalls could lead to lower rates of peri-implantitis and earlier diagnosis.

18.
J Oral Implantol ; 2020 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-32780812

RESUMEN

The insertion of zygomatic implants is a challenging surgery and requires special care and great precision. Piezoelectric surgery offers several advantages, since it provides a more precise bone cutting with an improved intraoperative visibility and a low temperature increase.The aim of this case-control study was to evaluate if the use of ultrasonic instruments for zygomatic implant surgery can be as effective as standard drilling instruments in terms of clinical outcomes. Ninety-two patients with atrophic maxilla were included in the study. Implant sites were prepared either with ultrasonic technique (Test group- 47 patients) or with traditional drilling (Control group- 45 patients). In total, 368 zygomatic implants were inserted (202 with "extrasinus technique", 77 with "sinus slot technique" and 89 with "Brånemark technique"). Complete arch provisional prostheses were delivered 3 to 5 hours after the surgical operations. The mean follow-up after surgery was 24 months (range 12-32 months). The primary outcome evaluations based on implant survival rates and postoperative complications. The operative time and surgeon's stress were evaluated as secondary outcomes. According to the results, implant survival rate was 100% in Test, and 98.89% in Control group. The postoperative complications were seen in 9 patients (4 in Test,  5 in Control group), and the difference was not statistically significant. The operative time was longer in the Test group, however surgeons were more comfortable while using ultrasonic instruments. Within the limitations of this preliminary study, ultrasonic technique can be considered as a feasible alternative to traditional drilling for zygomatic implant surgery.

20.
Oral Dis ; 26(8): 1803-1809, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32583493

RESUMEN

OBJECTIVE: Ectodermal dysplasia syndrome is a complex group of genetic disorders identified by the abnormal development of the ectodermal structures. The aim of this retrospective clinical case series report was to evaluate the outcomes of the ectodermal dysplasia syndrome patients that underwent zygomatic implant surgery. MATERIALS AND METHODS: A total of 9 ectodermal dysplasia syndrome patients aged between 21 and 56 years (mean age 36.8) with severely atrophic maxilla were included in this study. All the patients were treated with a total of 19 zygomatic implants. The mean follow-up of the patients was 55 months (with a range of 44-84 months). The implant survival rate was evaluated as a primary outcome. The intra- and postoperative complications were evaluated as additional criteria for success. RESULTS: The overall implant survival rate was 100% without any complications. Final or provisional prosthesis was delivered on the same day of surgery, which resulted in an improvement of the quality of life of the patients. CONCLUSION: According to the results of this study, zygomatic surgery can be considered as a viable and safe alternative to conventional treatment modalities for oral rehabilitation of ectodermal dysplasia syndrome patients.

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