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1.
BMC Oral Health ; 20(1): 96, 2020 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-32252728

RESUMEN

BACKGROUND: The posterior regions of the jaws usually represent a significant risk for implant surgery. A non-valid assessment of the available bone height may lead to either perforation of the maxillary sinus floor or encroachment of the inferior alveolar nerve and consequently to implant failure. This study aimed to evaluate the reliability of surgeon's decision in appraising the appropriate implant length, in respect to vital anatomical structures, using panoramic radiographs. METHODS: Only implants that are inserted in relation to the maxillary sinus (MS) or the mandibular canal (MC) were enrolled (first premolars [1P], second premolars [2P], first molars [1M], and second molars [2M]). All preoperative panoramic radiographs were evaluated under standard conditions. The postoperative estimation (under/over) was determined depending on the available bone height (ABH) measured from the apical end of the implant to the floor of the MS and the roof of the MC using cone beam computed tomography (CBCT). Any complication or side effect that associated with overestimated implants insertion was recorded. RESULTS: The study sample included 73 patients (predominantly females) who had consecutively received 148 implants, of which 68 were inserted in the posterior maxilla and 80 in the posterior mandible. Underestimation was recorded in 93.2% of the measurements. The remaining bone height after implants insertion was < 2 mm in the majority of underestimated cases (73.9%); they were significantly (P < 0.01) more than sites with remaining bone ≥ 2 mm (26.1%). In the posterior mandible, overestimation was significantly higher than posterior maxilla. Five cases with transient paresthesia were reported in the mandibular overestimated implants. CONCLUSIONS: This study specified that surgeon's choice of implants length, based on panoramic radiographs, was reliable regarding the incapability to insert implants with further length in the majority of underestimated cases, the low percent of overestimated measurements, and the minor associated complications.


Asunto(s)
Competencia Clínica , Implantes Dentales , Arcada Edéntula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Radiografía Panorámica/métodos , Cirujanos , Adolescente , Adulto , Anciano , Proceso Alveolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea/métodos , Femenino , Humanos , Masculino , Nervio Mandibular/diagnóstico por imagen , Seno Maxilar/diagnóstico por imagen , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados
2.
Niger J Clin Pract ; 23(3): 275-283, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32134023

RESUMEN

We aimed to assess the complications of minimally invasive balloon-assisted maxillary sinus floor augmentation, compared with the conventional sinus floor augmentation procedures done before placing a dental implant. A structured question was formulated and an electronic search was conducted in three databases (MEDLINE via PubMed, Google Scholar, and Scopus). A separate search of gray literature and a hand search for missing articles were also conducted. Apart from animal studies, in-vitro studies, and case reports, all other types of studies where maxillary sinus floor augmentation was done using a balloon were considered for review. Our review was registered in International Prospective Registration of Systematic Reviews (PROSPERO) under number CRD42018086770. Our search produced 73 articles. However, only eight articles were found eligible to be included in our review (seven case series and one case-control study). Quality check was done using Methodological Index for Non-Randomized Studies (MINORS). Results suggest that balloon-assisted augmentation is associated with low rates of membrane tears (9 out of 272 sinus augmentation attempts), and high follow-up bone gain levels (mean 212.91%, 95% confidence interval 158.07%-267.75%, I2 = 97.62%). Balloon-assisted augmentation seems to be safe. More clinical trials are needed to assess the advantages and disadvantages of balloon-assisted maxillary sinus floor augmentation compared with other procedures.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Seno Maxilar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Humanos
3.
Braz Oral Res ; 34: e008, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049109

RESUMEN

This study aimed to investigate the effects of chronic restraint stress (RS) and a high-fat diet (HFD) on the osseointegration of titanium implants in a rat model. After the surgical insertion of titanium implants into the metaphysis of the tibial bone, the rats were randomly divided into four equal groups (n = 8 each): control (CNT), restraint stress (RS), high-fat diet (HFD), and restraint stress plus high fat diet (RS-HFD). CNT: Rats received no further treatment during the 92-day experimental period. RS: Stress was applied to the rats beginning from two days after the implant surgery for one hour per day for the first 30 days, two hours per day for the next 30 days, and three hours per day for the last 30 days. HFD: Rats were fed a HFD for the following 90 days starting two days after surgery. RS-HFD: Rats were fed a HFD and RS was applied to rats for the following 90 days, starting two days after surgery. At the end of the experimental period, the rats were euthanized, and the implants and surrounding bone tissues were removed for histological analysis. Statistical analysis was performed by one way ANOVA and Bonferrroni tests. There were no significant differences in the bone-implant connection levels between the groups (p > 0.05), but in the HFD and RS-HFD groups, the bone filling ratios were found to be lower compared with the controls (p < 0.05) The data analyzed in this study suggest that an HFD with or without chronic RS adversely affected bone tissue in the rats during the 90-day osseointegration period.


Asunto(s)
Prótesis Anclada al Hueso , Dieta Alta en Grasa/psicología , Oseointegración/fisiología , Estrés Psicológico/fisiopatología , Tibia/fisiopatología , Titanio , Alanina Transaminasa/sangre , Animales , Aspartato Aminotransferasas/sangre , Glucemia/análisis , Colesterol/sangre , Implantación Dental Endoósea/métodos , Femenino , Distribución Aleatoria , Ratas Sprague-Dawley , Valores de Referencia , Reproducibilidad de los Resultados , Tibia/patología , Tibia/cirugía , Factores de Tiempo , Triglicéridos/sangre
4.
BMC Oral Health ; 20(1): 53, 2020 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-32066431

RESUMEN

BACKGROUND: To compare tissue response to two implant systems, featuring internal hexed connections with different designs. METHODS: Patients enrolled in this randomized controlled trial were assigned to two groups. In Group 1, patients were treated with implants with a 5° conical internal hexed connection (Anyridge®, MegaGen, South Korea). In Group 2, patients were treated with implants with an internal hexed connection (Core®, Kristal, Italy). After implant placement and a provisionalisation period of 12 months, impressions were taken, stone casts were poured and digitised with a desktop scanner (D700®, 3Shape, Copenhagen, Denmark). In a digital environment, for each fixture, two values were collected at the buccal zenith: the height of the peri-implant mucosa (mucosal height; MH), calculated from the vestibular shoulder of the implant analogue to the upper gingival margin of the supra-implant tissue; and the width of the peri-implant mucosa (mucosal thickness; MT), calculated from the vestibular shoulder of the analogue to the external mucosa point perpendicular to the implant major axis. The mean and standard deviation for MH and MT, as well as their ratios, were calculated for each group; the sectors in which the implants were placed were also considered. Finally, correlation between MH, MT, connection type and sector was assessed by Pearson's correlation coefficient, with significance level set at 0.05, and a confidence interval (CI) set at 95%. RESULTS: Data deriving from 188 implants placed in 104 patients were evaluated. The mean MH values were 3.32 (± 0.12) and 2.70 (± 0.16) mm for Groups 1 and 2, respectively. The mean MT values were 4.37 (± 0.16) and 3.93 (± 0.18) mm for Groups 1 and 2, respectively. Group 1 showed higher MH and MT values and a better ratio (1.50 ± 0.88) than Group 2 (1.81 ± 1.20). The MH, MT and MH/MT ratio were significantly influenced both by sector (p = 0.015) and group (p = 0.047). CONCLUSIONS: Within the limits of this study, the 5° connection implants supported a more extended tissue height and thickness at the buccal zenith, and a better ratio between them. TRIAL REGISTRATION: This study was retrospectively registered in Clinicaltrials.gov, with number NCT04160689, dated 13/11/2019.


Asunto(s)
Pilares Dentales , Diseño de Implante Dental-Pilar , Implantación Dental Endoósea/métodos , Implantes Dentales , Coronas , Humanos , Carga Inmediata del Implante Dental , Italia , República de Corea , Resultado del Tratamiento
5.
BMC Oral Health ; 20(1): 15, 2020 01 16.
Artículo en Inglés | MEDLINE | ID: mdl-31948414

RESUMEN

BACKGROUND: Guided implant surgery is considered as a safe and minimally invasive flapless procedure. However, flapless guided surgery, implant placement in post-extraction sockets and immediate loading of complete-arch fixed reconstructions without artificial gum are still not throughly evaluated. The aim of the present retrospective clinical study was to document the survival and success of complete-arch fixed reconstructions without artificial gum, obtained by means of guided surgery and immediate loading of implants placed also in fresh extraction sockets. METHODS: A total of 12 patients (5 males and 7 females, with a mean age of 50.0 ± 13.8) were enrolled in this study. Implant planning was performed with a guided surgery system (RealGuide®, 3Diemme, Como, Italy), from which 3D-printed surgical templates were fabricated. All implants (Esthetic Line-EL®, C-Tech, Bologna, Italy) were placed through the guides and immediately loaded by means of a temporary fixed full-arch restoration without any artificial gum; the outcome measures were implant stability at placement, implant survival, complications, prosthetic success, soft-tissue stability, and patient satisfaction. RESULTS: One hundred ten implants (65 of them post-extractive) were placed flapless through a guided surgery procedure and then immediately loaded by means of provisional fixed full arches. Successful implant stability at placement was achieved in all cases. After a provisionalization period of 6 months, 72 fixed prosthetic restorations were delivered. Only 2 implants failed to osseointegrate and had to be removed, in one patient, giving a 1-year implant survival rate of 98.2% (108/110 surviving implants); 8/12 prostheses did not undergo any failure or complication during the entire follow-up period. At the 1-year follow-up control, soft-tissue was stable in all patients and showed satesfactory aesthetic results. CONCLUSIONS: Within the limits of this study, complete-arch fixed reconstruction by means of guided surgery and immediate loading of implants placed in fresh extraction sockets appears to be a reliable and successful procedure. Further long-term prospective studies on a larger sample of patients are needed to confirm these positive outcomes.


Asunto(s)
Arco Dental/cirugía , Implantación Dental Endoósea/métodos , Implantes Dentales , Prótesis Dental de Soporte Implantado , Carga Inmediata del Implante Dental , Adulto , Anciano , Implantación Dental Endoósea/instrumentación , Retención de Prótesis Dentales , Fracaso de la Restauración Dental , Estética Dental , Femenino , Estudios de Seguimiento , Humanos , Italia , Masculino , Persona de Mediana Edad , Radiografía Panorámica , Estudios Retrospectivos , Resultado del Tratamiento
6.
Actual. osteol ; 15(3): 225-236, Sept-Dic. 2019. ilus
Artículo en Inglés | LILACS | ID: biblio-1116171

RESUMEN

Bone grafting is important to preserve the alveolar bone ridge height and volume for dental implant placement. Even though implant-supported overdentures present highly successful outcomes, it seems that a great number of edentulous individuals have not pursued implant-based rehabilitation. The cost of the treatment is one of the reasons of discrepancy between highly successful therapy and its acceptance. Therefore, the development of biomaterials for bone grafting with comparable characteristics and biological effects than those renowned internationally, is necessary. In addition, domestic manufacture would reduce the high costs in public health arising from the application of these biomaterials in the dental feld. The purpose of this clinical case report is to provide preliminary clinical evidence of the efficacy of a new bovine bone graft in the bone healing process when used for sinus floor elevation. (AU)


El uso de injertos óseos es importante para preservar la altura y el volumen de la cresta alveolar para la colocación de implantes dentales. Si bien las sobredentaduras implanto-soportadas presentan resultados altamente exitosos, la mayoría de las personas desdentadas no han sido rehabilitadas mediante implantes dentales. Uno de los principales motivos por los cuales los pacientes no aceptan este tipo de tratamiento, altamente exitoso, es el elevado costo del mismo. Por ello, es necesario el desarrollo de biomateriales de injerto óseo con características y efectos biológicos comparables a los reconocidos internacionalmente. Asimismo, la fabricación nacional reduciría los altos costos en Salud Pública derivados de la aplicación de estos biomateriales en el campo dental. El objetivo de esta comunicación es presentar un caso clínico a fin de proporcionar evidencia preliminar acerca de la eficacia de un nuevo injerto de hueso bovino en el proceso de cicatrización ósea en el levantamiento del piso del seno maxilar. (AU)


Asunto(s)
Humanos , Animales , Femenino , Persona de Mediana Edad , Bovinos , Ratas , Trasplante Óseo/métodos , Arcada Parcialmente Edéntula/rehabilitación , Elevación del Piso del Seno Maxilar/métodos , Osteogénesis , Argentina , Materiales Biocompatibles , Bovinos/fisiología , Carticaína/administración & dosificación , Clorhexidina/administración & dosificación , Naproxeno/administración & dosificación , Salud Pública/economía , Oseointegración , Dentaduras , Trasplante Óseo/tendencias , Arcada Parcialmente Edéntula/patología , Arcada Parcialmente Edéntula/terapia , Durapatita/uso terapéutico , Combinación Amoxicilina-Clavulanato de Potasio/administración & dosificación , Implantación Dental Endoósea/métodos , Elevación del Piso del Seno Maxilar/tendencias , Aloinjertos/inmunología , Aloinjertos/trasplante
7.
Biomed Res Int ; 2019: 2797210, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31781606

RESUMEN

Background: Endoscopy has seen a significant development over recent years in various medical fields with its application expanding from the support of minimal invasive surgery to in situ imaging. In this context, the application of endoscopic techniques to assess the quality of the regenerated bone in situ in the drill hole before implant placement is an appealing approach. Aim: The aim of this study was to use short distance support immersion endoscopy (SD-SIE) to compare the quality of regenerated bone in healed postextraction sites, which are grafted with an in situ hardening ß-TCP, against ungrafted sites, before implant placement. This assessment was based on microscopic bone analysis in combination with the blood vessel count. Method: 13 spontaneously healed and 13 grafted postextraction sites in 3 men and 6 women, aged 26-83 years, were evaluated using SD-SIE after 4-6 months. SD-SIE was applied in drill holes before implant placement, and videos were taken from representative central buccal areas. The video recordings were analyzed using Image J software for (1) number of blood vessels per area (NBV), (2) relative area of vessels (VA), (3) relative area of mineralized bone (MBA), (4) relative area of unmineralized bone (UMBA), and (5) relative area of bone substitute (BSA). Results: The grafted sites showed more (1) NBV as well as (2) VA (8.6 ± 1.1; 2.03 ± 0.28%) than the ungrafted sites (2.5 ± 0.6; 1.18 ± 0.36%) (independent t-test; p < 0.05); (3) MBA and (4) UMBA were similar to those in the grafted sites (86.3 ± 2.2 %; 13.7 ± 2.2 %) and to the ungrafted sites (89.5 ± 3.7%; 10.5 ± 3.6%) (independent t-test; p > 0.05); and (5) BSA in the grafted sites was 18.2 ± 5.4%. Conclusion: SD-SIE is an interesting new approach for in situ assessment of bone quality and blood supply before implant placement. The regenerated bone in ß-TCP grafted extraction sockets showed an increased vascularization compared to ungrafted sites providing a vital support for subsequent implant placement.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Pérdida de Hueso Alveolar/terapia , Proceso Alveolar/cirugía , Regeneración Ósea/ética , Sustitutos de Huesos/administración & dosificación , Fosfatos de Calcio/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Proceso Alveolar/efectos de los fármacos , Materiales Biocompatibles/administración & dosificación , Regeneración Ósea/efectos de los fármacos , Estudios de Casos y Controles , Implantación Dental Endoósea/métodos , Implantes Dentales , Endoscopía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Extracción Dental/métodos
8.
BMC Oral Health ; 19(1): 222, 2019 10 17.
Artículo en Inglés | MEDLINE | ID: mdl-31623636

RESUMEN

BACKGROUND: This study evaluated the operating performance of an implant navigation system used by dental students and dentists of prosthodontic background with varying levels of experience. A surgical navigation system and optical tracking system were used, and dentists' accuracies were evaluated in terms of differences between the positions of actually drilled holes and those of the holes planned using software before surgeries. METHODS: The study participants were 5 dental students or dentists who had studied in the same university and hospital but had different experience levels regarding implants. All participants were trained in operating the AqNavi system in the beginning of the study. Subsequently, using 5 pairs of dental models, each participant drilled 5 implant holes at 6 partially edentulous positions (11, 17, 26, 31, 36, and 47). In total, each participant conducted 30 drilling tests. RESULTS: In total, 150 tests among 5 dentists at 6 tooth positions (11, 17, 26, 31, 36, and 47) were conducted. Although a comparison of the tests revealed significant differences in the longitudinal error (P < .0001) and angular error (P = .0011), no significant difference was observed in the total error among the dentists. CONCLUSIONS: A relatively long operating time was associated with relatively little implant experience. Through the dental navigation system, dental students can be introduced to dental implant surgery earlier than what was possible in the past. The results demonstrated that the operational accuracy of the dental implant navigation system is not restricted by participants' implant experience levels. The implant navigation system assists the dentist in the ability to accurately insert the dental implant into the correct position without being affected by his/her own experience of implant surgery.


Asunto(s)
Competencia Clínica , Implantación Dental Endoósea/métodos , Implantes Dentales , Modelos Dentales , Odontólogos/psicología , Boca Edéntula , Cirugía Asistida por Computador/métodos , Adulto , Femenino , Humanos , Imagenología Tridimensional/métodos , Masculino , Persona de Mediana Edad , Cirugía Asistida por Computador/instrumentación
9.
Int J Immunopathol Pharmacol ; 33: 2058738419838092, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31663442

RESUMEN

The aim of this issue is to describe endosseous distal extension (EDE) surgical technique. This implant technique was conceived and applied since 1993 by Dr Luca Dal Carlo, as an evolution of the classical ramus blade implant technique. With this technique, you attain great stability of the blade implant, due to the following difference compared with the classical blade implant technique: the hard and soft tissues lying behind implant abutment are not being destroyed at all. A slot is made on the upper side of the bone ridge, and the blade is inserted into it and pushed backwards, so that the implant is embedded under untouched tissues. Using blade implants specially drawn for this particular surgery, the slot's length turns out to be about half of the implant's length. Piezo bistoury is useful to facilitate surgical proceedings. If we compare the regenerated bone on the mesial part of the implant and the bone that had remained untouched on the distal side, we will see a difference in the tissue density even after a long time. EDE technique is suitable for those cases in which the lower distal sector is characterized by scarceness of cancellous bone. Data collected during 22 years of clinical practice (97.7% 5-year success rate) allow to suggest employing this technique with asymmetric blades to treat D3-D4 narrow ridges located in the posterior mandible. Soft tissue response results are very good.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantación Dental Endoósea/estadística & datos numéricos , Regeneración Ósea/fisiología , Implantes Dentales , Femenino , Humanos , Masculino , Mandíbula/cirugía , Encuestas y Cuestionarios
10.
Clin Ter ; 170(5): e345-e351, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31612191

RESUMEN

BACKGROUND: Aim of this retrospective study was to evaluate the most appropriate timing for the implant placement in oral cancer patients treated with radiation therapy. MATERIALS AND METHODS: We collected data for 17 subjects (10 females, 7 males; mean age: 51 ± 19) with malignant oral tumors who had been treated with ablative surgery and radiation therapy of head and neck. The radiotherapy was set in accordance with the NCCN guidelines. Every patient received dental implant rehabilitation between 2014 and 2016. A total of 84 titanium implants were placed, at a minimum interval of 12 months, in irradiated residual bone. Every patient underwent a minimum follow-up of 12 months. RESULT: Implant loss was dependent on the position and location of the implants (P = 0.05-0.1). Moreover, implant survival was dependent on the total dose of radiation and, mostly, on the timing of implant insertion after the end of the radiation therapy. This result was highly statistically significant (P < 0.01). Whether the implant was loaded is another highly significant (P < 0.01) factor determining survival. We observed significantly better outcomes when the implant was placed at least after 14 months and not loaded until at least 6 months after placement. CONCLUSION: Although the retrospective design of this study could be affected by selection and information biases, we conclude that a delayed implant placement after the end of the radiation therapy and a delayed loading protocol will give the best chance of implant osseointegration, stability and, ultimately, effective dental rehabilitation.


Asunto(s)
Implantación Dental Endoósea/métodos , Neoplasias de Cabeza y Cuello/radioterapia , Mandíbula/cirugía , Maxilar/cirugía , Adulto , Implantes Dentales , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
11.
BMC Oral Health ; 19(1): 208, 2019 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-31488110

RESUMEN

BACKGROUND: To evaluate early failure and possible risk factors for failure of dental implants placed under practice-based conditions. METHODS: To clarify the research question, anonymized data from 106 patients with 186 dental implants were analyzed. The presence of sucessful healing (yes/no) at the time of incorporation of the final prosthesis was assessed. Mixed models were compiled for each target variable to enable estimation of the effects of patient-related and implant-related conditions on the risk of early implant failure. RESULTS: Nine out of 186 implants (4.8%) placed in 106 participants failed before incorporation of the final prosthesis. The use of shorter implants (< 10 mm) and the need for augmentation procedures were associated with a greater risk of early implant failure. For shorter implants, the risk was 5.8 times greater than that for longer implants (p = 0.0230). Use of augmentation procedures increased the risk by a factor of 5.5 (p = 0.0174). CONCLUSIONS: Implants placed in the dental practice with a specialization in implantology heal successfully. The use of augmentation procedures and of implants shorter than 10 mm seems to be associated with a greater risk of early implant failure.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Fracaso de la Restauración Dental , Carga Inmediata del Implante Dental , Adulto , Anciano , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Oseointegración , Estudios Retrospectivos , Resultado del Tratamiento
12.
J Craniomaxillofac Surg ; 47(11): 1793-1802, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31522823

RESUMEN

A comprehensive literature search on implant placement protocols after tooth extraction (immediate, early, delayed, or later) was performed up to 2018. The screening process selected only randomized clinical trials (RCTs) from PubMed, Embase, Cochrane Library, Web of Science, Scopus, LILACS, and grey literature. A series of pairwise meta-analyses was carried out to evaluate implant performance in each protocol. The primary outcomes were implant survival and esthetic outcome, measured by pink esthetic score (PES), and the secondary outcomes were peri-implant bone resorption and implant complications. The outcomes were at least 1 year after implant surgery. A total of 5056 studies were found, of which 16 were included for qualitative analysis and 9 for quantitative analysis. The meta-analysis showed increased risk of implant failure by 3% in the immediate implant protocol. PES analysis showed no statistical significant difference between immediate or delayed protocols (p = 0.16). However, the subgroup analysis showed that the anterior region presented better results with immediate implants, while the molar region presented better results with delayed implants. The quantitative analysis showed no statistical difference in peri-implant bone resorption between the immediate and delayed implant protocols (p = 0.42). Due to the lack of studies with a low risk of bias, further RCTs are needed for definitive conclusions.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales de Diente Único , Implantes Dentales , Extracción Dental , Proceso Alveolar , Estética Dental , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Tiempo , Alveolo Dental/cirugía , Resultado del Tratamiento
13.
Rev. esp. cir. oral maxilofac ; 41(3): 126-137, jul.-sept. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-191776

RESUMEN

OBJETIVO: El propósito de esta revisión fue evaluar sistemáticamente la literatura científica sobre los resultados que se obtienen al combinar la fibrina rica en plaquetas (PRF) y rellenos óseos en la regeneración ósea guiada. MATERIALES Y MÉTODOS: Búsqueda detallada en las bases de datos PubMed, Scopus, Web of Science, ScienceDirect, Cochrane y SciELO para obtener la información más actualizada de los resultados (grado de relleno óseo, éxito de la cirugía, movilidad del implante, complicaciones posquirúrgicas, supervivencia del implante) entre los casos tratados con PRF y los casos donde se combinó PRF con algún tipo de relleno óseo. RESULTADOS: De las 965 publicaciones identificadas inicialmente, se excluyeron reportes clínicos, revisiones, estudios observacionales, etc. Se incluyeron 12 ensayos clínicos que contrastaron las variables entre la técnica con PRF solo y la combinación con un relleno óseo. CONCLUSIÓN: La combinación entre PRF más rellenos óseos promueve la neoformación ósea, aumenta el trabeculado y mejora los tiempos de cicatrización; sin embargo, al cabo de 6 meses de control los resultados no son diferentes significativamente de los de los grupos que no utilizaron PRF en el procedimiento de levantamiento de piso de seno maxilar con técnica de ventana lateral. Respecto a la preservación de reborde alveolar, los distintos estudios no son concluyentes: algunos indican que la mezcla de PRF con un relleno óseo parece mejorar las proporciones volumétricas; sin embargo, otros refirieron pérdidas óseas en anchura e incluso mayor grado de inflamación


OBJECTIVE: To evaluate systematically the results obtained by combining platelet rich fibrin (PRF) and bone fill in guided bone regeneration, according to scientific literature. MATERIALS AND METHOD: Detailed search of database from PubMed, Scopus, Web of Science, ScienceDirect, Cochrane and SciELO to obtain the most updated information of clinical results (bone filling degree, surgical success, implant mobility, post-surgical complications, and implant survival) of the cases treated with PRF and the cases where the platelet rich fibrin was combined with a bone filler. Those results registered and compared. RESULTS: From the 965 files initially identified, were excluded clinical reports, reviews, observational studies, comments, studies with pediatric patients and so on. There were included 12 clinical essays where the variables of the technique with PRF and the technique where the PRF was combined with a bone filler were contrasted. CONCLUSION: The combination of PRF plus bone filler promotes bone neoformation, increased trabecular bones, and improved healing times; however, after 6 months of monitoring, the results were not significantly different with the groups that did not use the PRF in the procedure of maxillary sinus floor lift with lateral window technique. Regarding the preservation of alveolar ridge the different studies are not conclusive: some indicate that the mixture of a concentrate with a bone filling seems to improve the volumetric proportions; however, other studies report bone loss in width and even greater degree of inflammation


Asunto(s)
Humanos , Fibrina Rica en Plaquetas/fisiología , Sustitutos de Huesos/farmacocinética , Regeneración Tisular Guiada Periodontal/métodos , Plasma Rico en Plaquetas/fisiología , Regeneración Ósea/efectos de los fármacos , Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Implantación Dental Endoósea/métodos
14.
Niger J Clin Pract ; 22(8): 1033-1040, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31417044

RESUMEN

Objective: The objective of this review is to evaluate maxillary and mandibular all-on-four implant designs, their indications and contraindications, advantages and disadvantages. Methods: By using Pubmed, Cochrane Library, and Google Scholar, data from January 2003 to February 2018 were scanned electronically and manually as the title, abstract, and full text. The keywords specified were determined to be the all-on-four concept, full-arch implant prostheses, 4-implant full-arch, and tilted implants. The inclusion criteria consisted of the all-on-four implant design, its use in completely edentulous maxillary and mandibular cases, advantages and disadvantages of the technique, and changes observed in the maxilla and mandible in completely edentulous cases. Clinical trials and laboratory studies on the subject using the full text and English language were evaluated. Results: A total of 176 articles were found as a result of Google Scholar, Pubmed, and Cochrane Library. Thirty-seven articles were selected according to inclusion criteria; of these, 20 were related to the clinical trials. In addition, a total of 13 articles were found as a result of an additional hand search by screening the reference list of all included publications; of these, 11 was related to the clinical trials. Conclusions: It is necessary to carry out longer-term clinical and laboratory studies to determine long-term success criteria in all-on-four implant designs and to use new ceramic systems.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Humanos , Arcada Edéntula/rehabilitación , Arcada Edéntula/cirugía , Mandíbula/anatomía & histología , Mandíbula/cirugía , Maxilar/anatomía & histología , Maxilar/cirugía
15.
J Mater Sci Mater Med ; 30(9): 97, 2019 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-31440845

RESUMEN

Sinus elevation is a common procedure to increase bone volume in the atrophic maxilla to allow placement of dental implants. Autogenous bone is the gold standard but is limited in quantity and causes morbidity at the donor site. ß-TCP is a synthetic biomaterial commonly used in that purpose. It appears to induce a poor inflammatory response. This study aimed to evaluate the degree of edema of the sinus mucosa after sinus lift surgery according to the type of biomaterial. Forty sinuses (20 patients) were included retrospectively and divided into 2 groups according to the biomaterial that was used: synthetic biomaterial (BTCP group), natural bone (BONE group). A control group (CTRL group) was constituted by the non-grafted maxillary sinuses. Twelve measurements per sinus were realized on pre- and post-operative computed tomography and averaged to provide the sinus membrane thickness value (SM.Th). SM.Th was thicker post-operatively in the BTCP and BONE groups in comparison with the CTRL group and in comparison with pre-operative measurements. No difference was found post operatively between the BTCP and BONE groups. We found that a synthetic biomaterial (ß-TCP) induced the same degree of edema, and thus of inflammation, as natural bone. It constitutes therefore an interesting alternative to autogenous bone for maxillary sinus lifts.


Asunto(s)
Sustitutos de Huesos/efectos adversos , Trasplante Óseo/efectos adversos , Fosfatos de Calcio/efectos adversos , Fosfatos de Calcio/química , Sinusitis Maxilar/etiología , Elevación del Piso del Seno Maxilar/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Materiales Biocompatibles/efectos adversos , Sustitutos de Huesos/química , Trasplante Óseo/métodos , Implantación Dental Endoósea/efectos adversos , Implantación Dental Endoósea/métodos , Implantes Dentales/efectos adversos , Femenino , Humanos , Inflamación/etiología , Inflamación/patología , Masculino , Seno Maxilar/efectos de los fármacos , Seno Maxilar/patología , Sinusitis Maxilar/patología , Persona de Mediana Edad , Estudios Retrospectivos , Elevación del Piso del Seno Maxilar/métodos
16.
J Craniomaxillofac Surg ; 47(11): 1787-1792, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31451343

RESUMEN

For horizontal bone deficiency alveolar ridge osteotomy is considered an option for augmentation. Major advantages are the option for a one-stage approach and the absence of donor site morbidity. However, the conventional technique is associated with complications such as perforations and fractures of the cortical bone. A case using a 3D based modified, full-guided alveolar ridge expansion is described to explain the technique step by step. Main features of modified technique: successive application of surgical guides for ridge osteotomy and expansion - implementation of virtually determined splitting vector, which allows guided bone splitting along a guide surface of template in an ideal direction - osteotomy as deep as implant length. The example shows that the 3D based modified alveolar ridge osteotomy is a suitable alternative to the conventional technique as it has several advantages such as fewer fractures and perforations of the cortical vestibular bone. The individualized preoperative planning helps to minimize complications. However, long-term outcomes and a study, conducted on a study group, is needed to evaluate the benefits of our presented treatment protocol.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Trasplante Óseo , Implantación Dental Endoósea/métodos , Implantes Dentales , Trasplante Óseo/métodos , Imagenología Tridimensional , Osteotomía
17.
Medicine (Baltimore) ; 98(27): e16251, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31277143

RESUMEN

RATIONALE: The traditional maxillary sinus floor elevation has serious postoperative complications and long healing periods, for patients with insufficient residual bone height (RBH). The endoscopic technique improves the blind nature of the sinus floor elevation procedure. Platelet-rich fibrin (PRF) can promote tissue healing and prevent perforation. PATIENT CONCERN: A 25-year-old female with residual roots in the maxillary right second molar visited our hospital for dental implants. DIAGNOSE: CBCT results showed a low-density shadow at the root tip, and the height of the periapical distance from the maxillary sinus floor was less than 1 mm. INTERVENTION: Patient was immediately subjected to implant after root extraction. Two-step sinus floor elevation was performed under endoscopy. A 12 mm-long implant was installed. OUTCOMES: At 10 months after surgery, the hard and soft tissues were stable, and a full-ceramic crown was placed. LESSONS: Immediate implant and endoscope-guided sinus floor elevation through a transcrestal approach by using PRF as the only grafting material is viable in periapical infected sites with a RBH of less than 1 mm.


Asunto(s)
Implantación Dental Endoósea/métodos , Endoscopía/métodos , Seno Maxilar/cirugía , Fibrina Rica en Plaquetas , Elevación del Piso del Seno Maxilar/métodos , Adulto , Humanos , Masculino , Seno Maxilar/diagnóstico por imagen , Osteotomía/métodos , Tomografía Computarizada por Rayos X
18.
Int J Mol Sci ; 20(13)2019 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-31277204

RESUMEN

The surface modifications of titanium dental implants play important roles in the enhancement of osseointegration. The objective of the present study was to test two different implant surface treatments on a rabbit model to investigate the osseointegration. The tested surfaces were: a) acid-etched surface with sandblasting treatment (SA) and b) an oxidized implant surface (OS). The roughness was measured by an interferometeric microscope with white light and the residual stress of the surfaces was measured with X-ray residual stress Bragg-Bentano diffraction. Six New Zealand white rabbits were used for the in vivo study. Implants with the two different surfaces (SA and OS) were inserted in the femoral bone. After 12 weeks of implantation, histological and histomorphometric analyses of the blocks containing the implants and the surrounding bone were performed. All the implants were correctly implanted and no signs of infection were observed. SA and OS surfaces were both surrounded by newly formed trabeculae. Histomorphometric analysis revealed that the bone-implant contact % (BIC) was higher around the SA implants (53.49 ± 8.46) than around the OS implants (50.94 ± 16.42), although there were no significant statistical differences among them. Both implant surfaces (SA and OS) demonstrated a good bone response with significant amounts of newly formed bone along the implant surface after 12 weeks of implantation. These results confirmed the importance of the topography and physico-chemical properties of dental implants in the osseointegration.


Asunto(s)
Implantación Dental Endoósea/métodos , Implantes Dentales , Oseointegración , Titanio , Animales , Femenino , Fémur/cirugía , Implantes Experimentales , Conejos , Propiedades de Superficie
19.
Rom J Morphol Embryol ; 60(1): 261-266, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31263854

RESUMEN

The current very high success rate of dental implants osseointegration has led to patients having increasingly high expectations in regards to aesthetic outcomes; therefore, effective management of soft tissues and healing of attached gingiva and papillae are essential in the effort to obtain satisfying aesthetic results for the patient. Obtaining papillae to address aesthetic requirements cannot be accomplished without bone reconstruction; an adequate volume of bone is essential in providing necessary long-term dimensional stability. The aim of this work was to highlight the advantages of autogenous bone grafting combined with plasma rich in growth factors (PRGF) in order to improve healing and reduce dehiscence risks. Two clinical cases were presented, both with important (horizontal and vertical) bone loss: in the first case, bone augmentation was performed at the same time as tooth extraction with no surgery needed for reconstruction of dental papillae, keratinized and attached mucosa; in the second case, vertical augmentation was performed by placing the bone graft in contact with an uninfected tooth. In both cases, aesthetic outcomes were as desired at the completion of treatment and also satisfactory at seven years follow-up.


Asunto(s)
Trasplante Óseo/métodos , Implantación Dental Endoósea/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
20.
Biomed Res Int ; 2019: 1680158, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31321229

RESUMEN

Introduction: Dental aplasia is an anomaly in which the number of teeth is reduced. It is the most commonly occurring dental anomaly during tooth development. Treatment management of patients with dental aplasia is challenging. Objectives: The aim of this retrospective clinical study was to analyze the survival and success rates of dental implants placed in hypodontic patients, rated with different criteria. Methods: Forty-three patients were diagnosed with dental aplasia and treated with dental implants between November 2000 and February 2016. The variables assessed included the plaque level, bleeding on probing, probing depth, implant mobility, implant stability, and implant loss. To analyze the peri-implant bone level, a panoramic X-ray of each patient was taken. The results were compared with X-rays taken immediately after implantation. Results: Thirty-seven patients (16 males; 21 females) participated in this study. In total, 155 implants (86 maxillary; 69 mandibular) were inserted. Two of the 155 implants failed; the in situ survival rate was 98.7%. The success rate according to the criteria of Buser et al. was 96.8%, and that according to the criteria of Albrektsson et al. was 88.4%. Conclusion: The survival and success rates of dental implants in patients with congenitally absent teeth were very high and did not differ significantly from results achieved in an unaffected population. Dental implants are a reliable therapy for patients with dental aplasia.


Asunto(s)
Pérdida de Hueso Alveolar/prevención & control , Implantación Dental Endoósea/métodos , Implantes Dentales de Diente Único , Implantes Dentales , Adulto , Anciano , Pérdida de Hueso Alveolar/fisiopatología , Diseño de Prótesis Dental/métodos , Femenino , Humanos , Masculino , Mandíbula/fisiopatología , Maxilar/fisiopatología , Persona de Mediana Edad
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