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1.
Artículo en Inglés | MEDLINE | ID: mdl-34076630

RESUMEN

This study evaluated a panel of clinical, dimensional, volumetric, implant-related, histomorphometric, and patient-reported outcome measures (PROMs) following reconstruction of dehiscence defects in extraction sockets with a minimally invasive technique using particulate bone allograft and a nonresorbable dense polytetrafluoroethylene (dPTFE) membrane. Subjects (n = 17) presenting severe buccal dehiscence defects at the time of single-rooted tooth extraction participated in the study. The mean vertical dimension of the dehiscence defects at baseline was 5.76 ± 4.23 mm. Subjects were followed up at 1, 2, 5, and 20 weeks postoperatively. The dPTFE barrier was gently removed at 5 weeks. CBCT and intraoral scans were obtained at baseline and at 20 weeks. A bone core biopsy sample was harvested at 24 weeks (before implant placement). Linear radiographic measurements revealed a mean increase in buccal bone height from baseline to 20 weeks (5.66 ± 5.1 mm; P < .0001). A total alveolar bone volume gain of 9.12% was observed. Although approximately half of the sites required some degree of additional bone augmentation at the time of implant placement, all implants were placed in a favorable restorative position with adequate primary stability. Histomorphometric analyses revealed a mean mineralized tissue area of 31.04% ± 15.22%, and the proportions of remaining allograft material and nonmineralized tissue were 16.23% ± 10.63% and 52.71% ± 9.53%, respectively. All implants survived up to 12 months after placement. PROMs were compatible with minimal discomfort at different postoperative stages and a high level of overall satisfaction upon study completion. This study demonstrated that the reconstructive procedure employed was successful and predictable in treating large, postextraction alveolar ridge deformities to optimize tooth replacement therapy with implant-supported prostheses.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Pérdida de Hueso Alveolar/cirugía , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/cirugía , Trasplante Óseo , Implantación Dental Endoósea , Humanos , Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía , Trasplante Homólogo
2.
Int J Periodontics Restorative Dent ; 41(3): e103-e112, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34076644

RESUMEN

Clinical evidence suggests using lateral and vertical ridge preservation procedures to make dental implant placement possible. This study evaluates and compares the radiographic and volumetric changes following ridge preservation procedures using either mineralized plasmatic matrix grafts (MPM) or bone grafts alone (non-MPM) in the existing crestal ridges of sockets in maxillary and mandibular regions using CBCT scans. Healthy volunteers (n = 26) were recruited and randomized into MPM and non-MPM groups (n = 13 patients per group). Ridge preservation (RP) was performed in sockets after extraction. Preoperative baseline vertical measurements (V1) were made from the existing highest level of the socket crestal ridges to a reference point in an apicocoronal direction. Similarly, baseline horizontal measurements (H1) were made in a buccolingual direction on CBCT scans. The measurements were repeated after 3 months (V2 and H2) and 6 months (V3 and H3) using the same reference points. Difference between V3 and V1 as well as H3 and H1 was used to assess the gains in height and width of the sockets after RP. No significant difference was found in the initial baseline V1 and H1 values in MPM and non-MPM groups. Median (Mdn) V2 and H2 scores were significantly different between MPM (Mdn = 18.91) and non-MPM groups (Mdn = 27.81) after 3 months of RP (U = 37, z = -6.302, P < .001.) However, after 6 months of treatment, V3 and H3 scores were significantly different between the MPM (Mdn = 27.19) and the non-MPM group (Mdn = 37.81). MPM can be used as a valuable and predictable technique in obtaining bone fill in the maxillary and mandibular sockets with residual crestal ridges deemed necessary for RP in implant therapy.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Trasplante Óseo , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía
3.
Artículo en Inglés | MEDLINE | ID: mdl-34076631

RESUMEN

This case control study measured early crestal bone changes around subcrestally placed platform-switched implants surrounded by thin soft tissue and compared them with regular, matching-platform implants placed in a supracrestal position and surrounded by thick soft tissue. Sixty-six patients received two-piece internal hex dental implants. Control group patients (n = 33) received implants that had a horizontally matching implant-abutment connection and were placed approximately 0.5 to 1 mm supracrestally. Test group patients (n = 33) received platform-switched implants that were placed about 1.5 mm subcrestally. Clinical examinations were conducted, intraoral radiographs were taken, and statistical analysis was performed. After 2 months, the mean bone loss was 0.2 mm (SD: 0.22 mm; range: 0.1 to 1.2 mm) in the control group and -0.69 mm (SD: 0.65 mm; range: 0 to 2.6 mm) in the test group; this difference was found to be statistically significant (P < .05). After 1 year, mean bone loss was 0.28 mm (SD: 0.36 mm; range: 0.1 to 1.63 mm) in the control group and -0.6 mm (SD: 0.55 mm; range: 0.05 to 1.8 mm) in the test group. Platform-switched implants placed in a subcrestal position in vertically thin soft tissues showed statistically significantly more bone loss than non-platform-switched implants placed supracrestally with vertically thick tissues.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Huesos , Estudios de Casos y Controles , Implantación Dental Endoósea , Humanos
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 591-597, 2021 Jun 09.
Artículo en Chino | MEDLINE | ID: mdl-34098677

RESUMEN

Periodontitis is a common chronic infectious oral disease, which is characterized by gingival inflammation,pocket formation, alveolar bone loss and tooth mobility. Psoriasis is a common chronic inflammatory skin disease, whose pathological features in skin lesions are excessive proliferation of epidermal cells, parakeratosis of the derma, and the infiltration of inflammatory cells. Both periodontitis and psoriasis are closely related to the interleukin(IL)-23/helper T cell 17(Th17)/IL-17 axis in their immunopathological mechanisms. The risk factors of psoriasis include smoking, vitamin D deficiency, obesity, emotional stress, etc, of which most factors are also common risk factors of periodontitis. The present article reviews the research advances in the interaction of the two diseases and their possible common mechanisms from three aspects, i.e. clinical study, IL-23/Th17/IL-17 pathway and common risk factors, which may be helpful to provide new ideas for clinical diagnosis and treatment.


Asunto(s)
Pérdida de Hueso Alveolar , Periodontitis , Psoriasis , Humanos , Interleucinas , Células Th17
5.
Int J Oral Maxillofac Implants ; 36(3): 561-568, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34115072

RESUMEN

PURPOSE: To evaluate the clinical outcomes of unsplinted implant-supported single crowns placed in adolescents, ages 10 to 19 years, and followed up from 5 to 15 years. MATERIALS AND METHODS: This retrospective case series evaluated the outcomes of implant-supported single crowns placed in adolescents between June 2002 and January 2015. The patients were treated with locking-taper connection implants under a two-stage rehabilitation technique. The variables assessed included patient identification, age and reason for implant placement, implant dimensions, follow-up time, status at follow-up, and event description. To analyze peri-implant changes, bone crest level relative to the adjacent tooth was measured from periapical radiographs taken after implantation and the latest follow-up. A paired t test was performed to determine initial and follow-up differences, and data are shown as mean and 95% confidence interval. Cumulative Kaplan-Meier survival rates for implants and prostheses were calculated. RESULTS: Twenty-one adolescent patients with ages ranging from 14 to 19 years, mainly 16 to 18 years, received a total of 37 implant-supported single crowns more frequently placed in the anterior maxilla as a result of congenital aplasia and trauma. Mean changes in bone crests were 1.99 (± 0.4) mm at the day of crown insertion and 2.23 (± 0.4) mm at the latest follow-up (average: 10 years; P = .08). No implant was lost during the follow-up period, leading to 100% implant survival. A total of 34 surviving crowns and 3 crown failures at the time of the latest follow-up led to a cumulative survival rate of 70%. The most commonly observed event was loss of proximal contacts and infraocclusion, which were handled chairside by adding resin composite. CONCLUSION: Unsplinted implant-supported single crowns placed in adolescents showed high implant and prosthesis survival rates, with a mean bone crest level increase of approximately 0.23 mm relative to the adjacent teeth.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales de Diente Único , Implantes Dentales , Adolescente , Adulto , Niño , Coronas , Implantación Dental Endoósea/efectos adversos , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Estudios Retrospectivos , Adulto Joven
6.
Int J Oral Maxillofac Implants ; 36(3): 574-580, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34115074

RESUMEN

PURPOSE: To evaluate marginal bone level changes over 3 years around platform-shifting implants with internal conical connections, and to identify the factors relating to bone level changes. MATERIALS AND METHODS: Systemically healthy patients who lost one tooth or two consecutive teeth were enrolled in the study. The subjects received one or two implants with platform-shifting and internal conical connections in healed bone in a submerged manner. Digital standardized periapical radiographs were obtained at the time of implant placement, at prosthesis delivery, at 1 year, and at 3 years after the definitive restorations. Marginal bone level changes were measured at the mesial and distal aspects of each implant. Spearman correlation coefficients were calculated to examine the correlation between marginal bone level changes and clinical factors (age, vertical mucosal thickness, implant length and diameter, insertion torque value, and vertical implant position). RESULTS: Twenty-five patients with 30 implants (8 men and 17 women, mean age: 61.24 ± 13.18 years) were followed up to 3 years after the definitive restorations. The implant survival rate was 100%, and no remarkable complications were found. Mean peri-implant marginal bone level changes were -0.41 ± 0.61 mm (from placement to prosthesis delivery: C1); -0.08 ± 0.54 mm (from prosthesis delivery to 1 year: C2); -0.04 ± 0.95 mm (from prosthesis delivery to 3 years: C3); and 0.04 ± 0.60 mm (from 1 year to 3 years: C4), respectively. Statistically significant differences in bone level changes were observed between C1 and C3, and C1 and C4. Significant correlations of marginal bone level changes with implant diameter in C1 and with vertical implant position in C2 and C3 were observed. CONCLUSION: Within the limitations of this study, platform-shifting implants with internal conical connections appeared to prevent marginal bone resorption, especially after delivery of definitive prostheses, although marginal bone resorption attributed to the reestablishment of biologic width following subcrestal placement might be unavoidable.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Torque
7.
Int J Oral Implantol (Berl) ; 14(2): 141-154, 2021 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-34006078

RESUMEN

PURPOSE: To investigate the effect of laser microtextured collars or laser microtextured abutments on clinical measures that may relate to improved implant success and survival. MATERIALS AND METHODS: This review was registered on the PROSPERO database and conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. MEDLINE (via PubMed) and Embase were screened for studies with at least 10 participants and followed up for at least 1 year, reporting on the following clinical outcomes: radiographic marginal bone level, peri-implant probing depth, soft tissue index and failure rates of implants with laser microtextured collars or laser microtextured abutments. The quality of the studies was assessed using the Cochrane risk-of-bias tool or the Newcastle-Ottawa scale. RESULTS: After removal of duplicates, 86 articles were identified. A total of 25 articles were included after screening. Four were randomised controlled trials, two were non-randomised controlled trials, two were prospective studies, five were retrospective cohort studies and twelve had no control group. Most comparative studies reported that laser microtextured collar implants had less marginal bone loss and shallower peri-implant probing depth than machined collar implants. Only two studies had controls other than machined collar implants; in these, the use of laser microtextured collar implants was not observed to be significantly different. Three studies reported reduced marginal recession in laser microtextured collar implants when compared to machined collar controls. No difference in failure rate was observed between laser microtextured collar and machined collar implants. One study reported on peri-implant diseases and favoured laser microtextured collar implants. Three papers reported using laser microtextured abutments with no control, but no specific conclusions could be drawn. CONCLUSIONS: Laser microtextured collar implants appear to reduce marginal bone loss and peri-implant probing depth when compared to machined collar implants. There is weak evidence to suggest that laser microtextured collar implants may also improve aesthetic outcomes and reduce incidence of disease. Research is required regarding laser microtextured abutments, and studies comparing laser microtexturing with alternative solutions are also lacking.Conflict-of-interest statement: The authors declare there are no conflicts of interest related to this study.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/epidemiología , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Estética Dental , Humanos , Rayos Láser , Estudios Prospectivos , Estudios Retrospectivos
8.
Bull Tokyo Dent Coll ; 62(2): 107-117, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-33994421

RESUMEN

This report describes a case of generalized chronic periodontitis requiring periodontal regenerative therapy. The patient was a 62-year-old man who presented with the chief complaint of gingival swelling in the molar region. An initial examination revealed that 31.6% of sites had a probing depth of ≥4 mm and 18.5% bleeding on probing. Radiographic examination revealed vertical bone resorption in #14, 25, 26, 27, 32, 37, 45, and 47, and horizontal resorption in other regions. Based on a clinical diagnosis of moderate chronic periodontitis, initial periodontal therapy consisting of plaque control and scaling and root planing was performed. Occlusal adjustment of premature contact sites was performed after inflammation was suppressed. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using recombinant human fibroblast growth factor (rhFGF)-2 was performed on #14, 25, 26, 32, and 37. Combination therapy with rhFGF-2 and deproteinized bovine bone mineral (DBBM) was performed on #45 and 47. Other sites with residual periodontal pockets were treated by open flap debridement, and #27 was extracted due to a bone defect exceeding the root apex. Progress was then reevaluated and the patient placed on supportive periodontal therapy. Periodontal regenerative therapy using rhFGF-2 in combination with DBBM resulted in an improvement in clinical parameters and vertical bone resorption. This improvement has been adequately maintained over an 18-month period. The periodontal treatment provided resulted in a marked improvement in the patient's oral health-related quality of life.


Asunto(s)
Pérdida de Hueso Alveolar , Periodontitis Crónica , Pérdida de Hueso Alveolar/cirugía , Animales , Bovinos , Periodontitis Crónica/cirugía , Factor 2 de Crecimiento de Fibroblastos/uso terapéutico , Estudios de Seguimiento , Regeneración Tisular Guiada Periodontal , Humanos , Masculino , Persona de Mediana Edad , Minerales , Pérdida de la Inserción Periodontal , Calidad de Vida , Resultado del Tratamiento
9.
Bull Tokyo Dent Coll ; 62(2): 127-134, 2021 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-33994424

RESUMEN

We report a case of generalized chronic periodontitis requiring periodontal regenerative therapy. The patient was a 53-year-old woman who presented with the chief complaint of gingival swelling. An initial examination revealed 31.5% of sites with a probing depth of ≥4 mm and 46.3% with bleeding on probing. Radiographic examination showed vertical bone resorption in tooth #33. Horizontal adsorption was also observed in other areas. Based on a clinical diagnosis of severe generalized chronic periodontitis, initial periodontal therapy consisting of plaque control, scaling and root planing, occlusal adjustment, caries treatment, and splint placement was performed. After re-evaluation, surgical periodontal treatment was performed at selected sites. Periodontal regeneration therapy with recombinant human fibroblast growth factor (rhFGF)-2 was performed at #33. Two other sites (#14, 15), which had residual periodontal pockets, were treated by open-flap debridement. After re-evaluation, the patient was placed on a maintenance program. Periodontal regenerative therapy with rhFGF-2 resulted in an improvement in angular bone resorption, which has been properly maintained for 2 years. Continued care is needed to maintain stable periodontal conditions.


Asunto(s)
Pérdida de Hueso Alveolar , Periodontitis Crónica , Proteínas del Esmalte Dental , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Periodontitis Crónica/tratamiento farmacológico , Periodontitis Crónica/cirugía , Raspado Dental , Femenino , Factor 2 de Crecimiento de Fibroblastos/uso terapéutico , Estudios de Seguimiento , Regeneración Tisular Guiada Periodontal , Humanos , Persona de Mediana Edad , Pérdida de la Inserción Periodontal , Resultado del Tratamiento
10.
Am J Case Rep ; 22: e930529, 2021 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-34024900

RESUMEN

BACKGROUND Dental extraction is the only treatment option for terminal stage periodontal disease. Remnants of the pathological periodontal tissue can still be present after the extraction. Periodontal flap surgery contributes to achieving a better regeneration process at the extraction site. This case report includes a unique unconventional approach to periodontal therapy, not commonly reported in the literature. CASE REPORT A 37-year-old man reported mobility and migration of the teeth in both jaws and was referred to the Periodontology Department of the University of Prishtina Dentistry School. The patient had no personal history of any current systemic condition or family history of similar gum conditions. After a clinical and radiographic evaluation (periodontal probing depth and gingival index), most of the front teeth of both jaws were diagnosed with terminal stage periodontal disease (stage 4, grade C). Modified Widman flap periodontal surgery was conducted on the maxilla and mandible to extract most of the front teeth. The sites of tooth extraction underwent profound debridement to remove the pathological soft tissues and sharp bone extrusions. The 4 postoperative follow-up visits at 1, 4, 8, and 10 weeks showed sufficient restitution of the wounds. He received temporary mobile prostheses for the areas with multiple extractions. After 10 weeks, he began treatment for a fixed prosthetic bridge. He had a satisfactory recovery and was followed up over 3 annual visits after his surgery. CONCLUSIONS Multiple extractions can be considered as a treatment option for terminal stage periodontitis.


Asunto(s)
Pérdida de Hueso Alveolar , Periodontitis , Adulto , Estudios de Seguimiento , Humanos , Masculino , Colgajos Quirúrgicos
11.
Artículo en Inglés | MEDLINE | ID: mdl-33819328

RESUMEN

A postextraction socket is always open to different treatment possibilities. A straightforward clinical classification may help evaluate which surgical approach is best suited for the case being treated. Four different classes are defined on the basis of the local anatomy of the site, available bone volume, and soft tissue level. For every clinical situation, either immediate placement, early placement, alveolar ridge preservation, or staged approach can be selected as a treatment modality according to the classifications listed.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Proceso Alveolar/cirugía , Atención Odontológica , Humanos , Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía
12.
Artículo en Inglés | MEDLINE | ID: mdl-33819334

RESUMEN

The efficacy of the socket preservation procedure using deproteinized bovine bone mineral, bioabsorbable collagen membrane, and collagen sponge on molar extraction sites with severe periodontitis was assessed at 6 postoperative months, before implant placement. Results revealed excellent soft tissue healing without loss of keratinized tissue and no statistically significant differences in socket marginal bone changes in 20 molar extraction sockets. High levels of primary implant stability were recorded. Socket preservation using a minimally invasive surgical technique provides good soft and hard tissue healing as well as anticipated stability of implant placement at sites of extracted molars with severe periodontitis.


Asunto(s)
Pérdida de Hueso Alveolar , Periodontitis , Pérdida de Hueso Alveolar/prevención & control , Pérdida de Hueso Alveolar/cirugía , Animales , Bovinos , Humanos , Diente Molar/cirugía , Periodontitis/cirugía , Extracción Dental , Alveolo Dental/cirugía
13.
Artículo en Inglés | MEDLINE | ID: mdl-33819335

RESUMEN

This study aimed to evaluate facial peri-implant tissue dimensions for implants connected to either convex or concave final abutments. Patients (n = 28) were randomly allocated to receive a single implant with an abutment of either convex (Group CX) or concave (Group CV) emergence shape. Twelve months after implant placement, CBCT scans were taken and reference points were identified: first visible bone-to-implant contact, implant shoulder (IS), bone crest (BC), and marginal mucosal level (MML). Mucosal thickness was evaluated at the level of IS (MT1), above the level of BC (MT2), and at the mid-distance of BC-MML (MT3). The mean total vertical peri-implant mucosa height was 3.26 ± 0.77 mm for Group CX and 3.70 ± 0.99 mm for Group CV (P = .23). The mean vertical peri-implant mucosa height below the bone crest was 0.62 ± 0.57 mm for Group CX and 1.26 ± 0.95 mm for Group CV (P = .04). Group CV had greater mean MT2 (4.09 ± 0.72 mm vs 3.36 ± 0.81 mm; P = .02) and MT3 (2.81 ± 0.66 mm vs 2.03 ± 0.60 mm; P = .005) compared to Group CX. Abutment macrodesign may have an effect on vertical and horizontal peri-implant tissue dimensions.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Tomografía Computarizada de Haz Cónico Espiral , Coronas , Pilares Dentales , Implantación Dental Endoósea , Humanos , Membrana Mucosa
14.
BMC Oral Health ; 21(1): 219, 2021 04 29.
Artículo en Inglés | MEDLINE | ID: mdl-33926447

RESUMEN

BACKGROUND: Beta-tricalcium phosphate in regenerative surgery has shown promising results in terms of bone gain and new vital bone formation; however, several studies have contradicted this finding. The aim of this study was to evaluate the effectiveness of beta-tricalcium phosphate compared to other grafting materials in the regeneration of periodontal infra-bony defects. METHODS: Electronic database (Cochrane, MEDLINE, PubMed, Embase, Science Citation Index Expanded) and manual searches for related data were performed up until March 2020. The outcomes were pocket depth reduction, clinical attachment level gain, and amount of bone fill. RESULTS: Five studies were selected based on the inclusion criteria. Bone regeneration with beta-tricalcium phosphate was observed to be superior to that with debridement alone but showed comparable results to other bone graft materials in terms of pocket depth reduction, clinical attachment level gain, and bone fill. Regenerative procedures for periodontal infra-bony defects that used beta-tricalcium phosphate in combination with other growth factors yielded superior outcomes. The meta-analysis revealed that for cases with two-wall defects, the use of beta-tricalcium phosphate yielded statistically significant differences in pocket depth reduction and clinical attachment level gain, but not in bone fill. CONCLUSIONS: Beta-tricalcium phosphate appears to be a promising material for use in periodontal infra-bony defect regeneration around natural teeth. However, randomized clinical trials with larger sample sizes and more controlled study designs are needed to support these findings.


Asunto(s)
Pérdida de Hueso Alveolar , Sustitutos de Huesos , Pérdida de Hueso Alveolar/cirugía , Regeneración Ósea , Sustitutos de Huesos/uso terapéutico , Fosfatos de Calcio/uso terapéutico , Regeneración Tisular Guiada Periodontal , Humanos , Pérdida de la Inserción Periodontal/cirugía , Resultado del Tratamiento
15.
BMC Oral Health ; 21(1): 171, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33794841

RESUMEN

BACKGROUND: This study assessed retrospectively the clinical outcomes of single implant-supported crowns and implant-supported fixed dental prostheses (FDPs). METHODS: This case series compared biological and technical complications in single implant-supported crowns and implant-supported bridges in a time framed sample of all patients who received dental implants between 2009 and 2016 in Dubai Health Authority. Only 3-unit implant-supported prostheses (FDPs) with one intervening pontic and an implant each end were included for comparison to single crown supported implants. Cantilevered implants, implant-supported dentures and cases involving bone grafts or sinus lifts were excluded. The primary outcome measure was marginal bone loss, measured on digital radiographs taken after prosthesis placement at baseline and one year after implant loading, whilst peri-implantitis and technical complications were secondary outcomes. Mixed regression models adjusted for clustering of implants within patients was used for patient and implant factor associations. RESULTS: A total of 454 patients (152 males; 302 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than females (49.3 years, SD 12.9, p < 0.001). Mean mesial bone loss on the FDPs was significantly greater at 1 year (1.14 mm, SD 0.63) compared with the mesial surface of single implant-supported crowns (0.30 mm, SD 0.43, p < 0.001). Mean distal bone loss was also significantly greater at 1 year on the distal surfaces of implants supporting bridgework (1.29 mm, SD 0.71) compared with distal surfaces on single implant-supported crowns (0.36 mm, SD 0.54, p < 0.001). Mean marginal bone loss mesially and distally around implants placed in the lower anterior sextant was significantly greater compared to all other sites (p < 0.001). Bone loss by gender, patient's age and medical condition was not different between the 2 implant groups. Screw loosening was the main technical complication (11.5%) whilst peri-implantitis occurred rarely (0.5%). The 66 cement retained implants had significantly more complications compared to the 1607 screw retained implants (p < 0.001). CONCLUSIONS: Mean marginal bone loss around the supporting implants of FDPs (3-unit fixed bridgework) was greater than on single implant-supported crowns at one year after implant loading. Position in the mouth was associated with bone loss. Biological and technical complications occurred rarely.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Coronas , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Dentadura Parcial Fija , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
16.
Int J Mol Sci ; 22(5)2021 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-33803323

RESUMEN

Periodontitis is the inflammatory destruction of the tooth-surrounding and -supporting tissue, resulting at worst in tooth loss. Another locally aggressive disease of the oral cavity is tooth resorption (TR). This is associated with the destruction of the dental mineralized tissue. However, the underlying pathomechanisms remain unknown. The complement system, as well as mast cells (MCs), are known to be involved in osteoclastogenesis and bone loss. The complement factors C3 and C5 were previously identified as key players in periodontal disease. Therefore, we hypothesize that complement factors and MCs might play a role in alveolar bone and tooth resorption. To investigate this, we used the cat as a model because of the naturally occurring high prevalence of both these disorders in this species. Teeth, gingiva samples and serum were collected from domestic cats, which had an appointment for dental treatment under anesthesia, as well as from healthy cats. Histological analyses, immunohistochemical staining and the CH-50 and AH-50 assays revealed increased numbers of osteoclasts and MCs, as well as complement activity in cats with TR. Calcifications score in the gingiva was highest in animals that suffer from TR. This indicates that MCs and the complement system are involved in the destruction of the mineralized tissue in this condition.


Asunto(s)
Pérdida de Hueso Alveolar/metabolismo , Complemento C3/metabolismo , Complemento C5/metabolismo , Mastocitos/metabolismo , Periodontitis/metabolismo , Resorción Dentaria/metabolismo , Pérdida de Hueso Alveolar/patología , Animales , Gatos , Mastocitos/patología , Osteoclastos/metabolismo , Osteoclastos/patología , Periodontitis/patología , Resorción Dentaria/patología
17.
Sensors (Basel) ; 21(6)2021 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-33809165

RESUMEN

Resolution plays an essential role in oral imaging for periodontal disease assessment. Nevertheless, due to limitations in acquisition tools, a considerable number of oral examinations have low resolution, making the evaluation of this kind of lesion difficult. Recently, the use of deep-learning methods for image resolution improvement has seen an increase in the literature. In this work, we performed two studies to evaluate the effects of using different resolution improvement methods (nearest, bilinear, bicubic, Lanczos, SRCNN, and SRGAN). In the first one, specialized dentists visually analyzed the quality of images treated with these techniques. In the second study, we used those methods as different pre-processing steps for inputs of convolutional neural network (CNN) classifiers (Inception and ResNet) and evaluated whether this process leads to better results. The deep-learning methods lead to a substantial improvement in the visual quality of images but do not necessarily promote better classifier performance.


Asunto(s)
Pérdida de Hueso Alveolar , Aprendizaje Profundo , Diagnóstico por Imagen , Humanos , Procesamiento de Imagen Asistido por Computador , Redes Neurales de la Computación
18.
BMC Oral Health ; 21(1): 214, 2021 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-33906655

RESUMEN

BACKGROUND: The influence of different hypoglycemic agents on peri-implant variables among type 2 diabetes mellitus patients is still unclear. Therefore, the aim of this study was to assess the radiographic marginal bone loss and clinical parameters around implants in patients using different hypoglycemic agents. METHODS: In this retrospective cohort study, the dental implant records of type 2 diabetes mellitus patients who met the inclusion criteria were collected. The patients using only single medication as follows: insulin, metformin, or glucagon-like peptide-1 (GLP-1) drugs, were grouped according to their medication. These patients received implant placement with the same initial status, and all the prosthesis restorations were cement-retained ceramic crowns. The peri-implant marginal bone levels were evaluated by periapical radiographs immediately after implant placement and at 1 and 2-year follow-up visits. The baseline characteristics were compared among groups. The peri-implant radiographic marginal bone loss and clinical parameters were preliminarily compared using the Kruskal-Wallis test, and then the covariates were controlled by covariance analysis. Bonferroni post hoc adjustment test was performed for the multiple comparisons. RESULTS: After a review of more than 7000 medical records, a total of 150 patients with 308 implants at 1-year follow-up were assessed. The peri-implant marginal bone loss in the GLP-1 drug group was significantly smaller than the insulin group and metformin group (P < 0.01). The radiographic bone loss in the metformin group was higher than the insulin group (P < 0.05). Some of these included patients were lost to follow-up. Only 74 patients with 129 implants completed the 2-year follow-up. The radiographic bone loss in the metformin group was still higher than the insulin group (P < 0.05) and GLP-1 group (P < 0.01). There was no significant difference in the BOP (+) and the mean PD among groups (P > 0.05). CONCLUSIONS: The radiographic variables were not exactly the same among the patients with different hypoglycemic agents at both the 1 and 2-year follow-ups. After ensuring consistency in baseline characteristics, the positive effect of GLP-1 drugs on peri-implant bone remodeling may be no less than insulin or metformin. More studies are needed to verify the direct effect of these drugs on peri-implant bone. Clinical trial registration number ChiCTR2000034211 (retrospectively registered).


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Diabetes Mellitus Tipo 2 , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Coronas , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Estudios de Seguimiento , Humanos , Hipoglucemiantes/uso terapéutico , Estudios Retrospectivos , Resultado del Tratamiento
19.
Biomed Res Int ; 2021: 6685991, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33791377

RESUMEN

The possibility of platelet-rich plasma (PRP) on the improvement of bone and adjacent tissue recovery has previously been validated. However, there is insufficient data supporting the use of platelet-rich plasma to improve the healing of bone and adjacent tissues around an implant in the oral cavity. The purpose of this randomized controlled trial was to observe the effect of platelet-rich plasma (PRP) concentrate on marginal bone loss and bone density around immediate implant placement using Cone Beam Computerized Tomography (CBCT). This clinical study was conducted over a period of six months on 12 subjects, who were equally categorized into two groups. Group I was the control, whereas the subjects in Group II received PRP therapy at the surgical site. All subjects were given a standard treatment with a single implant system (DIO UFII hybrid sandblasted acid-etched implants). Inserted implants were analyzed through CBCT, and records were registered at baseline, at the 12th week before functional loading and the 26th week after functional loading. The bone loss was calculated at the proximal (mesial and distal) side of the implant and bone density at baseline, 12th week, and 26th week after implant placement. SPSS version 23.0 was used for statistical analysis of data. The changes in bone levels were measured and compared between the two groups using the Mann-Whitney U test, with no significant difference. Bone density was analyzed by an independent sample t-test, p value ≤ 0.05 was considered statistically significant. Again, no significant difference in bone density was observed between both groups at all three instances. Therefore, it can be concluded that local injection of PRP after immediate implant placement did not show any decrease in marginal bone loss or improvement in bone density. This trial is registered with NCT04650763.


Asunto(s)
Pérdida de Hueso Alveolar , Tomografía Computarizada de Haz Cónico , Carga Inmediata del Implante Dental , Plasma Rico en Plaquetas , Alveolo Dental , Cicatrización de Heridas , Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía
20.
Artículo en Inglés | MEDLINE | ID: mdl-33802261

RESUMEN

We present the preliminary results of the treatment of teeth with a deep, non-contained periodontal residual defect, vestibular bone dehiscence, and soft tissue recession, by combining an apical non-incised papilla surgical approach (NIPSA) to the defect and leukocyte platelet-rich fibrin (L-PRF) in the vestibular aspect. Four patients (upper left first premolar, upper left central incisor, upper right central incisor and upper right lateral incisor) have been treated. At one year of follow up, all cases showed a considerable reduction in the periodontal pocket depth, a gain in clinical attachment and no bleeding on probing, as well as an improvement in the marginal soft tissue minimizing soft tissue contraction (recession and/or loss of papilla) and improving soft tissue architecture. NIPSA plus L-PRF seem to improve clinical outcomes in deep non-contained intrabony defects associated with soft tissue recession.


Asunto(s)
Pérdida de Hueso Alveolar , Fibrina Rica en Plaquetas , Pérdida de Hueso Alveolar/cirugía , Regeneración Tisular Guiada Periodontal , Humanos , Leucocitos , Pérdida de la Inserción Periodontal/cirugía , Resultado del Tratamiento
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