Comparison of the success rate and marginal bone loss of implants placed simultaneously with either bone expansion or ridge splitting in maxillary sites: a prospective non-randomized study.

This study was performed to compare the amount of marginal bone loss (MBL) and the success rate of implants placed following maxillary ridge expansion with two surgical techniques. A non-randomized prospective study was designed. The patients underwent either bone expansion or ridge splitting, and simultaneous implant placement. The implants were loaded according to the delayed loading protocol with single crowns. Each study group included 35 implants placed in 31 patients. One year after loading, the implant success rate was 100 % in both groups. The median MBL was 1.00 mm in both groups (interquartile range 0.10 mm in the bone expansion group and 0.30 mm in the ridge splitting group) (no significant difference, P = 0.749). The median MBL around implants placed in sites with D2, D3, and D4 density bone was 1.40 mm, 1.00 mm, and 0.80 mm in the expansion group and 1.50 mm, 1.00 mm, and 0.85 mm in the splitting group, respectively. There was a significant difference in MBL between the different bone density types within both groups (P < 0.001). In conclusion, no significant difference in the amount of MBL or the success rate was observed between implants placed simultaneously with ridge splitting and those placed simultaneously with bone expansion, in the maxilla.

Prospective, multi-centric, international, single-arm, cohort study to assess a synthetic polyamide suture material in oral surgery to close the mucosa - MUCODA study.

OBJECTIVES: The aim was to collect different clinical parameters systematically and proactively regarding safety, effectiveness, and performance of a nylon monofilament suture under routine clinical practice for oral surgery. METHODS: The study design was prospective, bicentric, international, single-armed, and observational. A non-absorbable suture was applied to close the mucosa after different dental surgical interventions. Main objective was the incidence of combined postoperative complications until suture removal. The 95 % Confidence Interval (Agresti-Coull method) was used to prove the non-inferiority with a pre-specified upper margin of 21.9 %. Secondary variables were intraoperative suture handling, patient pain and satisfaction, wound healing, aesthetic appearance, and bacterial contamination. RESULTS: 105 patients were enrolled. Complication rate was low (1.9 %), 2 swellings occurred. Pain was present for 1.61 days ± 1.42 after various dental interventions with an average pain level of 20.98 ± 22.60 (VAS). Patients with impacted third molar extraction showed the longest pain duration (6 days) combined with the highest mean pain level of 35.33 ± 30.45 (VAS). Intraoperative suture handling was very good to excellent. Suture removal was done after an average duration of 7.56 ± 2.09 days. Patient's satisfaction was high, and an excellent wound healing was reported by the dentists. Aesthetic appearance only performed in implant patients was rated by oral surgeons with an average of 96.19 ± 3.79 points [min. 80 - max. 100] at 5 months postoperatively. Thread bacterial analysis showed that F. nucleatum was the most present species. CONCLUSIONS: Our findings indicate that the non-absorbable, nylon-based monofilament suture used is safe and quite suitable for oral mucosal closure after various dental surgical interventions such as tooth extraction, implant placement and impacted third molar extraction. CLINICAL SIGNIFICANCE: This study showed the safe use of a non-absorbable, nylon-based monofilament suture for different oral surgical interventions under daily routine clinical practice.

Volumetric changes in alveolar ridge preservation with a compromised buccal wall: a systematic review and meta-analysis.

BACKGROUND: Many studies have addressed socket preservation, though fewer publications considering buccal wall loss can be found, since the literature typically considers sockets with four walls. A systematic review was made on the influence of type II buccal bone defects, according to Elian's Classification, in socket grafting materials upon volumetric changes in width and height. MATERIAL AND METHODS: An electronic and manual literature search was conducted in accordance to PRISMA statement. The search strategy was restricted to randomized controlled trials (RCTs) and controlled clinical trials (CCTs) describing post-extraction sockets with loss of buccal wall in which alveolar ridge preservation (ARP) was carried out in the test group and spontaneous healing of the socket (SH) was considered in the control group. RESULTS: The search strategy yielded 7 studies. The meta-analysis showed an additional bone loss of 2.37 mm in width (p > 0.001) and of 1.10 mm in height (p > 0.001) in the absence of ARP. The reconstruction of the vestibular wall was not evaluated in any study. The results also showed moderate to great heterogeneity among the included studies in terms of the changes in width and height. CONCLUSIONS: Despite the heterogeneity of the included studies, the results indicate a benefit of ARP versus SH. Further studies are needed to determine the volumetric changes that occur when performing ARP in the presence of a buccal bone wall defect.

Virtual quad zygoma implant placement using cone beam computed tomography: sufficiency of malar bone volume, intraosseous implant length, and relationship to the sinus according to the degree of alveolar bone atrophy.

The objective of this study was to investigate the malar bone volume and length that a zygomatic implant can engage, and the relationship to the sinus according to the degree of alveolar bone atrophy. A three-dimensional evaluation was performed using cone beam computed tomography scans from 23 patients with a totally edentulous maxilla; quad zygoma implants were virtually placed. The predictor variable was the amount of malar bone volume and length that a zygomatic implant can engage. The primary outcome variable was the relationship to the sinus according to the degree of alveolar bone atrophy. Other variables were the residual alveolar bone height to the floor of the sinus and the nasal cavity. The mean volume of malar bone engaged in this sample of 92 zygomatic implants was 0.19±0.06cm3. The implant had an extrasinus path in 60.9% of cases, a parasinus path in 25%, and an intrasinus path in 14.1%. The results suggest that the average volume of malar bone engaged by a zygomatic implant is constant regardless of implant position and the degree of alveolar bone atrophy. As alveolar atrophy increases, the trajectory of the implant becomes more parasinus and intrasinus. The examiners were able to find enough bone to adequately distribute the implants in all cases.

Una rara complicación en la extracción del tercer molar inferior incluido. Caso clínico / A rare complication during the extraction of the included inferior third molar. Case report

Presentamos una rara complicación ocurrida tras el intento deextracción del tercer molar incluido en una consulta odontológica bajo anestesialocal. El paciente requirió ingreso en el servicio de urgencias para laextracción, de forma urgente, de la pieza a través de un abordaje cervicalbajo anestesia general e intubación nasaotraqueal por desplazamiento de lapieza hacia la fosa submandibular durante el intento de extracción ambulatoria.El paciente presentó signos evidentes de inflamación en la región submandibularcon desplazamiento de la vía aérea hacia el lado opuesto. Lascomplicaciones derivadas de la cirugía del tercer molar son, en algunos casos,mortales y pueden aparecer tras un acto quirúrgico aparentemente de bajoriesgo. Estas complicaciones han sido ampliamente descritas en la literatura.Aún así consideramos importante el presentar complicaciones poco frecuentesen la cirugía del tercer molar ya que esto nos permitirá conocerlas y ofrecerla mejor solución en cada caso(AU)

We present a rare complication that appeared after anattempt to extract the included third molar with local anaesthesiaat the odontologist office. The patient was admitted to the emergencyroom to have the tooth removed cervically under general anaesthesiaand nasotracheal tubation because of its movement towards thesubmandibular fossa during the ambulatory extraction attempt.The patient showed evident signs of swelling in submandibularregion and the airway was displaced towards the opposite side.The resulting complications from the third molar surgery are, insome cases, mortal and can occur after an apparently low risksurgery. These complications have been thoroughly described inliterature. Still, we consider it important to describe infrequentcomplications of third molar surgery because it will allow us to knowmore about them and offer the best solution in every case(AU)

Celulitis gangrenosa cervical complicada con mediastinitis. Caso clínico / Cervical necrotiziting celullitis complicated with mediastinitis. A case report

Presentamos un caso clínico de celulitis gangrenosa cervical de origen odontógeno que progresó al espacio mediastínico, comentando la importancia de un tratamiento precoz y agresivo (quirúrgico y antíbioterapia endovenosa). Discutimos la necesidad de realizar sistemáticamente traqueostomía, así como el momento de llevar a cabo la exodoncia de las piezas causantes del proceso infeccioso. (AU)