Pilot clinical study of the efficacy of a hyaluronic acid (1%) and chlorhexidine (0.20%) gel in post-extraction dentistry

Objective: The objective of the present study was to compare the efficacy, in terms of oral healing and post-surgical pain, in a group of patients treated with an oral application of 1% hyaluronic acid (HA) together with 0.20% chlorhexidine (CHX), compared to patients treated with placebo and a third group treated with HA 0.20%, CHX 0.20% + Panthenol. Method: The study design is an analytical, experimental, randomised, blind, prospective longitudinal study. A sampleof 45 patients was randomised and divided into 3 comparison groups of 15, with each group receiving a different composition gel after a dental extraction. The control group received a gel of 0.20% hyaluronic acid and 0.20% chlorhexidine; the placebo group was applied a gel of similar consistency but without the active ingredients; and the experimental group received a gel with 1% hyaluronic acid and 0.20% chlorhexidine. Efficacy variables were measured at 24, 48 and 72 hours and 7 days. Results: For post-operative pain, we found no statistically significant differences in any of the groups analysed. For healing, the group receiving 1% hyaluronic acid and 0.20% chlorhexidine had the best results from a statistical point of view in the first 24-48 hours compared to the other two groups. Conclusions: The results obtained seemed to show that topical application of 1% hyaluronic acid together with 0.20% chlorhexidine influences soft tissue healing positively after a tooth extraction; however, it does not seem to have any beneficial effects on post-operative oral pain. (AU)

Estudio clínico piloto de la eficacia de un gel de ácido hialurónico 1% y clorhexidina 0.20% postextracción dental / Pilot clinical study of the effectiveness of a post-dental extraction gel of 1% hyaluronic acid and 0.20% Chlorhexidine

OBJETIVO: El objetivo del presente estudio es comparar la eficacia, en términos de cicatrización oral y dolor postquirúrgico, en un grupo de pacientes tratados con una aplicación oral de ácido hialurónico al 1% junto con clorhexidina al 0,20% frente a pacientes tratados con placebo y un tercer grupo con CHX 0,20% + AH 0,20% + Pantenol. MÉTODO: El diseño del estudio es de un estudio analítico, experimental, aleatorizado, ciego, longitudinal prospectivo. Se randomizó una muestra de 45 pacientes, 15 en cada grupo de comparación, en los que se aplicaron postextracción dental unos geles de distinta composición en función del grupo objeto de estudio. En el grupo control se aplicó un gel de ácido hialurónico al 0,20%, clorhexidina al 0,20% y pantenol, en el grupo placebo se aplicó un gel de consistencia similar al anterior pero en ausencia de compuesto y en el grupo experimental se aplicó ácido hialurónico al 1% y clorhexidina al 0,20%. Las variables de eficacia fueron medidas a las 24h., 48h, 72h y 7 días. RESULTADOS: En relación al dolor postoperatorio no encontramos diferencias estadísticamente significativas en ninguno de los grupos analizados. En relación a la cicatrización el grupo en el que se aplicó ácido hialurónico 1% junto con clorhexidina 0,20% fue el que mejores resultados ofreció desde un punto de vista estadístico en las primeras 24-48h con respecto a los otros dos. CONCLUSIONES: En vista de los resultados obtenidos parece que las aplicaciones tópicas de ácido hialurónico al 1% junto con la clorhexidina al 0,20% influyen de manera positiva en cuanto a la cicatrización del tejido blando post extracción dental, sin embargo, no parece que tenga efectos beneficiosos en cuanto a los niveles de dolor oral post-intervención

OBJECTIVE: The objective of the present study is to compare the efficacy, in terms of oral healing and post-surgical pain, in a group of patients treated with an oral application of 1% hyaluronic acid (HA) together with 0.20% chlorhexidine (CHX), compared to patients treated with placebo and a third group treated with HA 0.20%, CHX 0.20% + Panthenol. METHOD: The study design is an analytical, experimental, randomized, blind, prospective longitudinal study. A sample of 45 patients was randomized and divided into 3 comparison groups of 15, with each group receiving a different composition gel after a dental extraction. The control group received a gel of 0.20% hyaluronic acid, 0.20% chlorhexidine; the placebo group was applied a gel of similar consistency to the previous but without active ingredients; and the experimental group received a gel with 1% hyaluronic acid and 0.20% chlorhexidine. Efficacy variables were measured at 24 hours, 48 hours, 72 hours and 7 days. RESULTS: For post-operative pain, we found no statistically significant differences in any of the groups analysed. For healing, the group receiving 1% hyaluronic acid and 0.20% chlorhexidine had the best results from a statistical point of view in the first 24-48 hours compared to the other two groups. CONCLUSIONS: The results obtained seemed to show that topical applications of 1% hyaluronic acid together with 0.20% chlorhexidine have a positive influence on the healing of soft tissue after dental extraction; however, it does not seem to have any beneficial effects in terms of post-operative oral pain

New horizons in anticoagulation: Direct oral anticoagulants and their implications in oral surgery

Background: Thrombotic disorders remain a leading cause of death in the Western World. For decades, vitamin K antagonists used in the prevention of this pathology, such as warfarin or sintrom, were the only oral agents available for long-term anticoagulation, in spite of their disadvantages. Material and Methods: An electronic database search was carried out on MedLine and The Cochrane Library Plus, without restrictions on the type of study nor dates, in English and Spanish. Abstracts were reviewed, and complete articles if necessary, considering all articles that included recommendations on DOACs and oral surgery. Results: In recent years, the so-called "new oral anticoagulants" have been introduced in clinical practice to treat those patients whose medical conditions require long-term anticoagulant treatment, replacing traditional oral anticoagulants. Conclusions: The new oral anticoagulants represent new therapeutic options, with a number of advantages such as poor interaction with food, minor drug interactions, and do not require periodic dose adjustments or routine controls. The purpose of this review is to establish an update on the new oral anticoagulants: Dabigatran, Rivarozaban, Apixaban and Edoxaban (AU)

No disponible

Manejo de tejidos blandos en regeneración/reconstrucción ósea mediante la técnica quirúrgica ‘Double Flap Incision Technique modificada’. Técnica de preservación del periostio / Oral surgery management of soft tissues with a new ‘Double Flap Incision Technique’ A periosteal preservation technique

Introducción: Las técnicas implantológicas demandan la existencia de unas estructuras óseas adecuadas en calidad y cantidad para alojar las fijaciones oseointegradas de un modo predecible. En ocasiones, el sustrato óseo es insuficiente, por lo que son necesarias técnicas de reconstrucción/regeneración ósea que precisan de un cierre primario completo para asegurarnos que los fenómenos que conducirán a la formación de nuevo tejido óseo se sucedan. El objetivo de este estudio es mostrar una serie de ocho casos clínicos donde la ‘Double Flap Incision Technique modificada’ nos sirve para reconstruir zonas de defecto óseo en la región mandibular posterior que limitaban la colocación de fijaciones oseointegradas. Métodos: Se realiza un estudio prospectivo de ocho casos clínicos procedentes de nuestra práctica privada, con déficit óseo en la zona posterior mandibular en pacientes demandantes de un tratamiento rehabilitador con prótesis fija implantosoportada. En todos los casos se utilizó la denominada ‘Double Flap Incision Technique modificada’ (DFITm). Resultados: En todos los casos conseguimos un cierre primario completo a los 15 días y fue posible la colocación de los implantes en la zona regenerada con criterio protésicamente guiado. Conclusión: La técnica de doble colgajo ‘Double Flap Incision Technique modificada’ nos permite llevar a cabo un adecuado cierre primario sin tensión en casos que requieran una reconstrucción o regeneración ósea, evitando la aparición de dehiscencias que conllevarían al fracaso del tratamiento (AU)

Introduction: Dental implants’ techniques needed to appropiate high-quality bones structures which can support osteointegration bindings in a predictable way. Occasionally, bone substrate is not the suitable one, it is for that reason that we need bone reconstruction and regeneration techniques in which we have to make a complete wound healing in order to guarantee bone regeneration in a correct way. The aim of this article is to comment eight case reports in which we used ‘Double flap incision technique’ to repair bone loss in posterior mandibular region. Methods: We have carried out a pilot study in about eight cases reports whose patients had bone loss in posterior mandibular region and treated with a dental implants’ repair treatment. ‘New Double Flap Incision Technique’ was used in all the cases we report. Results: We obtained an appropiate and complete wound healing in 15 days. In addition, dental implants were positionated in regenerated region correctly in all cases. Conclusion: This ‘New Double Flap Incision Technique’ provide us a way to obtain complete wound healing with no strain in cases which needed bone regeneration or reconstruction, avoid the presence of dehiscences which fail the treatment (AU)

Implantes cigomáticos: una puesta al día / Zygomatic implants: an up-to-datepatient

Un maxilar con reabsorción ósea moderada o severa representa un reto para la implantología contemporánea. El tratamiento convencional con implantes no puede ser realizado en situaciones de pérdida ósea avanzada, ni en situaciones que impliquen proximidad del seno maxilar al lugar de la intervención, dado que no hay suficiente hueso para anclar los implantes sin la realización de técnicas de regeneración ósea. El objetivo de este trabajo es estudiar la viabilidad de los implantes cigomáticos como alternativa a las técnicas de regeneración ósea, así como la técnica quirúrgica y sus variantes, complicaciones y la supervivencia. La evaluación clínica indica un alto índice de supervivencia. Los resultados sugieren que la rehabilitación sobre implantes cigomáticos en grandes atrofias maxilares es segura y predecible, siendo una excelente alternativa a los injertos óseos. Por este motivo los implantes cigomáticos constituyen un posible nuevo ‘Gold Standard’ para el manejo de la reabsorción ósea avanzada (AU)

The severely atrophic maxilla represents a challenge for the contemporaneous implantology. Conventional treatment using dental implants cannot be performed in situations where there is an advanced bone loss, neither in situations, involving extensive maxillary sinuses which lead to inadequate amount of bone tissue for the anchorage of implants without the performance of bone grafting techniques. The aim of this paper is to study the viability of the use of zygomatic implants as an alternative to bone augmentation procedures. A revision of surgical techniques, variations, complications and survival is included. Clinical assessment indicates a high survival rate. The reviewed results suggest that oral rehabilitation using zygomatic implants, in severely atrophic maxillas is a safe and predictable procedure. Being an excellent alternative to bone augmentation techniques, the use of zygomatic implants represents a possible new Gold Standard in the treatment of advanced bone resorption (AU)