Effect of undersized drilling on the stability of immediate tapered implants in the anterior maxillary sector. A randomized clinical trial / Efecto de una perforación de tamaño insuficiente sobre la estabilidad de los implantes cónicos inmediatos en el sector anterior del maxilar. Un ensayo clínico aleatorizado

Background: To evaluate the effect of undersized drilling on the primary and secondary stability of immediateimplants placed in the anterior maxilla.Material and methods: A comparative randomized clinical trial was carried out in 30 healthy adults. Thirty ta-pered implants, 16 involving conventional drilling and 14 undersized drilling, were placed immediately afteranterior maxillary tooth removal. Insertion torque and implant stability assessed by resonance frequency analysis(RFA) were evaluated at three different timepoints: at implant placement and 6 and 12 weeks post-implantation.The results were compared using parametric statistical tests.Results: All implants showed adequate stability during follow-up. At implant placement, the undersized drillinggroup exhibited greater insertion torque values than the conventional drilling group, but stability assessed by RFAshowed greater mean values in the conventional group. After 6 and 12 weeks of follow-up, both groups showedimproved stability, though the RFA values remained comparatively higher in the conventional group. The differ-ences were not statistically significant.Conclusions: Based on the results obtained, undersized drilling does not appear to afford significantly improvedstability of immediate implants placed in the anterior zone of the maxilla during the osseointegration period.(AU)

Dimensiones de la cresta ósea vestibular en incisivos maxilares con indicación de implantes inmediatos. Un estudio transversal y sus implicaciones en el plan de tratamiento / Dimensions of facial bone ridge in maxillary incisors with immediate implants indication. A cross-sectional study and treatment plan implications

RESUMEN: Objetivo: Determinar las dimensiones de la cresta ósea vestibular de los incisivos maxilares con indicación de implantación inmediata. Pacientes y método: Un estudio transversal fue realizado en pacientes con necesidad de colocación de implantes inmediatos unitarios en la zona incisiva superior, durante el periodo de Enero-2015 a Diciembre-2017. Cortes tomográficos sagítales fueron utilizados para determinar la altura y el grosor de la cresta ósea alveolar vestibular. El punto de medición del grosor fue localizado a 4 mm apical a la linea amelocementaria. Un análisis T-student, fue utilizado para comparar las variables según la edad, el género y el grupo dentario, con un intervalo de confianza de 95%. Resultados: 298 imágenes fueron incluidas en la evaluación. El promedio de altura fue 10,68 mm, no hubo diferencias al comparar los grupos. El grosor promedio fue de 0,73 mm, diferencias de grosor, estadísticamente significativas, fueron observadas al comparar la edad y el género, no así en el grupo dentarlo. Conclusiones: La altura del hueso alveolar vestibular de incisivos superiores es suficiente para colocar implantes inmediatos dentro de un marco óseo. No obstante, el grosor observado, se traduciría en la necesidad de complementar la implantación con técnicas de regeneraciónn tisular guiada.

ABSTRACT: Objective : Determine the dimensions of the facial bone ridge of the maxillary incisors with indication of immediate implantation. Patients and method: A cross-sectional study was carried out in patients in need of single immediate implant placement in the upper incisor area, during the period from January-2015 to December-2017. Sagittal tomographic sections were used to determine the height and thickness of the vestibular alveolar bone ridge. The thickness measurement point was located 4 mm apical to the amelocementary junction. A T-student analysis was used to compare the variables according to age, gender, and dental group, with a 95% confidence interval. Results: 298 images were included in the evaluation. The mean height was 10.68 mm, there were no differences when comparing the groups. The mean thickness was 0.73 mm, statistically significant differences in thickness were observed when comparing age and gender, but not in the dental group. Conclusions: The height of the vestibular alveolar bone of the upper incisors could be sufficient to place immediate implants within a bone framework. However, the thickness observed would result in the need to complement the implantation with guided tissue regeneration techniques.

Primary Apical Stability of Tapered Implants Through Reduction of Final Drilling Dimensions in Different Bone Density Models: A Biomechanical Study.

PURPOSE: A biomechanical study of the primary apical stability obtained in tapered implants through the reduction of final drilling dimensions in different bone density models. MATERIAL AND METHODS: An in vitro study of maximum insertion torque and primary stability based on the resonance frequency analysis (RFA) of 24 conical implants measuring 13 mm in length and 3.75 and 4.20 mm in diameter, randomly inserted in 10-mm sockets prepared in 4 polyurethane blocks with a density of 15, 20, 30, and 40 pounds per cu ft, respectively, reducing the diameter of the final drill at constant speed (400 rpm) to obtain exclusive 4 mm anchoring of the apical third of each implant. RESULTS: The decrease in drilling diameter resulted in an increase in the insertion torque and implant stability quotient (ISQ) values in all implants, although without reaching statistical significance. In turn, a significant direct correlation was found between increasing bone analog block density and the insertion torque and ISQ values. CONCLUSIONS: Under the conditions of this study, the primary apical stability obtained may be more dependent on bone density than on reduction of the final drilling diameter.

Thermal increment due to ErCr: YSGG and CO2 laser irradiation of different implant surfaces. A pilot study

Objective: An evaluation and comparison is made of the thermal increment at different implant surfaces during irradiation with CO2 and ErCr:YSGG lasers.Study design: Five threaded and impacted implants with four types of surfaces were inserted in an adult pig rib:two implants with a hydroxyapatite surface (HA)(impacted and threaded, respectively), a machined titanium surface implant (TI mach), a titanium plasma spray surface implant (TPS), and a sandblasted, acid-etched surface implant (SBAE). A 0.5-mm diameter bone defect was made in the implant apical zone, and a type-K thermocouple(Termopar)® was placed in contact with the implant. The implants were irradiated in the coronal zone of each implant with a CO2 (4 W continuous mode) and an ErCr:YSGG laser (1.5 W, pulsed mode) first without and then with refrigeration. The temperature variations at the implant apical surface were recorded. Results: An apical temperature increase was recorded in all cases during CO2 and ErCr:YSGG laser irradiation without refrigeration. However, when the ErCr:YSGG was used with a water spray, a decrease in temperature was observed in all implants. The acid-etched and sandblasted surfaces were those most affected by the thermal changes.Conclusions: The ErCr:YSGG laser with a water spray applied to the sealing cap or coronal zone of the implants does not generate thermal increments in the apical surface capable of adversely affecting osseo integration and the integrity of the peri-implant bone tissue (AU)

No disponible

Thermal increment due to ErCr:YSGG and CO2 laser irradiation of different implant surfaces. A pilot study.

OBJECTIVE: An evaluation and comparison is made of the thermal increment at different implant surfaces during irradiation with CO2 and ErCr:YSGG lasers. STUDY DESIGN: Five threaded and impacted implants with four types of surfaces were inserted in an adult pig rib: two implants with a hydroxyapatite surface (HA) (impacted and threaded, respectively), a machined titanium surface implant (TI mach), a titanium plasma spray surface implant (TPS), and a sandblasted, acid-etched surface implant (SBAE). A 0.5-mm diameter bone defect was made in the implant apical zone, and a type-K thermocouple (Termopar) was placed in contact with the implant. The implants were irradiated in the coronal zone of each implant with a CO2 (4 W continuous mode) and an ErCr:YSGG laser (1.5 W, pulsed mode) first without and then with refrigeration. The temperature variations at the implant apical surface were recorded. RESULTS: An apical temperature increase was recorded in all cases during CO2 and ErCr:YSGG laser irradiation without refrigeration. However, when the ErCr:YSGG was used with a water spray, a decrease in temperature was observed in all implants. The acid-etched and sandblasted surfaces were those most affected by the thermal changes. CONCLUSIONS: The ErCr:YSGG laser with a water spray applied to the sealing cap or coronal zone of the implants does not generate thermal increments in the apical surface capable of adversely affecting osseointegration and the integrity of the peri-implant bone tissue.

Estudio comparativo de la eficacia anestésica de la Articaína al 4% respecto a la Lidocaína al 2% en el bloqueo troncal del nervio alveolar inferior durante la extracción quirúrgica de terceros molares inferiores / Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars

Objetivo: Valorar y comparar la eficacia anestésica de la Articaína al 4% respecto a la Lidocaína al 2%, ambas con una concentración de 1:100.000 de epinefrina en el bloqueo troncal del nervio alveolar inferior durante la extracción quirúrgica de terceros molares inferiores incluidos.Diseño del estudio: Se realizó un ensayo clínico aleatorio a doble ciego en una muestra de 30 pacientes programados para las extracciones quirúrgicas bilaterales de terceros molares inferiores simétricos en el Servicio de Cirugía Bucal del Máster de Cirugía e Implantología Bucal de la Universidad de Barcelona. Previo consentimiento del paciente, dos operadores efectuaron las intervenciones quirúrgicas de forma extemporánea, utilizando como anestésico local la Articaína al 4% o la Lidocaína al 2 % con la misma concentración de vasoconstrictor (epinefrina 1:100.000). Las variables estudiadas para cada anestésico fueron: tiempo de latencia (o de inicio del efecto anestésico), duración del efecto anestésico, cantidad de solución anestésica utilizada y la necesidad de reanestesiar la zona operatoria. Se utilizó una escala analógica visual para valorar la cantidad de dolor experimentado durante el acto quirúrgico y, así, evaluar subjetivamente la profundidad anestésica de las dos soluciones.Resultados: Se observaron diferencias estadísticamente significativas (p= .003) en cuanto a la duración del efecto anestésico,que fue mayor para la artcaína al 4% (220,8 minutos), respecto a la lidocaína al 2% (168,20 minutos). En las variables tiempo de latencia, cantidad de solución anestésica utilizada y necesidad de reanestesiar el campo operatorio se evidenciaron diferencias clínicas a favor de la articaína, aunque estas diferencias no fueron estadísticamente significativas.La valoración cualitativa de los anestésicos mediante la escala analógica visual mostró similitud en el dolor experimentado por los pacientes con ambos anestésicos.Conclusiones: De acuerdo con los resultados obtenidos se puede afirmar que la articaína al 4% muestra mejores característicasclínicas que la lidocaína al 2%, especialmente en cuanto al tiempo de latencia y duración del efecto anestésico. Sin embargo, no hubieron diferencias estadísticamente significativas que confirmen la superioridad de una solución respecto a la otra, al valorar la eficacia anestésica

Background: A comparative study is made of the anesthetic efficacy of 4% articaine versus 2% lidocaine, both with epinephrine 1:100,000, in truncal block of the inferior alveolar nerve during the surgical extraction of impacted lower third molars.Study design: A randomized double-blind clinical trial was conducted of 30 patients programmed for the bilateral surgical extraction of symmetrical lower third molars in the context of the Master of Oral Surgery and Implantology (University of Barcelona, Barcelona, Spain). Following the obtainment of informed consent, two operators performed surgery on an extemporaneous basis, using as local anesthetic 4% articaine or 2% lidocaine with the same concentration of vasoconstrictor (epinephrine 1:100,000). The study variables for each anesthetic were: latency (time to action) and duration of anesthetic effect, the amount of anesthetic solution used, and the need of re-anesthetize the surgical zone. A visual analog scale was used to assess pain during surgery, and thus subjectively evaluate the anesthetic efficacy of the two solutions.Results: Statistically significant differences (p = 0.003) were observed in the mean duration of anesthetic effect (220.86 min. for 4% articaine vs. 168.20 min. for 2% lidocaine). Latency, the amount of anesthetic solution and the need to re-anesthetize the surgical field showed clinical differences in favor of articaine, though statistical significance was not reached. The pain scores indicated similar anesthetic efficacy with both solutions.Conclusions: The results obtained suggest that 4% articaine offers better clinical performance than 2% lidocaine, particularlyin terms of latency and duration of the anesthetic effect. However, no statistically significant differences in anesthetic efficacy were recorded between the two solutions

Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars.

BACKGROUND: A comparative study is made of the anesthetic efficacy of 4% articaine versus 2% lidocaine, both with epinephrine 1:100,000, in truncal block of the inferior alveolar nerve during the surgical extraction of impacted lower third molars. STUDY DESIGN: A randomized double-blind clinical trial was conducted of 30 patients programmed for the bilateral surgical extraction of symmetrical lower third molars in the context of the Master of Oral Surgery and Implantology (University of Barcelona, Barcelona, Spain). Following the obtainment of informed consent, two operators performed surgery on an extemporaneous basis, using as local anesthetic 4% articaine or 2% lidocaine with the same concentration of vasoconstrictor (epinephrine 1:100,000). The study variables for each anesthetic were: latency (time to action) and duration of anesthetic effect, the amount of anesthetic solution used, and the need of re-anesthetize the surgical zone. A visual analog scale was used to assess pain during surgery, and thus subjectively evaluate the anesthetic efficacy of the two solutions. RESULTS: Statistically significant differences (p = 0.003) were observed in the mean duration of anesthetic effect (220.86 min. for 4% articaine vs. 168.20 min. for 2% lidocaine). Latency, the amount of anesthetic solution and the need to re-anesthetize the surgical field showed clinical differences in favor of articaine, though statistical significance was not reached. The pain scores indicated similar anesthetic efficacy with both solutions. CONCLUSIONS: The results obtained suggest that 4% articaine offers better clinical performance than 2% lidocaine, particularly in terms of latency and duration of the anesthetic effect. However, no statistically significant differences in anesthetic efficacy were recorded between the two solutions.