Effectiveness of a toothpaste and a serum containing calcium silicate on protecting the enamel after interproximal reduction against demineralization.

To evaluate the effectiveness of a calcium silicate/phosphate fluoridated tooth paste and a serum compared with a toothpaste containing hydroxyapatite on protecting the enamel after interproximal reduction against demineralization. 3 sets of eleven incisors were created. The teeth underwent interproximal enamel reduction (IER) of 0.5 mm. Each set was allocated to one of three groups: (1) Brushing without toothpaste (control group); (2) Vitis toothpaste + Remin Pro; (3) Regenerate toothpaste + Regenerate Serum. The agents were applied three times a day and specimens subjected to demineralization cycles for 30 days. The weight percentages of calcium (Ca) and phosphorous (P) were quantified by X-ray microfluorescence spectroscopy. Surface microhardness measurements and electron scanning microscopy (SEM) observations were made. Ca data and the Ca/P ratio were significantly higher in Group 3 than the other groups (p < 0.017), while P was significantly lower in Group 3 (p < 0.017). No significant differences were found between Groups 1 and 2 (p > 0.017). Group 3 showed significantly higher microhardness values (p < 0.05) than Group 1. No significant differences were found for other comparisons between groups (p < 0.05). SEM images showed less demineralization in Group 3. The application of a calcium silicate/phosphate fluoridated tooth paste (Regenerate advance) and a dual serum (Regenerate advance enamel serum) protect the enamel with interproximal reduction against demineralization. Therefore, this treatment could be used to prevent the dissolution of hydroxyapatite after IER.

Effects of diabetes on oxidative stress, periodontal ligament fiber orientation, and matrix metalloproteinase 8 and 9 expressions during orthodontic tooth movement.

OBJECTIVES: To evaluate the influence of diabetes on oxidative stress, periodontal ligament (PDL) orientation, and matrix metalloproteinase (MMP) 8 and 9 expressions during orthodontic tooth movement in a rat model. MATERIALS AND METHODS: An orthodontic appliance was placed in 60 Sprague-Dawley rats divided into three groups: normoglycemics (n = 20) and two streptozotocin-induced diabetic groups, one untreated (n = 20) and one insulin-treated (n = 20). At 24, 48, and 72 h and 1 week, rats were sacrificed. At each time point, myeloperoxidase (MPO) and malondialdehyde (MDA) were quantified by spectrophotometry, tooth movement was evaluated by micro-CT analysis, and hematoxylin and eosin staining was used to evaluate PDL fiber orientation and immunohistochemistry staining with semi-quantitative H-score analysis of MMP-8 and MMP-9 was performed.. RESULTS: At 24 h, MPO activity was significantly higher in untreated-diabetics than normoglycemics. At 24 and 48 h, the MDA level in untreated-diabetic rats was significantly higher than in normoglycemics and insulin-treated animals. At 72 h and 1 week, PDL fibers were oriented significantly more irregularly in untreated-diabetics than in normoglycemics. At all time points, MMP-8 and MMP-9 expressions were significantly higher in both diabetic groups than in the normoglycemic group. After the second day, tooth movement was significantly greater in untreated-diabetics than in the insulin-treated and normoglycemic groups. CONCLUSIONS: Mechanical stress in untreated-diabetic rats produces more inflammatory response, oxidative stress, tooth movement, PDL disorganization, and MMP-8 and MMP-9 expressions than among normoglycemics. Insulin reverses these effects, favoring the reorganization of periodontal ligament. CLINICAL RELEVANCE: Our results suggest that the application of orthodontic force in diabetic patients would increase inflammation and delay periodontal restructuring. Insulin would partly reverse this situation although glycemic decompensation episodes may occur. For these reasons, the periods between fixed orthodontic appliance activations should be of sufficient duration to allow adequate tissue recovery.

Craniofacial morphology in down syndrome: a systematic review and meta-analysis.

The aim of this study was to evaluate the craniofacial cephalometric characteristics of individuals with Down syndrome (DS), comparing them with healthy subjects. An electronic search was made in Pubmed, Embase, Lilacs, Scopus, Medline and Web of Science without imposing limitations on publication date or language. Studies were selecting following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The PECO acronym was applied as follows: P (population), individuals with DS; E, (exposition) diagnosis of DS; C (comparison), individuals without DS; O (outcomes) craniofacial characteristics based on cephalometric measurements. Independent reviewers performed data extraction and assessed the methodological quality of the articles using the Newcastle-Ottawa Quality-Assessment-scale. Seven case-control studies were included in meta-analysis. Given the variability of the cephalometric measurements used, only those that had been reported in at least three or more works could be included. Anterior cranial base length (SN), posterior cranial base length (SBa), total cranial base length (BaN), effective length of the maxilla (CoA), sagittal relationship between subspinale and supramentale (ANB), anterior facial height (NMe), and posterior facial height (SGo) values were significantly lower in the DS population than among control subjects. No significant differences were found in sagittal position of subspinale relative to cranial base (SNA) and sagittal position of supramentale relative to cranial base (SNB). Summarizing, individuals with DS present a shorter and flatter cranial base than the general population, an upper jaw of reduced sagittal dimension, as well as a tendency toward prognatic profile, with the medium third of the face flattened and a reduced anterior and posterior facial heights.

High-throughput DNA sequencing of microbiota at interproximal sites.

Objective: The oral microbiota has been deeply studied by high-throughput sequencing techniques. However, although the interproximal regions have one of the highest caries rates in the oral cavity, information about the bacterial composition at those sites is scarce. Methods: In this study, we used 16S rRNA Illumina sequencing to describe the microbiota associated to interproximal regions at two time points. In addition, dental plaque samples at the vestibular and lingual surfaces from the same teeth were also analysed at the two time points. Results: Interproximal-associated microbiota was found to be similar to already described bacterial communities in other mouth niches. Streptoccocus, Veillonella, Rothia, Actinomyces, Neisseria, Haemophilus and Fusobacterium were the most abundant genera in this oral region. Statistical analyses showed that the microbiota from interproximal sites was more similar to that sampled from the vestibular surfaces than to the lingual surfaces. Interestingly, many potentially cariogenic bacteria such as Scardovia, Atopobium or Selenomonas were over-represented in the interproximal regions in comparison with vestibular and lingual sites. Conclusion: The microbiota at interproximal regions appears to be specific and stable through time. Potentially pathogenic bacteria may increase caries development risk and gingival inflammation at those sites.

Second primary molar hypomineralisation and drugs used during pregnancy and infancy. A systematic review.

OBJECTIVES: Hypomineralised second primary molars (HSPM) are due to idiopathic hypomineralisation that affects from 1- to 4-s primary molars, and its aetiology remains unclear. Our objective was to systematically review studies in which the investigators had studied the association between HSPM and drug use during pregnancy and the first year of life. MATERIALS AND METHODS: A systematic search for publications until July 2018 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. No restrictions were placed on year of publication. The PECO Question was as follows: P, children exposed to drugs during pregnancy and the first year of life; E, drugs to which mothers, during pregnancy and their offspring were exposed; C, control groups from studies with the same characteristics not exposed to drugs during pregnancy and the first year of life; and O, relationship between drug exposure during pregnancy and the first year of life and HSPM. Two reviewers extracted the data and assessed the risk of bias using the Newcastle-Ottawa Scale criteria. RESULTS: We initially identified 986 articles, or which seven were selected for review: two case-control studies, one cross-sectional studies and four cohort studies. Four studies reported data on drug consumption during pregnancy and four investigated drug use during the first year of life and the occurrence of enamel defects in primary dentition. CONCLUSIONS: There is no clear evidence that the use of drugs during pregnancy and during the first year of life is associated with HSPM. Further well-designed prospective studies are needed. CLINICAL RELEVANCE: Determining the etiological factors related to the development of HSPM would help to establish preventive protocols in patients at potential risk. As HSPM is predictive of molar incisor hypomineralisation (MIH), the application of preventive protocols would avoid complications in both the primary and permanent dentition.

Enamel Resistance to Demineralization After Bracket Debonding Using Fluoride Varnish.

The aim of this study was to evaluate the elemental content and morphology of enamel subjected to demineralization cycles after bracket debonding, adhesive remnant removal, and application of a fluoride varnish. 125 bovine teeth were divided into five groups (n = 25): 1) Intact enamel; 2) Intact enamel + demineralization cycles (DC); 3) Enamel after adhesive removal; 4)Enamel after adhesive removal + DC; 5) Enamel after adhesive removal + Profluorid + DC. The weight percentages of calcium (Ca), phosphorous (P) and fluoride (F) were calculated using energy dispersive X-ray spectroscopy (EDX). Samples were observed under scanning electron microscopy (SEM). Data were analyzed using Kruskal-Wallis and Mann-Whitney test. The weight percentages of Ca and P in Group 1 were significantly higher than Groups 2, 4, and 5. The weight percentages of Ca and P in Group 2 were significantly higher than Groups 4 and 5. Group 3 presented significantly higher percentages of Ca and P than Group 4. Group 5 showed a significantly higher percentage of Ca than Group 4. The presence of F was detected in Group 5. SEM images showed more signs of demineralization in Group 4 than Group 5. Fluoride varnish application may protect enamel from demineralization after bracket debonding.

Efficacy of fluoride varnishes for preventing enamel demineralization after interproximal enamel reduction. Qualitative and quantitative evaluation.

OBJECTIVES: To evaluate quantitatively and qualitatively the changes produced to enamel after interproximal reduction and subjected to demineralization cycles, after applying a fluoride varnish (Profluorid) and a fluoride varnish containing tricalcium phosphate modified by fumaric acid (Clinpro White). MATERIALS AND METHODS: 138 interproximal dental surfaces were divided into six groups: 1) Intact enamel; 2) Intact enamel + demineralization cycles (DC); 3) Interproximal Reduction (IR); 4) IR + DC; 5) IR + Profluorid + DC; 6) IR + Clinpro White + DC. IR was performed with a 0.5 mm cylindrical diamond bur. The weight percentage of calcium (Ca), phosphorous (P) and fluoride (F) were quantified by energy-dispersive X-ray spectrometry (EDX). Samples were examined under scanning electron microscopy (SEM). RESULTS: The weight percentage of Ca was significantly higher (p<0.05) in Groups 1, 2 and 5 than Groups 4 and 6. No significant differences were detected in the weight percentage of Ca between Group 3 and the other groups (p>0.05). The weight percentage of P was similar among all six groups (p>0.05). F was detected on 65% of Group 6 surfaces. SEM images of Groups 4 and 6 showed signs of demineralization, while Group 5 did not. CONCLUSIONS: Profluorid application acts as a barrier against the demineralization of interproximally reduced enamel.

Roughness and wettability effect on histological and mechanical response of self-drilling orthodontic mini-implants.

OBJECTIVES: Self-drilling orthodontic mini-implants can be used as temporary devices for orthodontic treatments. Our main goal was to evaluate surface characteristics, roughness and wettability, of surface modified mini-implants to increase their stability during orthodontic treatment without inducing bone fracture and tissue destruction during unscrewing. MATERIALS AND METHODS: Modified mini-implants by acid etching, grit-blasting and its combination were implanted in 20 New Zealand rabbits during 10 weeks. After that, the bone-to-implant (BIC) parameter was determined and the torque during unscrewing was measured. The surface characteristics, roughness and wettability, were also measured, onto modified Ti c.p. discs. RESULTS: Acid-etched mini-implants (R a ≈ 1.7 µm, contact angle (CA) ≈ 66°) significantly improved the bone-to-implant parameter, 26 %, compared to as-machined mini-implants (R a ≈ 0.3 µm, CA ≈ 68°, BIC = 19 %) due to its roughness. Moreover, this surface treatment did not modify torque during unscrewing due to their statistically similar wettability (p > 0.05). Surface treatments with higher roughness and hydrophobicity (R a ≈ 4.5 µm, CA ≈ 74°) lead to a greater BIC and to a higher removal torque during unscrewing, causing bone fracture, compared to as-machined mini-implants. CONCLUSIONS: Based on these in vivo findings, we conclude that acid-etching surface treatment can support temporary anchoring of titanium mini-implants. CLINICAL RELEVANCE: This treatment represents a step forward in the direction of reducing the time prior to mini-implant loading by increasing their stability during orthodontic treatment, without inducing bone fracture and tissue destruction during unscrewing.

Development of Biomimetic NiTi Alloy: Influence of Thermo-Chemical Treatment on the Physical, Mechanical and Biological Behavior.

A bioactive layer, free of nickel, has been performed for its greater acceptability and reliability in clinical applications for NiTi shape memory alloys. In the first step, a safe barrier against Ni release has been produced on the surface by means of a thicker rutile/anastase protective layer free of nickel. In the second step, a sodium alkaline titanate hydrogel, which has the ability to induce apatite formation, has been performed from oxidized surface. An improvement of host tissue-implant integration has been achieved in terms of Ni ions release and the bioactivity of the treated NiTi alloys has been corroborated with both in vitro and in vivo studies. The transformation temperatures (As, Af, Ms, and Mf), as well as the critical stresses (σß⇔M), have been slightly changed due to this surface modification. Consequently, this fact must be taken into account in order to design new surface modification on NiTi implants.

Increased Zn/Glutathione Levels and Higher Superoxide Dismutase-1 Activity as Biomarkers of Oxidative Stress in Women with Long-Term Dental Amalgam Fillings: Correlation between Mercury/Aluminium Levels (in Hair) and Antioxidant Systems in Plasma.

BACKGROUND: The induction of oxidative stress by Hg can affect antioxidant enzymes. However, epidemiological studies have failed to establish clear association between dental fillings presence and health problems. OBJECTIVES: To determine whether heavy metals (in hair), antioxidant enzymes (SOD-1) and glutathione levels could be affected by the chronic presence of heavy metals in women who had dental amalgam fillings. MATERIALS AND METHODS: 55 hair samples (42 females with amalgam fillings and 13 female control subjects) were obtained. All subjects (mean age 44 years) who had dental amalgam filling for more than 10 years (average 15 years). Certain metals were quantified by ICP-MS (Mass Spectrophotometry) in hair (µg/g: Al, Hg, Ba, Ag, Sb, As, Be, Bi, Cd, Pb, Pt, Tl, Th, U, Ni, Sn, Ti) and SOD-1 and Glutathione (reduced form) levels in plasma. Data were compared with controls without amalgams, and analyzed to identify any significant relation between metals and the total number of amalgam fillings, comparing those with four or less (n = 27) with those with more than four (n = 15). As no significant differences were detected, the two groups were pooled (Amlgam; n = 42). FINDINGS: Hg, Ag, Al and Ba were higher in the amalgam group but without significant differences for most of the heavy metals analyzed. Increased SOD-1 activity and glutathione levels (reduced form) were observed in the amalgam group. Aluminum (Al) correlated with glutathione levels while Hg levels correlated with SOD-1. The observed Al/glutathione and Hg/SOD-1 correlation could be adaptive responses against the chronic presence of mercury. CONCLUSIONS: Hg, Ag, Al and Ba levels increased in women who had dental amalgam fillings for long periods. Al correlated with glutathione, and Hg with SOD-1. SOD-1 may be a possible biomarker for assessing chronic Hg toxicity.

Biological width formation to immediate implants placed at different level in relation to the crestal bone: an experimental study in dogs.

PURPOSE/AIM: Evaluate differences in bone remodeling, soft tissue reactions and biological width formation around immediate implants placed at different level in relation to the crestal bone in beagle dogs. MATERIAL AND METHODS: The mandibular second, third and fourth premolars of six beagle dogs were extracted, and three implants were placed in the right side of each dog. Healing abutments were adjusted (n = 18). After 4 weeks, the procedure was repeated on the left side of the mandible (n = 18). Randomly, three implants were placed at crestal level (control group), and three implants were placed 2 mm subcrestally (test group) in relation to the crestal bone in each animal. The dogs were sacrificed after 8 weeks from the first surgical procedure, and biopsies were obtained. Samples were processed for ground sectioning. Histometric analysis was carried out to compare buccal and lingual bone resorption, soft tissue behavior and biological width formation in both groups. RESULTS: Crestal bone resorption was higher in the test group when considering the difference of 2 mms (IS-B = 2.05 ± 0.36 mm, control; 1.75 (+2) ± 0.38 mm, test). However, the dimensions of the biological width were similar for both groups (PM-C = 3.34 ± 0.53 mm, control; 3.13 ± 0.55 mm, test). CONCLUSIONS: The alterations that occurred in the peri-implant soft tissues may be related to the hard tissue remodeling, showing similar quantitative findings in the biological width formation in both groups. Even though the subcrestal placement might reduce the distance from the implant shoulder to the first bone-to-implant contact and reestablish the biological width dimension in a most coronal position, it might not have any effect on minimizing the marginal bone loss.

Comparison of shear bond strength of brackets recycled using micro sandblasting and industrial methods.

OBJECTIVE: To evaluate in vitro the shear bond strength of brackets recycled by sandblasting with aluminum oxide particles of different sizes or reconditioned industrially after successive rebonding. MATERIALS AND METHODS: Eighty brackets were bonded and debonded sequentially three times. After the first debonding, brackets were divided into four groups: (group 1) sandblasting with aluminum oxide particles of 25 µ, (group 2) 50 µ, and (group 3) 110 µ, and (group 4) industrial recycling. Bond strength and adhesive material remaining on debonded bracket bases were evaluated for each successive debond. RESULTS: No significant differences were detected between the four groups following the first recycle (P > .05). After the second recycle, bond strength was significantly greater for the industrially recycled group than the other groups (P < .016). When shear bond strength was compared within each recycling method, the bond strength of sandblasted brackets decreased with the increase of particle size and with each recycle; for the industrially recycled group, no significant differences were detected between the three sequences (P > .016). In the evaluation of bond material remnant, the industrially recycled group left significantly less bond material after successive recycling than the other groups did (P < .016). Within each recycling method, the adhesive remnant decreased significantly after successive debond (P < .016). CONCLUSIONS: Industrial recycling obtained better results than sandblasting after three successive debondings. The brackets' shear bond strength decreased as the size of the aluminum oxide particle used for sandblasting increased and as recycling was repeated.

Effect of posterior gingival smile on the perception of smile esthetics

OBJECTIVES: To evaluate and compare the influence of posterior gummy smile on the perception of smile esthetics by orthodontists, general-dentists and laypersons. Study DESIGN: A frontal photograph of a smile with normal gum exposure was chosen and manipulated digitally using Adobe Photoshop C3 to generate three further images with posterior gum exposure of 4, 6 and 8 mm. These four images were assessed by the three evaluator groups: orthodontists (n = 40), general-dentists (n=40) and lay-persons (n=40). Both orthodontists and dentists had at least ten years professional experience and lay-persons were aged between 40-50 years. The proportion of men to women was 20:20 in each group. Evaluators awarded a score to the smile esthetics of each image: 1=acceptable, 2=moderately acceptable, 3=unacceptable. Afterwards, each evaluator placed the four images in order of esthetic preference. RESULTS: No significant differences (p > 0.05) were detected between the three evaluator groups for the photo with-out posterior gummy smile. The perception of smile esthetics for a the 4mm posterior gummy smile (median for orthodontists=2, general-dentists= 1, lay-persons=1), the 6mm (median for orthodontists=2, general-dentists=1, laypersons=1) and the 8mm (median for orthodontists=3, general-dentists=2, laypersons=2) was significantly dif-ferent between orthodontists and the other two evaluator groups (p < 0.0017).The three evaluator groups coincided in placing the image with the 6mm gum exposure in first place in order of esthetic preference. CONCLUSIONS: Posterior gummy smile influences the perception of smile esthetics more negatively among ortho-dontists than the rest of the groups

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In vitro study of the antibacterial properties and microbial colonization susceptibility of four self-etching adhesives used in orthodontics.

OBJECTIVES: 1. To determine the in vitro antibacterial effectiveness of the orthodontic bonding Transbond XT (3M Unitek) and four self-etching adhesives with possible use in orthodontic bonding (Clearfil Protect Bond, CPB; Clearfil Self-etching Bond, CSB; Transbond Plus Self-Etching Primer, TSEP; iBond) against Streptococcus mutans and Lactobacillus gasseri in order to compare that capacity among the adhesives and with respect to Transbond XT; 2. To determine the bacterial adhesion capacity of the above mentioned microorganisms to the tested adhesives. MATERIALS AND METHODS: The inhibitory effects of the adhesives against S. mutans and L. gasseri were examined using the agar diffusion method with Whatman No.1 5mm disks loaded with 15 µl of adhesive, UV polymerized, layered on previously inoculated BHI and MRS plates incubated microaerobically for 48 hours at 37 degree C. Data were analysed with Kruskal-Wallis (P < 0.05) and Mann-Whitney tests, applying the Bonferroni correction (P < 0.003). Bacterial adhesion was studied with scanning electron microscopy. RESULTS: Only CPB and iBond produced a clear growth inhibition halo against S. mutans and L. gasseri (P < 0.0001). iBond was the only tested product to which the bacteria adhere profusely, particularly S. mutans. CONCLUSIONS: CPB has shown antimicrobial properties in vitro, and, provided the limitations of an in vitro study, the use of this self-etching adhesive may contribute to reduce microbial decalcification, making the use of this self-etching adhesive an attractive option for bracket bonding.

Effect of posterior gingival smile on the perception of smile esthetics.

OBJECTIVES: To evaluate and compare the influence of posterior gummy smile on the perception of smile esthetics by orthodontists, general-dentists and laypersons. STUDY DESIGN: A frontal photograph of a smile with normal gum exposure was chosen and manipulated digitally using Adobe Photoshop C3 to generate three further images with posterior gum exposure of 4, 6 and 8mm. These four images were assessed by the three evaluator groups: orthodontists (n=40), general-dentists (n=40) and laypersons (n=40). Both orthodontists and dentists had at least ten years professional experience and laypersons were aged between 40-50 years. The proportion of men to women was 20:20 in each group. Evaluators awarded a score to the smile esthetics of each image: 1=acceptable, 2=moderately acceptable, 3=unacceptable. Afterwards, each evaluator placed the four images in order of esthetic preference. RESULTS: No significant differences (p>0.05) were detected between the three evaluator groups for the photo without posterior gummy smile. The perception of smile esthetics for a the 4mm posterior gummy smile (median for orthodontists=2, general-dentists= 1, laypersons=1), the 6mm (median for orthodontists=2, general-dentists=1, laypersons=1) and the 8mm (median for orthodontists=3, general-dentists=2, laypersons=2) was significantly different between orthodontists and the other two evaluator groups (p<0.0017). The three evaluator groups coincided in placing the image with the 6mm gum exposure in first place in order of esthetic preference. CONCLUSIONS: Posterior gummy smile influences the perception of smile esthetics more negatively among orthodontists than the rest of the groups.

Análisis de la variabilidad y coincidencia diagnóstica de los planos Sella-Nasion y de Frankfurt respecto a la horizontal verdadera en posición natural de la cabeza / Analysis of variability of the frankfort horizontal and sella-nasion planes with respect to the true horizontal plane and diagnostic agreement in natural head position

El objetivo principal de este estudio fue investigar la variabilidad de los planos intra y extracraneales en posición natural de la cabeza (PNC) utilizando registros fotográficos y radiográficos. En la primera parte de la investigación, se analizó la reproducibilidad de PNC y la variabilidad de los planos de Frankfurt (FH) y Sella-Nasion (SN) respecto a la horizontal verdadera (HV) obtenida en PNC. Los resultados mostraron una buena reproducibilidad de PNC utilizando registros fotográficos (coeficiente de Dahlberg 1,60). El FH presentó una variabilidad menor que el plano SN, con varianzas de 4,59 y 10,12, respectivamente. En la segunda parte, se analizó el grado de coincidencia de las variables cefalométricas que determinan la posición sagital de los maxilares basadas en los 3 planos investigados (FH, SN y HV). En el caso del maxilar superior, la prueba Wilcoxon resultó ser significativa para las variables basadas en los planos FH-HV y FH-SN, no siendo significativa para los planos SN-HV. Respecto a la mandíbula, la prueba de Wilcoxon para muestras repetidas resultó ser significativa para todas las variables basadas en los 3 planos. Aunque la variabilidad del plano SN resultó ser significativamente mayor que la del plano FH, se observó una mayor coincidencia diagnóstica entre los planos HV y SN. Sin embargo, a pesar de los buenos resultados de fiabilidad del FH, fue este el que menos coincidencias presentó en el diagnóstico facial (AU)

Consideraciones de la reproducibilidad de posición natural de la cabeza utilizando diferentes métodos / Considerations on the reproducibility of natural head position using different methods

El objetivo principal de este estudio fue analizar la reproducibilidad de la posición natural de la cabeza (PNC) utilizando diferentes métodos. La muestra del estudio obtenida de forma aleatoria está compuesta por 51 individuos, a los que se les realizó registros fotográficos y radiográficos en PNC. Para analizar la reproducibilidad de PNC y concordancia de método se trazó la variable 1.ª; ángulo formado por la vertical verdadera y la línea E. Los resultados de la reproducibilidad de los 4 métodos de registro fotográfico de PNC resultaron ser adecuados (desviación típica [DT] 2,60 o inferior). Se obtuvo una buena concordancia de método entre los métodos del espejo y el método corregido por el operador, mostrando este último mejores resultados de reproducibilidad (DT 2,23). La concordancia de método entre los registros fotográficos y radiográficos resultó ser adecuada (DT 1,67). A pesar de los buenos resultados de reproducibilidad en términos de coeficiente de Dahlberg (1,83 o inferior), hasta un 17% de la muestra presentó en algún momento una diferencia de la postura > 5°, por lo que el coeficiente de Dahlberg (1,83) utilizado comúnmente para el análisis de la reproducibilidad solo proporciona un intervalo del 52% que no es lo suficientemente ancho como para permitir la evaluación clínica del método que se está analizando. Sin embargo, el coeficiente de reproducibilidad (4,55 o inferior) aporta un intervalo del 95% que coincide con 2 DT de una distribución normal y representa mejor la realidad clínica del método analizado (AU)

Immediate maxillary restoration of single-tooth implants using platform switching for crestal bone preservation: a 12-month study.

PURPOSE: The aim of this prospective clinical study was to evaluate the survival rates at 12 months of a new implant design placed in the anterior and premolar areas of the maxilla and immediately restored with single crowns. Crestal bone loss was also assessed. MATERIALS AND METHODS: Patients seeking replacement of at least one failing maxillary tooth were recruited to participate in the study. Exclusion criteria included compromised general health conditions, severe maxillomandibular skeletal discrepancies, severe parafunctional habits, drug or alcohol abuse, poor oral hygiene, and a need for bone augmentation. Implants incorporating the platform-switching concept were placed into fresh extraction sockets in the maxilla, with each patient receiving a provisional restoration immediately after implant placement. After 15 days, definitive restorations were inserted. Mesial and distal bone levels were evaluated with digital radiography on the day after implant placement, 15 days later, and 1, 2, 3, 6, 8, and 12 months later. Primary stability was measured with resonance frequency analysis (RFA). Analysis of variance for repeated measures and a binary logistic regression model were used to assess the data. RESULTS: Sixty-one implants were placed into fresh extraction sites in 25 men and 25 women ranging in age from 29 to 51 years (mean, 39.64 +/- 6.06 years). One of the implants failed, and one was lost to follow-up. The mean bone loss measured on the mesial was 0.08 mm (SD 0.53 mm). Mean distal bone loss was 0.09 mm (SD 0.65 mm). Over the course of 12 months, the mean RFA value between baseline and 12 months was 71.1 +/- 6.2. CONCLUSIONS: The implants remained stable over the course of 12 months and had an overall survival rate of 96.7%. Minimal crestal bone loss was recorded around the surviving implants.

Immediate loading and immediate restoration in 105 expanded-platform implants via the Diem System after a 16-month follow-up period.

OBJECTIVE: The aim of this study was to report on our experience and outcomes with Certain Prevail Implants and immediate loading via the Diem System after a 16-month follow-up period. MATERIALS AND METHODS: Over a 16-month period, 105 (14 maxilla, 91 mandible) expanded-platform implants were placed in 18 patients (15 females, 3 males; 55.97 +/-7.25 SD years). Resonance frecuency analysis (RFA) was measured on the day of placement and at 3, 12 and 16 months. All prostheses were screw mounted on IOL DIEM standard abutments. The follow-up time varied between 3 up to 16 months. RESULTS: One implant (0.9%) failed during final prothetic placement (3 months).The RFA (ISQ) measurements at 16 months evalution for 4 mm- and 5 mm diameter implants were: 76.13 +/- 5.0 SD and 76 +/-7.7 SD respectively. The RFA data related to mandible and maxilla, the day 0 mean was 76.47 +/- 4.75 SD and 70.13 +/- 1.35 SD, at 3 months 70.53 +/- 4.0 SD and 66.07 +/-2.9 SD, at 12 months 68.23+/- 3.6 SD and 66.40 +/-2.7 SD and 16 months 68.23+/- 3.6 SD and 66.60 +/- 2.5 SD respectively. The crestal bone resorption was 0.6 mm at 16 months in platform switching implants. CONCLUSIONS: The cumulative implant survival rate during the follow-up period was 99.1% Immediate loading on IOL Diem abutments is a reliable and effective technique for edentulous patients in the maxilla and mandible.

Immediate loading and immediate restoration in 105 expanded-platform implants via the Diem System after a 16-month follow-up period

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Objective: The aim of this study was to report on our experience and outcomes with Certain Prevail Implants andimmediate loading via the Diem System after a 16-month follow-up period. Materials and Methods: Over a 16- month period, 105 (14 maxilla, 91 mandible) expanded-platform implants were placed in 18 patients (15 females, 3 males; 55.97 ±7.25 SD years). Resonance frecuency analysis (RFA) was measured on the day of placement and at 3, 12 and 16 months. All prostheses were screw mounted on IOL DIEM standard abutments. The follow-up time varied between 3 up to 16 months. Results: One implant (0.9%) failed during final prothetic placement (3 months). The RFA (ISQ) measurements at 16 months evalution for 4 mm- and 5 mm diameter implants were: 76.13 ± 5.0 SD and 76 ±7.7 SD respectively. The RFA data related to mandible and maxilla, the day 0 mean was 76.47 ± 4.75 SD and 70.13 ± 1.35 SD, at 3 months 70.53 ± 4.0 SD and 66.07 ±2.9 SD, at 12 months 68.23± 3.6 SD and 66.40 ±2.7 SD and 16 months 68.23± 3.6 SD and 66.60 ± 2.5 SD respectively. The crestal bone resorption was 0.6 mm at 16 months in platform switching implants.Conclusions: The cumulative implant survival rate during the follow-up period was 99.1% Immediate loading on IOL Diem abutments is a reliable and effective technique for edentulous patients in the maxilla and mandible