Autologous Tooth Granulometry and Specific Surface Area with Three Grinding Methods: An In Vitro Study.

A postextraction socket becomes a clinical challenge due to the fact that a series of changes associated with bone remodelling and resorption of the socket that occur after extraction, which limits the aesthetic and functional prognosis of implant-supported rehabilitations. It has been studied that the use of the autologous tooth-derived graft (ATDG) has regenerative properties and could therefore be useful for solving this type of problem. There is no consensus in the scientific literature on a standardized protocol for the use of the autologous tooth. Therefore, the aim of the present study was to evaluate the most relevant parameters to achieve the best properties of ground ATDG using three methods, namely Gouge forceps, electric grinder, and manual, that made up the study group (SG) and compared with the control group (CG) consisting of Bio-Oss®. The sample obtained by the electric grinder had the highest value of specific surface area (2.4025 ± 0.0218 m2/g), while the particle size as average diameter (751.9 µm) was the lowest and most homogeneous of the three groups. Therefore, the electric grinder allowed for obtaining ATDG with more regenerative properties due to its specific surface-area value and particle size in accordance with the xenograft with the greatest bibliographical support (Bio-Oss®). The higher specific surface increases the reaction with the physiological media, producing faster biological mechanisms.

Rehabilitación de dientes con pronóstico imposible mediante extrusión quirúrgica: a propósito de un caso / Surgical extrusion for restoring impossible prognosis teeth: case report

La extrusión quirúrgica es una alternativa terapéutica que persigue el desplazamiento coronal de aquellos dientes con márgenes subgingivales y limitada estructura remanente. El correcto diag nóstico de cada caso y la aplicación de una técnica mínimamente traumática serán clave en el éxito del tratamiento. En la presente revisión, a propósito de un caso con 12 meses de seguimiento, se analizan los factores críticos del procedi miento (AU)

Surgical extrusion is a therapeutic alternative that pursues the coronal displacement of those teeth with subgingival margins and limited remaining structure. The correct diagnosis of each case and the application of a minimally traumatic technique will be key to the success of the treatment. In this review, about a case with 12 months of follow-up, the critical factors of the procedure are analyzed (AU)

Double Lateral Sliding Bridge Flap versus Laterally Closed Tunnel for the Treatment of Single Recessions in the Mandibular Anterior Teeth: A Pseudorandomized Clinical Trial.

(1) Background: This study compared the clinical and esthetic results of the double lateral sliding bridge flap (DLSBF) and the laterally closed tunnel (LCT) techniques, with a subepithelial connective tissue graft (SCTG), for the treatment of single Miller class II-III recessions in the mandibular anterior teeth. (2) Methods: This pseudorandomized clinical trial evaluated 14 patients, 7 of whom were part of the DLSBF + SCTG group, with an average follow-up of 58.7 ± 24.0 months, and 7 of whom were in the LCT + SCTG group, with an average follow-up of 16.7 ± 3.3 months. Clinical and esthetic evaluations of the following parameters were performed and the results for the two groups were compared: gingival recession depth, probing depth, keratinized tissue width, gingival thickness, percentage of root coverage and root coverage esthetic score. (3) Results: After the follow-up period, each technique provided evidence of a reduction in recession depth and clinical attachment level, as well as increased keratinized tissue width and gingival thickness, with statistically significant differences (p < 0.05). The analysis showed that gingival recession depth decreased less in the DLSBF group (4.3 ± 1.2 mm to 0.6 ± 1.1 mm) than it did in the LCT group (4.9 ± 1.1 mm to 0.1 ± 0.4 mm), but no significant difference was found between the two groups. Similarly, a greater reduction in the clinical attachment level parameter was observed in the LCT group, while a greater increase in gingival thickness was observed in the DLSBF group. The presence of scars was the only parameter for which statistically significant differences (p < 0.05) between the two study groups were found. (4) Conclusions: Within the limitations of the study, it indicates that the LCT + SCTG technique may be considered an optimal technique in terms of reducing gingival recession depth, complete root coverage and esthetic results for the treatment of single gingival recessions in the mandibular anterior teeth.

Uso de dentina particulada en procedimientos de preservación alveolar / Use of particulate dentin in alveolar preservation procedures: systematic review of the literature

Introducción: Los procesos biológicos que acontecen tras las exodoncias dentales provocan defectos en los tejidos blandos y duros de los maxilares, lo que dificulta las técnicas rehabilitadoras con implantes. Los procedimientos de preservación alveolar han sido propuestos para disminuir estos cambios dimensionales. A pesar de que el hueso autógeno se presenta como el material con mejores propiedades, también conlleva un aumento de la morbilidad en el paciente. Por ello, el propio diente se presenta como alternativa. Los objetivos de esta revisión fueron analizar los cambios dimensionales en la altura/anchura de la cresta alveolar tras los procedimientos de preservación alveolar con dentina particulada, además de las posibles complicaciones intra y postoperatorias, formación de hueso nuevo y tiempo de reentrada en la zona injertada. Material y método: Se realizó una revisión de la literatura relevante a través de PubMed en la base de datos MEDLINE, identificando los estudios en los que se evaluaran los procedimientos de preservación alveolar con dentina particulada en pacientes humanos y se registrara su seguimiento. Resultados: Un total de 12 estudios se incluyeron en el análisis sistemático. Los cambios dimensionales, tras el injerto con dentina particulada, fue comparable al de otros biomateriales y menor que en los grupos control. La aparición de complicaciones fue baja. La formación de hueso nuevo y el tiempo de reentrada fue similar al de otros biomateriales. Conclusiones: El uso de dentina particulada en procedimientos de preservación alveolar se presenta como una opción prometedora respecto a otros materiales de relleno y superior a la ausencia de preservación alveolar. (AU)

Introduction: The biological processes that take place following dental extractions cause defects in the soft and hard tissues of the jaw, which hinders rehabilitation techniques with implants. Alveolar preservation procedures have been proposed to decrease these dimensional changes. Although autogenous bone is presented as the material with the best properties, it also leads to an increase in morbidity in the patient. Therefore, the tooth itself is presented as an alternative. The objectives of this review were to analyse the dimensional changes in alveolar ridge height/width after alveolar preservation procedures using particulate dentin, as well as possible intraoperative and postoperative complications, new bone formation and re-entry time in the grafted area. Material and method: A review of the relevant literature in the PubMed and MEDLINE databases was carried out, identifying studies evaluating alveolar preservation procedures with particulate dentin in human patients with recorded follow-up. Results: A total of 12 studies were included in the systematic analysis. The dimensional changes, after grafting with particulate dentin, were comparable to those of other biomaterials and lower than in the control groups. The occurrence of complications was low. New bone formation and re-entry time was similar to that of other biomaterials. Conclusions: The use of particulate dentin in alveolar preservation procedures is presented as a promising option compared with other filling materials and superior to the absence of alveolar preservation. (AU)

Use of particulate dentin in alveolar preservation procedures: a systematic review

Introduction: The biological processes that take place following dental extractions cause defects in the soft and hard tissues of the jaw, which hinder rehabilitation techniques with implants. Alveolar preservation procedures have been proposed to decrease these dimensional changes. Although autogenous bone is considered the material with the best properties, it also leads to an increase in patient morbidity. Therefore, the tooth itself is considered as an alternative. The objectives of this review were to analyse the dimensional changes in alveolar ridge height/width after alveolar preservation procedures using particulate dentin, as well as possible intraoperative and postoperative complications, new bone formation and re-entry time in the grafted area. Materials and method: A review of the relevant literature in the PubMed and MEDLINE databases was carried out, identifying studies evaluating alveolar preservation procedures with particulate dentin in human patients with recorded follow-up. Results: A total of 12 studies were included in the systematic analysis. The dimensional changes, after grafting with particulate dentin, were comparable to those of other biomaterials and fewer than in the control groups. The occurrence of complications was low. New bone formation and re-entry time were similar to other biomaterials. (AU)

Análisis de los tejidos peri-implantarios en implantes anteriores: relación entre la presencia o ausencia de tabla ósea y el Pink Esthetic Score / Analysis of peri-implant tissues in anterior maxila implants: Relationship between the presence or absence of buccal bone table and the Pink Esthetic Score

INTRODUCCIÓN: La dehiscencia es una pérdida de la cortical que deja expuesta parte de la raíz al medio oral. Se considera como un factor predisponente de las recesiones gingivales y, por tanto, de una alteración estética. El objetivo principal fue estudiar la relación entre la presencia o ausencia de la tabla ósea vestibular en implantes anteriores y el resultado estético valorado mediante el índice Pink Esthetic Score (PES). Los objetivos secundarios fueron analizar la opinión del paciente comparándolo además con lo valores de PES hallados por el evaluador principal. MATERIAL Y MÉTODO: Se llevó a cabo un estudio analítico, longitudinal, retrospectivo, de cohortes en un grupo de 31 pacientes quienes llevaban implantes antero-superiores con un mínimo de 3 años de carga protésica. Se realizó un TAC para valorar la presencia/ausencia de tabla ósea junto con una exploración para evaluar el PES. RESULTADOS: El índice PES fue significativamente más elevado (10,4 ± 2,3) en presencia de tabla ósea. La valoración del paciente tuvo una nota media global de 8,2 ± 1,6. No se halló correlación entre la opinión del paciente y la del evaluador. CONCLUSIONES: La ausencia de tabla ósea vestibular en implantes anteriores conlleva alteraciones estéticas de los tejidos peri-implantarios

INTRODUCTION: Dehiscence is the loss of the bone wall that leaves part of the root exposed to the oral cavity. It can be a predisposing factor of gingival recessions and therefore it is considered an aesthetic alteration. OBJECTIVES: To analyze the relationship between the presence or absence of the buccal bone table in anterior implants and the esthetic result valued using the PES index. Secondary objectives were to analyse the patient's opinion by comparing it with the PES values found by the evaluator. MATERIAL AND METHOD: An analytical, longitudinal, retrospective cohort study was performed in a group of 31 patients who had antero-superiors implants with a minimum of 3 years of crown-loading. CBCT was performed to evaluate the presence /absence of a bone table with an intraoral exploration to evaluate the PES. RESULTS: The PES index was significantly higher (10.4 ± 2.3) in presence of bone table. The patient's assessment had an overall mean score of 8.2 ± 1.6. No correlation was found between the patient's opinion and the evaluator. CONCLUSION: The absence of buccal bone table lead to aesthetic alterations of the peri-implant tissues

Las tres caras de la sonrisa gingival. Revisión bibliográfica / The three faces of the gummy smile. Literature review

Hablamos de sonrisa gingival cuando se altera la armonía establecida entre los dientes, labios y encía, exponiendo más allá de 2 mm de encía coronal a los incisivos maxilares, una circunstancia que, en ocasiones, genera un problema estético para algunos pacientes. La etiopatogenia de dicha condición se resume en tres facetas: dentoperiodontal (erupción pasiva alterada y erupción activa alterada), ósea (esquelética y/o dentoalveolar) y muscular (labio superior corto e hipermovilidad labial).Una condición multifactorial como la sonrisa gingival precisa un abordaje multidisciplinar: cirugía plástica periodontal, ortodoncia, cirugía ortognática, reposición labial, infiltración de toxina botulínica y tratamiento estético complementario

The excessive gingival display when a patient smiles (from 2 mm or more) is known as gummy smile. When the harmony established between the teeth, lips and gum is altered, exhibiting short clinical crown of the maxillary anterior teeth, in occasions generates an aesthetic problem for some patients.There are different etiologies of gummy smile, it concludes in three facets: dentoperiodontal (Altered Passive Eruption and Altered Active Eruption), bone defect (excessive vertical bone growth, dentoalveolar extrution) and muscular (short upper lip and upper lip hyperactivity), and the combination of some of these factors.A multifactorial condition requires a multidisciplinary boarding: plastic periodontal surgery, orthodontic, orthognathic surgery, lip reduction, infiltration of Botulinum toxin and complementary aesthetic treatment