Intraoperative complications during oral implantology.

Dental implant placement is a controlled, programmed surgical procedure, not without its complications. The aim of the present paper is to study the intraoperative complications in implant surgery, carrying out a review of articles appearing in Medline over the last 10 years. Among the intra operative complications related with surgery, hemorrhagic accidents occur most frequently in the interforaminal region, since the majority of the vascular branches enter the mandibular bone in this region. Nerve damage can arise as a consequence of inferior alveolar nerve transposition or lateralization; or the excessive intrusion of drills or implant fixture into the mandibular canal. Mandibular fractures secondary to implant placement occur more easily when placing implants in atrophic mandible. Occasionally, incorrect positioning or lack of relative parallelism in the placing of the implants causes damage to an adjacent tooth. Absence of primary stability may occur as a result of overworking the implant bed during preparation, also to poor bone quality, and more frequently to immediate post-extraction implantation. Another possible complication is the migration of implants into the maxillary sinus.

Intraoperative complications during oral implantology

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Dental implant placement is a controlled, programmed surgical procedure, not without its complications. The aim of the present paper is to study the intraoperative complications in implant surgery, carrying out a review of articles appearing in Medline over the last 10 years.Among the intra operative complications related with surgery, hemorrhagic accidents occur most frequently in the interforaminal region, since the majority of the vascular branches enter the mandibular bone in this region. Nerve damage can arise as a consequence of inferior alveolar nerve transposition or lateralization; or the excessive intrusion of drills or implant fixture into the mandibular canal. Mandibular fractures secondary to implant placement occur more easily when placing implants in atrophic mandible. Occasionally, incorrect positioning or lack of relative parallelism in the placing of the implants causes damage to an adjacent tooth. Absence of primary stability may occur as a result of overworking the implant bed during preparation, also to poor bone quality, and more frequently to immediate post-extraction implantation. Another possible complication is the migration of implants into the maxillary sinus

Evaluation of healing criteria for success after periapical surgery

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Introduction: In periapical surgery, the absence of standardization between different studies makes it difficult to compare the outcomes.Objective: To compare the healing classification of different authors and evaluate the prognostic criteria of periapical surgery at 12 months.Material and methods: 278 patients (101 men and 177 women) with a mean age of 38.1 years (range 11 to 77) treated with periapical surgery using the ultrasound technique and a 2.6x magnifying glass, and silver amalgam as root-end filling material were included in the study. Evolution was analyzed using the clinical criteria of Mikkonen et al., 1983; radiographic criteria of Rud et al., 1972; the overall combined clinical and radiographic criteria of von Arx and Kurt, 1999; and the Friedman (2005) concept of functional tooth at 12 months of surgery.Results: After 12 months, 87.2% clinical success was obtained according to the Mikkonen et al., 1983 criteria; 73.9% complete radiographic healing using Rud et al. criteria; 62.1% overall success, following the clinical and radiographic parameters of von Arx and Kurt, and 91.9% of teeth were functional. The von Arx and Kurt criteria was found to be the most reliable.Conclusion: Overall evolution according to von Arx and Kurt agreed most closely with the other scales (AU)

Evaluation of healing criteria for success after periapical surgery.

INTRODUCTION: In periapical surgery, the absence of standardization between different studies makes it difficult to compare the outcomes. OBJECTIVE: To compare the healing classification of different authors and evaluate the prognostic criteria of periapical surgery at 12 months. MATERIAL AND METHODS: 278 patients (101 men and 177 women) with a mean age of 38.1 years (range 11 to 77) treated with periapical surgery using the ultrasound technique and a 2.6x magnifying glass, and silver amalgam as root-end filling material were included in the study. Evolution was analyzed using the clinical criteria of Mikkonen et al., 1983; radiographic criteria of Rud et al., 1972; the overall combined clinical and radiographic criteria of von Arx and Kurt, 1999; and the Friedman (2005) concept of functional tooth at 12 months of surgery. RESULTS: After 12 months, 87.2% clinical success was obtained according to the Mikkonen et al., 1983 criteria; 73.9% complete radiographic healing using Rud et al. criteria; 62.1% overall success, following the clinical and radiographic parameters of von Arx and Kurt, and 91.9% of teeth were functional. The von Arx and Kurt criteria was found to be the most reliable. CONCLUSION: Overall evolution according to von Arx and Kurt agreed most closely with the other scales.

The post-endodontic periapical lesion: Histologic and etiopathogenic aspects

Apical periodontitis is produced in the majority of cases by intraradicular infection. Treatment consists in the elimination of the infectious agents by endodontia. Even when carrying out a correct cleansing and filling of canals, it is possible that periapical periodontitis will persist in the form of an asymptomatic radiolucency, giving rise to the post-endodonticperiapical lesion.The chronic inflammatory periapical lesion is the most common pathology found in relation to alveolar bone of the jaw. From the histological point of view, it can be classified as chronic periapical periodontitis (periapical granuloma), radicular cyst, and as scar tissue. The most frequent is the periapical granuloma, constituted by a mass of chronic inflammatorytissue, in which isolated nests of epithelium can be found. The radicular cyst is characterized by the presence of a cavity, partially or wholly lined by epithelium. Scar tissue is a reparative response by the body, producing fibrousconnective tissue.The aim of this study is to review and update the etiopathogenic and histological aspects of chronic post-endodontic periapical lesions

Rehabilitation of severely resorbed maxillae with zygomatic implants: an update.

Studies highlight the zygomatic bone as a suitable anatomical structure for implant placements since they cross four corticals. Zygomatic implants were described by Branemark in 1988, since then zygomatic implants are indicated in maxillae with atrophy of the posterior area. They have been used in systemic diseases associated with bone loss in this area, and in patients who have suffered radical surgery for maxillofacial tumors. Computed tomography is recommended before placement in order to discount any pathology of the maxillary sinus. The surgical technique has been slightly modified since its description with procedures such as the sinus slot technique. The success rate obtained by different authors varies between 82% and 100%, indicating this technique as a valid treatment option. The objective of this study was to revise the literature with the aim of updating the subject.

Rehabilitación de maxilar con implantes cigomáticos: puesta al día / Rehabilitation of severely resorbed maxillae with zygomatic implants: an update

Los estudios, destacan al hueso cigomático como una buena estructura anatómica donde colocar implantes, ya que se atraviesan cuatro corticales. El procedimiento quirúrgico fue descrito en 1998, por Branemark, desde entonces, los implantes cigomáticos se indican en maxilares con atrofias del sector posterior; se han utilizado en enfermedades sistémicas asociadas a pérdida ósea en esta zona y en pacientes que han sufrido cirugía radical por tumores maxilofaciales. Para su colocación, se recomienda el estudio previo con tomografía computerizada, para descartar patología en el senomaxilar. La técnica quirúrgica desde su descripción ha sido discretamente modificada con procedimientos como el dela ranura sinusal. El porcentaje de éxito obtenido por los distintos autores, se sitúa entre el 82% y 100%, indicando que es una opción de tratamiento válida. El objetivo de este trabajo fue la revisión de la literatura con el fin de actualizar el tema

Studies highlight the zygomatic bone as a suitable anatomical structure for implant placements since they cross fourcorticals. Zygomatic implants were described by Branemark in 1998, since then zygomatic implants are indicated in maxillae withatrophy of the posterior area. They have been used in systemic diseases associated with bone loss in this area, and inpatients who have suffered radical surgery for maxillofacial tumors. Computed tomography is recommended before placement in order to discount any pathology of the maxillary sinus. The surgical technique has been slightly modified since its description with procedures such as the sinus slot technique.The success rate obtained by different authors varies between 82% and 100%, indicating this technique as a valid treat-ment option. The objective of this study was to revise the literature with the aim of updating the subject

An update in periapical surgery.

Periapical surgery has largely improved at all levels due to new technologies provided by researchers throughout the last years. The aim of this article is to carry out a bibliographic revision of the last seven years. For this reason, we will analyse the studies published in Medline and the most important Spanish dental magazines. The subjects to investigate are mainly based on the incorporation of ultrasonic root-end, which allow the performance of small and adjusted retrograde cavities; as well as the new filling materials. We also include magnifying glasses or surgical microscope to the work material, plus surgical laser and the application of guided tissue regeneration.

An update in periapical surgery

En los últimos años, la cirugía periapical ha mejorado a todos los niveles debido a las nuevas aportaciones técnicas proporcionadas por los investigadores. El objetivo del presente artículo es realizar una revisión bibliográfica de los trabajosde los últimos siete años, analizando los estudios publicados en el Medline y las principales revistas odontológicas españolas. Los temas de investigación se centran principalmente en la incorporación de las puntas de ultrasonidos que permiten realizar pequeñas y ajustadas cavidades retrógradas; así como los nuevos materiales de relleno para las mismas, capaces de conseguir un mejor sellado apical. También se incorporan las lentes de aumento o el microscopio quirúrgico al material de trabajo, así como el láser quirúrgico y la aplicación de la regeneración tisular guiada

Periapical surgery has largely improved at all levels due to new technologies provided by researchers throughout the last years. The aim of this article is to carry out a bibliographic revision of the last seven years. For this reason, we will analyse the studies published in Medline and the most important spanish dental magazines. The subjects to investigate are mainly based on the incorporation of ultrasonic root-end, which allow the performance of small and adjusted retrogradecavities; as well as the new filling materials. We also include magnifying glasses or surgical microscope to the work material, plus surgical laser and the application of guided tissue regeneration

Periapical surgery using the ultrasound technique and silver amalgam retrograde filling. A study of 71 teeth with 100 canals.

INTRODUCTION: Periapical surgery using ultrasound allows the treatment of root canals of difficult access, with the sacrifice of little root tissue. As a result, periapical disorders which were condemned to treatment failure in the past can now be dealt with successfully. MATERIAL AND METHODS: In 71 teeth presenting 100 root canals treated with ultrasound and subjected to retrograde filling with silver amalgam, the course and short-term success of management was evaluated in relation to lesion size, the magnitude of apical resection, and the size of the retrograde filling cavity. The duration of follow-up was one year, with post-treatment controls after 6 and 12 months. RESULTS: After 6 months, the percentage clinical and radiological success was 92% and 58%, respectively. One year after periapical surgery the corresponding percentages were 95% and 80%. Global success after 6 months was 63%, versus 84.2% after 12 months. No statistically significant relation was observed between treatment success and the size of the periapical lesion, the amount of apex resected, or the size of retrograde filling. CONCLUSION: Periapical surgery using ultrasound and retrograde filling with silver amalgam affords a high success rate after 12 months.