Retratamiento multidisciplinar de una agenesia de un incisivo lateral superior con un implante cerámico monobloque. A propósito de un caso clínico / Multidisciplinary re-treatment of an agenesis of an upper lateral incisor with an one-piece ceramic implant. A clinical report

Introducción: Los implantes dentales de circona son una buena opción terapéutica que surge como alternativa a los implantes dentales convencionales de titanio, dadas sus excelentes propiedades de biocompatibilidad, baja acumulación de placa bacteriana y escaso infiltrado inflamatorio. El objetivo del presente caso clínico es describir la colocación de un implante monobloque de circona para reponer un incisivo lateral superior izquierdo en un paciente de 34 años de edad, para la posterior realización de una corona implantosoportada monolítica de circona. Descripción del caso: Se presenta un paciente varón de 34 años de edad, no fumador y sin antecedentes médico-quirúrgicos de interés (ASA I), que acudió a la consulta demandando una mejora en la estética de su sonrisa. El paciente presentaba una agenesia congénita en el incisivo lateral superior izquierdo que había sido tratada previamente con ortodoncia para cerrar dicho espacio. Tras el examen intraoral del paciente y el estudio radiográfico, se plantea la opción de tratamiento de abrir nuevamente el espacio mediante ortodoncia para rehabilitar la ausencia con un implante de circona, asegurando la estética que demandaba el paciente. Conclusiones: La rehabilitación mediante implantes de circona para el tratamiento de agenesias congénitas en incisivos laterales superiores, es una opción válida y efectiva, obteniendo resultados óptimos a nivel estético y funcional. Sin embargo, se necesitan más estudios clínicos con tamaños muestrales suficientes que comparen implantes de titanio y cerámicos con el fin de tener datos más concluyentes. (AU)

Introduction: Zirconia dental implants are a good therapeutic option emerging as an alternative to conventional titanium dental implants, given their excellent properties of biocompatibility, low bacterial plaque accumulation and low inflammatory infiltrate. The aim of the present clinical case is to describe the placement of a zirconia implant to replace an upper left lateral incisor in a 34-year-old patient, for the subsequent restoration of a monolithic implant-supported zirconia crown. Case description: A clinical case of a 34-year-old man is presented, nonsmoker and with no previous registered medical records (ASA I) who came to the dental clinic demanding an improvement in the aesthetics of his smile. The patient had a congenital agenesis of the left lateral incisor that had previously been treated with orthodontics to close the space. After the radiographic study and intraoral examination of the patient, the treatment option of reopening the space with a new phase of corrective orthodontics to rehabilitate the absence with a zirconia implant was proposed, ensuring the aesthetics demanded by the patient. Conclusions: Restoration using zirconia implants for the treatment of congenital agenesis in upper lateral incisors is a valid and effective option, obtaining optimal aesthetic and functional results. However, more clinical studies with sufficient sample sizes comparing titanium and ceramic implants are needed in order to have more conclusive data. (AU)

Sinusitis originada por patologías o tratamientos dentales: revisión de la literatura / Sinusitis caused by dental treatment or pathology: a literature review

Introducción: la sinusitis odontogénica (SO) es una condición infradiagnosticada de la esfera otorrinolaringológica a pesar de su frecuencia que se estima entre 10 y el 40% de la rinosinusitis crónica. La SO representa hasta 75% de los casos de sinusitis maxilar unilateral y sigue pasando desapercibida en las guías más actuales de rinosinusitis, ocasionando una falta de consenso sobre los criterios diagnósticos y las pautas terapéuticas a observar. La dificultad en identificar el foco odontogénico en otorrinolaringología (ORL), y la de estimar la magnitud de la sinusitis en consultas de odontología, conduce frecuentemente a la persistencia de los síntomas y al fracaso de las terapias conducidas, impactando considerablemente en la calidad de vida de los pacientes. Por lo tanto, se elaboró esta revisión de la literatura para entender los desafíos que esta condición supone, a la luz de los estudios recientes en el tema. Métodos: se ha realizado una búsqueda exhaustiva de la literatura en Pubmed, Scopus y Google Scholar con términos relativos a las secciones y subsecciones de esta revisión. Resultados y conclusiones: el diagnóstico y el manejo de la SO plantean, por tanto, un desafío importante debido a la falta de protocolos estandarizados de diagnóstico y de procedimientos terapéuticos multidisciplinares consensuados. Se recomienda un enfoque interdisciplinar personalizado para lograr la resolución de la sintomatología y se precisan estudios bien diseñados, con estratificación según los causantes dentales y iatrogénicos, para generar una evidencia que respalde los futuros protocolos. (AU)

Introduction: Despite it being responsible for 10-40% of chronic rhinosinusitis cases, odontogenic sinusitis (OS) is an underdiagnosed otorhinolaryngological condition. OS represents up to 75% of cases of unilateral maxillary sinusitis and is still overlooked in most current rhinosinusitis guidelines. This leads to a lack of consensus on the diagnostic criteria and therapeutic guidelines to be observed. The difficulty in identifying the odontogenic focus in ENT consultations as well as estimating the magnitude of sinusitis in dental consultations frequently leads to the persistence of symptoms and the failure of the therapies undertaken, considerably impacting the quality of life of patients. This literature review was implemented to understand the challenges that this condition poses, in the light of recent studies on the subject. Methods: An exhaustive search of the literature in PubMed, Scopus and Google Scholar with terms related to the sections and subsections of this review. Results and conclusions: The diagnosis and management of OS therefore poses a significant challenge due to the lack of standardised diagnostic protocols and consensual multidisciplinary therapeutic procedures. A personalised interdisciplinary approach is recommended to achieve resolution of symptoms along with well-designed studies, stratified according to dental and iatrogenic causes, to provide evidence to support future protocols. (AU)

Retratamiento multidisciplinar de una agenesia de un incisivo lateral superior con un implante cerámico monobloque. A propósito de un caso clínico / Multidisciplinary re-treatment of an agenesis of an upper lateral incisor with an one-piece ceramic implant. A clinical report

Introducción: Los implantes dentales de circona son una buena opción terapéutica que surge como alternativa a los implantes dentales convencionales de titanio, dadas sus excelentes propiedades de biocompatibilidad, baja acumulación de placa bacteriana y escaso infiltrado inflamatorio. El objetivo del presente caso clínico es describir la colocación de un implante monobloque de circona para reponer un incisivo lateral superior izquierdo en un paciente de 34 años de edad, para la posterior realización de una corona implantosoportada monolítica de circona. Descripción del caso: Se presenta un paciente varón de 34 años de edad, no fumador y sin antecedentes médico-quirúrgicos de interés (ASA I), que acudió a la consulta demandando una mejora en la estética de su sonrisa. El paciente presentaba una agenesia congénita en el incisivo lateral superior izquierdo que había sido tratada previamente con ortodoncia para cerrar dicho espacio. Tras el examen intraoral del paciente y el estudio radiográfico, se plantea la opción de tratamiento de abrir nuevamente el espacio mediante ortodoncia para rehabilitar la ausencia con un implante de circona, asegurando la estética que demandaba el paciente. Conclusiones: La rehabilitación mediante implantes de circona para el tratamiento de agenesias congénitas en incisivos laterales superiores, es una opción válida y efectiva, obteniendo resultados óptimos a nivel estético y funcional. Sin embargo, se necesitan más estudios clínicos con tamaños muestrales suficientes que comparen implantes de titanio y cerámicos con el fin de tener datos más concluyentes. (AU)

Introduction: Zirconia dental implants are a good therapeutic option emerging as an alternative to conventional titanium dental implants, given their excellent properties of biocompatibility, low bacterial plaque accumulation and low inflammatory infiltrate. The aim of the present clinical case is to describe the placement of a zirconia implant to replace an upper left lateral incisor in a 34-year-old patient, for the subsequent restoration of a monolithic implant-supported zirconia crown. Case description: A clinical case of a 34-year-old man is presented, nonsmoker and with no previous registered medical records (ASA I) who came to the dental clinic demanding an improvement in the aesthetics of his smile. The patient had a congenital agenesis of the left lateral incisor that had previously been treated with orthodontics to close the space. After the radiographic study and intraoral examination of the patient, the treatment option of reopening the space with a new phase of corrective orthodontics to rehabilitate the absence with a zirconia implant was proposed, ensuring the aesthetics demanded by the patient. Conclusions: Restoration using zirconia implants for the treatment of congenital agenesis in upper lateral incisors is a valid and effective option, obtaining optimal aesthetic and functional results. However, more clinical studies with sufficient sample sizes comparing titanium and ceramic implants are needed in order to have more conclusive data. (AU)

Sinusitis originada por patologías o tratamientos dentales: revisión de la literatura / Sinusitis caused by dental treatment or pathology: a literature review

Introducción: la sinusitis odontogénica (SO) es una condición infradiagnosticada de la esfera otorrinolaringológica a pesar de su frecuencia que se estima entre 10 y el 40% de la rinosinusitis crónica. La SO representa hasta 75% de los casos de sinusitis maxilar unilateral y sigue pasando desapercibida en las guías más actuales de rinosinusitis, ocasionando una falta de consenso sobre los criterios diagnósticos y las pautas terapéuticas a observar. La dificultad en identificar el foco odontogénico en otorrinolaringología (ORL), y la de estimar la magnitud de la sinusitis en consultas de odontología, conduce frecuentemente a la persistencia de los síntomas y al fracaso de las terapias conducidas, impactando considerablemente en la calidad de vida de los pacientes. Por lo tanto, se elaboró esta revisión de la literatura para entender los desafíos que esta condición supone, a la luz de los estudios recientes en el tema. Métodos: se ha realizado una búsqueda exhaustiva de la literatura en Pubmed, Scopus y Google Scholar con términos relativos a las secciones y subsecciones de esta revisión. Resultados y conclusiones: el diagnóstico y el manejo de la SO plantean, por tanto, un desafío importante debido a la falta de protocolos estandarizados de diagnóstico y de procedimientos terapéuticos multidisciplinares consensuados. Se recomienda un enfoque interdisciplinar personalizado para lograr la resolución de la sintomatología y se precisan estudios bien diseñados, con estratificación según los causantes dentales y iatrogénicos, para generar una evidencia que respalde los futuros protocolos. (AU)

Introduction: Despite it being responsible for 10-40% of chronic rhinosinusitis cases, odontogenic sinusitis (OS) is an underdiagnosed otorhinolaryngological condition. OS represents up to 75% of cases of unilateral maxillary sinusitis and is still overlooked in most current rhinosinusitis guidelines. This leads to a lack of consensus on the diagnostic criteria and therapeutic guidelines to be observed. The difficulty in identifying the odontogenic focus in ENT consultations as well as estimating the magnitude of sinusitis in dental consultations frequently leads to the persistence of symptoms and the failure of the therapies undertaken, considerably impacting the quality of life of patients. This literature review was implemented to understand the challenges that this condition poses, in the light of recent studies on the subject. Methods: An exhaustive search of the literature in PubMed, Scopus and Google Scholar with terms related to the sections and subsections of this review. Results and conclusions: The diagnosis and management of OS therefore poses a significant challenge due to the lack of standardised diagnostic protocols and consensual multidisciplinary therapeutic procedures. A personalised interdisciplinary approach is recommended to achieve resolution of symptoms along with well-designed studies, stratified according to dental and iatrogenic causes, to provide evidence to support future protocols. (AU)

Comportamiento del injerto autólogo de diente en preservación alveolar: evaluación clínica, radiográfica e histomorfométrica de un caso clínico tras un año de seguimiento / Behavior of the autologous tooth graft in alveolar preservation: clinical, radiographic and histomorphometric evaluation of a clinical case after one year of follow-up

Introducción: tras las extracciones, se producen una serie de cambios dimensio nales en sentido horizontal y vertical de la cresta alveolar, los cuales pueden ser minimizados mediante algunas técnicas quirúrgicas, como la preservación alveo lar, que utiliza diferentes sustitutos óseos, entre los que se encuentra actualmente el injerto autólogo de diente. Caso clínico: se presenta el caso clínico de una mujer de 61 años, que acudió a consulta presentando dolor intenso en la zona del segundo premolar superior de recho (1.5). Se realizó la exodoncia del 1.5, usándose como diente donante para realizar una preservación del alveolo tras la extracción. Cuatro meses tras el proce dimiento, se colocó un implante y se tomó una biopsia para realizar un análisis histo morfométrico. Un año tras la carga del im plante se observaron buenos resultados clínicos y radiográficos. Discusión: el diente y el tejido óseo tie nen similitudes en su composición quími ca, tanto en sus componentes inorgáni cos y orgánicos como en la cantidad de agua. En cuanto al contenido orgánico destacan los factores de crecimiento, la proteína morfogenética ósea 2 (BMP-2) y el colágeno tipo 1, dotando al diente como biomaterial de la propiedad de os teoinducción. El empleo del diente como sustituto en preservación alveolar consi gue porcentajes altos de hueso neofor mado, variando entre 37,55% cuando se usa el diente completo, al 48,40% usando dentina desmineralizada. Además de los buenos resultados histomorfométricos, goza de una buena aceptación por parte de los pacientes, fundamentalmente en determinadas ra zas o culturas, y consigue una reducción de las dimensio nes óseas evaluadas mediante escáner de haz cónico. Sin embargo, requiere un tiempo de preparación, que aumenta si el diente tiene restauraciones o tratamientos de conduc tos asociados (AU)

Introduction: following tooth extraction, horizontal and vertical resorption of bone volume occurs, but they can be reduced by many surgical procedures, such as alveolar ridge preservation, which uses different bone substitutes, being one of them autogenous tooth-graft. Clinical case: a 61-year-old woman is presented, who came to private dental clinic presenting intense pain in the area of an upper bicuspid of the first quadrant (1.5). Exodontia of the 1.5 was performed, using it as a donor tooth to obtain the biomaterial to preserve its alveolus. After 4 months re-entry was performed and an implant was placed, harvesting a bone biopsy for histomorphometric analysis. One year post-loading, good clinical and radiographic results were shown. Discussion: human bone and tooth have similarities in their chemical composition, both in their inorganic and organic components and in the amount of water. The organic content, growth factors, bone morphogenetic protein 2 (BMP-2) and type 1 collagen stand out, give the tooth the property of osteoinduction. The use of the tooth as a substitute in alveolar preservation achieves high percentages of neoformed bone, varying between 37.55% when the whole tooth is used, to 48.40% using demineralized dentin. In addition, it is well accepted by patients, especially in certain races or cultures, and achieves a reduction in bone dimensions evaluated by cone beam computed tomography. However, it has a drawback, requiring a long preparation time, which increases if the tooth has associated restorations or root canals. Conclusions: Autologous tooth-graft has a high biocompatibility, a low rate of intraoperative complications and good patient acceptance. It requires 25 minutes for preparation, which increases if there are restorations, root canals and caries. The percentage of vital bone obtained in the present clinical case shows new bone formation of 20% 4 months after alveolar ridge preservation (AU)

Autogenous particulated dentin for alveolar ridge preservation. A systematic review.

PURPOSE: This review aimed to investigate the clinical outcomes of autogenous particulated dentin (APD) used for alveolar ridge preservation (ARP), evaluating volume gain, histologic/histomorphometric data, and associated complications. MATERIAL AND METHODS: The review followed PRISMA guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An automated search was made in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library) supplemented by a manual search for relevant clinical articles published before March 10th, 2022. The review included human studies of at least four patients in which extraction and subsequent ARP were performed in a single surgery. Both comparative studies and studies that assessed ARP with APD exclusively were admitted. The quality of evidence was assessed with the Cochrane bias assessment tool, the Newcastle-Ottawa Quality Assessment Scale, and the Joanna Briggs Institute Critical Appraisal tool. RESULTS: Eleven studies fulfilled the inclusion criteria and were included for descriptive analysis, with a total of 215 patients, and 337 alveoli preserved by APD, spontaneous healing (blood clot), or other bone substitutes, obtaining comparatively less vertical and horizontal resorption when APD was used. CONCLUSIONS: After dental extraction, autogenous dentin was effective in terms of volume maintenance, showing promising results in histologic/histomorphometric analysis, and a low complication rate. Nevertheless, few comparative studies with comparable parameters have been published and so more research providing long-term data is needed to confirm these findings.

Piperacillin-Tazobactam as an Adjuvant in the Mechanical Treatment of Patients with Periodontitis: A Randomized Clinical Study.

In this study, the aim was to evaluate the effects of the adjuvant piperacillin-tazobactam solution in the mechanical treatment of periodontitis. A single-blind split-mouth randomized study, it included 24 participants. All of them presented periodontitis stage III according to the 2018 World Workshop classification and the presence of at least one of the following periodontal pathogens: Aggregatibacter actinomycetemcomitans; Porphyromona gingivalis; Treponema denticola; Tannerella forsythia; Prevotella intermedia. The study established two groups: a control group (SRP: scaling and root planing) and a test group (SRP plus local piperacillin-tazobactam). The final recruitment included 11 women (45.8%) and 13 men (54.2%). The age range was between 25 and 72 years, and the mean age was 57 ± 10.20 years. Clinical controls were performed at 2 weeks, 3 months, and 6 months, repeating the SRP and applying the piperacillin-tazobactam solution again at the 3-month appointment. The clinical attachment level decreased by a mean of 2.13 ± 0.17 mm from the baseline to 6 months in the test group versus 1.63 ± 0.18 mm in the control group. The mean probing pocket depth decreased from 1.32 ± 0.09 mm in the test group, versus from 0.96 ± 0.14 mm on the control side. The plaque index in the test group decreased by 0.46 ± 0.04, while it decreased by an average of 0.31 ± 0.04 in the control group. In conclusion, the local use of piperacillin-tazobactam as complementary therapy produces better clinical results in patients with periodontitis. However, these results are not maintained over time, and so a more persistent local application is necessary.

Dental Transmigration: An Observational Retrospective Study OF52 Mandibular Canines.

The aim of this study was to analyze the prevalence of transmigrated canines in a Spanish population by evaluating their clinical and radiological characteristics. The descriptive observational study obtained 6840 orthopantomographs from all patients seeking dental care in the years 2017-21 via the Patient Reception Service and Dentistry Service at the Faculty of Dentistry at the Complutense University of Madrid and the Central Hospital of the Red Cross of Madrid (Spain). In total, 52 patients presented transmigrated canines, establishing a prevalence of 0.76%. This sample comprised 28 women and 24 men. Whenever a transmigrated canine was identified, a CBCT scan was obtained and used to evaluate the clinical and radiological variables associated with canine transmigration. The predominant side of the transmigration was the left (57.69%) compared to the right side (42.30%). The position of the canine, in order of frequency, according to the Mupparapu classification, corresponded to type IV (42.30%), type II (36.53%), type I (15.38%), and type V (5.76%), with no type III transmigrations found. Clinical manifestations were only recorded in 17.30% of cases, and 11.53% of the radiological findings showed the presence of tooth cysts that were confirmed by histopathological studies. Other impactions, in addition to the transmigrated canine, were found in five patients (9.61%), with the majority being the presence of third molars.

Xerostomia, the perception of general and oral health and health risk behaviours in people over 65 years of age.

BACKGROUND: This study investigated the association between xerostomia and health risk behaviours, general and oral health and quality of life. METHODS: A cross-sectional study involving 800 adults over 65 years of age residing in Spain using a computer-assisted telephone questionnaire. The severity of xerostomia was assessed through the Xerostomia Inventory (XI). Both univariate and adjusted multinomial logistic regression were used to determine the risk (OR) of xerostomia. RESULTS: The sample comprised of 492 females (61.5%) and 308 males, with a mean age of 73.7 ± 5.8 years. Some, 30.7% had xerostomia: 25.6% mild, 4.8% moderate and 0.3% severe, the majority being female (34.8% vs 24%; p = 0.003). The mean XI was 24.6 ± 6.3 (95% CI 19.2-24.8) for those with poor health, whereas it was 17.4 ± 6.3 (95%CI 16.1-18.6) in those reporting very good health (p < 0.001). This difference was also observed in terms of oral health, with the XI mean recorded as 14.7 ± 10.7 for very poor oral health and 6.4 ± 5.4 for those with very good health (p = 0.002). Logistic regression showed that the highest OR for xerostomia was observed among adults with poor general health (2.81; 95%CI 1.8-4.3; p < 0.001) and for adjusted model the OR was still significant (2.18; 95%CI 1.4-3.4; p = 0.001). Those who needed help with household chores had 2.16 higher OR (95%CI 1.4-3.4; p = 0.001) and 1.69 (95%CI 1.1-2.7; p = 0.03) in the adjusted model. Females had a higher risk of suffering from xerostomia than males. CONCLUSION: The strong association between xerostomia and the general and oral health status of older adults justifies the need for early assessment and regular follow-up.

Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography.

PURPOSE: This study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity. METHODS: 212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P < 0.05 was considered statistically significant. RESULTS: PSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males. CONCLUSIONS: The use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery.

Utilización de dentina autógena para relleno del gap en el implante inmediato postextracción: a propósito de un caso clínico con seis meses de seguimiento / Autogenous dentin graft in the immediate post-extractive implant gap: six-month follow up of a clinical report

Introducción: las extracciones dentarias producen una reabsorción horizontal y vertical de la cresta alveolar, que se puede minimizar con algunas técnicas quirúrgicas, como la colocación de implantes inmediatos post-extracción, asociados al empleo de biomateriales. Caso clínico: se presenta el caso clínico de una mujer de 48 años, que acudió a consulta presentando dolor intenso en la zona del incisivo lateral superior izquierdo, asociado a una profundidad de sondaje de 12 mm. Se realizó la exodoncia del 2.2, y la colocación de un implante inmediato post-extracción, utilizando la dentina de la raíz extraída, para rellenar el gap entre el implante y la cortical vestibular, mostrando buenos resultados clínicos y radiográficos a los 6 meses tras la intervención. Discusión: aunque en la actualidad se utilizan multitud de biomateriales para reducir la reabsorción ósea en los implantes inmediatos post-extracción, ninguno de ellos parece tener mejores resultados que el resto, suponiendo en este sentido la dentina autógena una alternativa útil al tratarse de un material autólogo, con buenas tasas de aceptación por parte de los pacientes, y teniendo unas propiedades adecuadas de osteoconducción y osteoinducción.Conclusiones: la dentina autógena presenta buenos resultados clínicos y radiográficos para rellenar el gap en implantes inmediatos post-extracción (AU)

Introduction: Tooth extraction produces an horizontal and vertical resorption of the alveolar ridge, which can be reduced by many surgical techniques, such as immediate post-extractive implants, in combination with bone substitutes. Clinical case: A clinical case of a 48-year-old woman is presented, who went to dental clinic referring pain in her upper lateral incisor, associated to high probing depth. An immediate post extractive implant was placed, employing autogenous dentin from the root extracted, to fill the gap between the implant and the buccal plate, showing good clinical and radiographic evolution 6 months after surgery. Discussion: Although nowadays there are different bone substitutes to reduce bone resorption when immediate implants are placed, they have similar results, becoming autogenous dentin an useful alternative, which is an autologous material, with good patient acceptation rates and osteoconductive and osteoinductive properties.Conclusion: Autogenous dentin shows promising clinical and radiographical results when it is used to fill the gap in the post-extractive immediate implant (AU)

Consensus Report on Preventive Antibiotic Therapy in Dental Implant Procedures: Summary of Recommendations from the Spanish Society of Implants.

Current patterns of preventive antibiotic prescribing are encouraging the spread of antimicrobial resistance. Recently, the Spanish Society of Implants (SEI) developed the first clinical practice guidelines published to date, providing clear guidelines on how to prescribe responsible and informed preventive antibiotic therapy (PAT) based on the available scientific evidence on dental implant treatments (DIs). The present document aims to summarise and disseminate the recommendations established by this expert panel. These were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were analysed using the Scottish Intercollegiate Guidelines Network (SIGN) checklist templates and ranked according to their level of evidence. They were then assigned a level of recommendation using the Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). Guidelines were established on the type of PAT, antibiotic and dosage of administration in the placement of DIs without anatomical constraints, in bone augmentation with the placement of DIs in one or two stages, placement of immediate DIs, sinus elevations, implant prosthetic phase, as well as recommendations in patients allergic to penicillin. Therefore, the PAT must be adapted to the type of implant procedure to be performed.

Autotrasplante de un tercer molar superior para reposición de un primer molar superior: a propósito de un caso clínico / Autotransplant of an upper third molar to replace a first molar: a clinical case

Introducción: el desarrollo de los implantes dentales ha hecho que los autotrasplantes se realicen con menor frecuencia, pese a sus altas tasas de éxito y desuponer una alternativa terapéutica quepermite la realización de rehabilitacionesnaturales, funcionales y estéticas.Caso clínico: se presenta el caso de unvarón de 28 años, que acudió a consulta por la presencia de unos restos radiculares en localización de primer molarsuperior izquierdo. Se realizó un autotrasplante dental, siendo el diente donanteel tercer molar superior izquierdo, quese trasplantó al alveolo del primer molar,mostrando buena evolución clínica y radiográfi ca.Discusión: existen diferentes alternativas terapéuticas para reponer los dientesausentes, dentro de las cuáles se encuentran los autotrasplantes, con altas tasasde éxito en dientes con ápices abiertos ycerrados. Los dientes más frecuentemente trasplantados son los terceros molares,como se muestra en el presente caso clínico, sugiriéndose como una opción más,que deben tener en cuenta profesionalesy pacientes.Conclusiones: aunque los autotrasplantes tienen indicaciones más limitadas, suponen un menor coste para los pacientes,y una restauración más simple para elprofesional. Además, sufren micromovimientos, consiguiendo una armonía oclusal en relación a los dientes adyacentes,presentando una alta tasa de éxito (AU)

Introduction: dental autotransplants arenot performed frequently due to dentalimplant development, although theiracceptable success rates, and being atherapeutic option which allows natural,functional and aesthetic restorations.Clinical case: a clinical case of a 28-yearold man is presented, who went todental clinic for removal of left fi rst molarroots. An autotransplant was performedusing left third molar as donor tooth,which was transplanted into fi rst molaralveolus, showing promising clinical andradiographic evolution.Discussion: there are different therapeuticalternatives to restore missing teeth,being one of them dental autotransplants,with acceptable success rates in teethwith both opened and closed apexes.Third molars are the most frequentlytooth being transplanted, as shown in thisclinical case, being suggested as anotheroption, important for professionals andpatients.Conclusion: althouth autotransplants´indications are more limited, they aremore economical, and are simpler tobe restored. Besides, they suffer micromovements, having an occlusal harmonyin relation to adjacent teeth, with highsuccess rates(AU)

Demirjian and Cameriere methods for age estimation in a Spanish sample of 1386 living subjects.

Currently, human identification is a challenge. Migration due to war, economic crisis or other factors is frequent. The wisdom teeth are the last teeth to initiate and complete development therefore, are fundamental for determining the legal age of majority in different countries. The aim of the study is to determine the validity of two methods based on mineralisation of the third molar to predict the ages of majority of individuals in a Spanish population. Orthopantomographies of 636 men and 750 women (mean age, 16.5 years) were analysed. The Demirjian and Cameriere methods were used, and each tooth was assigned a value according to the degree of mineralisation and maturation. The level of significance used in the analyses was 5% (α = 0.05), with a power of 96.2%. The predictive ability of the Demirjian method to determine 18 years of age in the lower wisdom teeth 93%, respectively. The Cameriere method has a predictive capacity of 88%. There are no statistically significant differences between men and women. Stage H and a cut-off point of 0.08 were the guiding values for determining the age of majority of the study population. For other proposed age ranges (14 and 16 years), both methods were useful in determining the actual age of individuals, with the Demirjian method having a sensitivity of 97.5% with and Cameriere having a predictive capacity of 95%. Both methods can be used with high reliability to determine the age of individuals where reliable documentation is unavailable. Stage H with the Demirjian method and a cut-off point of 0.08 with the Cameriere method can determine the age of majority of the Spanish population. The combination of the two methods does not substantially increase predictive ability.

Analysis of the Radiological Changes of the Sinus Membrane Using Cone Beam Computed Tomography and Its Relationship with Dental Treatments. A Retrospective Study.

The aim of this study was to identify the most relevant dental factors and iatrogenic causes in the development of pathological changes to the sinus membrane and to analyse their possible influence on the development of odontogenic sinusitis. A descriptive, observational study was designed, with 276 patients who had been evaluated via cone beam computed tomography, analysing possible sinus thickening factors, such as apical infections, endodontic treatments, periodontitis, radicular cysts and impacted teeth, as well as iatrogenic factors caused by implant treatments or the development of oroantral communications produced during tooth extraction manoeuvres. Among the dental factors, periodontitis (47.1%), apical pathology (23.5%) and endodontic treatments (23.1%) were the predominant causes of sinus membrane thickening that most frequently produced an occupancy between 2 and 10 mm. Regarding the implant treatments, the placement of implants through the floor of the maxillary sinus was the main cause (9.8%), followed by sinus elevation techniques (6.2%). Dental extraction was the first cause of oroantral communication (5.0%), being the procedure that caused the greatest thickening of the sinus membrane. This study highlights the importance of dental treatments and iatrogenic factors in sinus pathology, and the need for diagnostic interrelations between the different specialists who address this pathology.

Regeneración ósea guiada con dentina autógena tras la exodoncia de un premolar retenido en posición invertida: evaluación a 4 meses de un caso clínico / Guided bone regeneration with autogenous dentin after extraction of an impacted bicuspidin inverse position: 4-month evaluation of a clinical case

Introducción: el empleo de técnicas regenerativas tras la extracción de dientes retenidos ha mostrado su eficacia con diversos materiales de regeneración, al asociarse al empleo de membranas, pero en los últimos años se ha descrito el empleo de dentina autógena en procedimientos de regeneración ósea, mostrando unos resultados favorables. Caso clínico: se presenta un caso clínico de una mujer de 20 años, sin antecedentes médico-quirúrgicos de interés, que acudió a consulta remitida por su ortodoncista, para la extracción de un premolar maxilar retenido, en posición invertida. Tras la extracción del premolar y del tercer molar inferior retenidos, se obtuvo dentina procedente de ambos, para la regeneración ósea guiada del defecto resultante de la extracción del premolar, realizando revisiones a la semana y a los 4 meses de la intervención. Conclusiones: la dentina autógena demuestra ser un biomaterial biocompatible, adecuado para procedimientos de regeneración ósea guiada, tras la extracción de dientes retenidos, como alternativa a otros biomateriales. (AU)

Introduction: regenerative bone techniques after impacted teeth extraction have shown to be effective with different materials, when used in conjunction with membranes, but in the last few years, autogenous dentin has been used in bone regeneration procedures, having promising results. Clinical case: a clinical case of a 20-year-old woman is presented, with no interesting medical record, who went to dental clinic for removal of an inverse maxillary bicuspid retained. After maxillary bicuspid and lower third molar extractions, autogenous dentin was obtained from both teeth, to perform a guided bone regeneration of the bicuspid defect. A week and 4-month check-up were carried out. Conclusion: autogenous dentin has shown to be a biocompatible material, adequate for guided bone regeneration procedures, after extraction of impacted teeth, as an alternative to other biomaterials. (AU)

Traumatismos bucodentales en la práctica del rugby: a propósito de un caso / Oral trauma in rugby practice: about a case

Introducción: La participación en el rugby se ha visto incrementada con el paso de los años, especialmente en países donde la práctica de este deporte no era habitual, lo que ha arrojado como consecuencia un aumento en la incidencia de lesiones, dada la naturaleza de alto impacto del mismo. Diversos estudios epidemiológicos han evaluado la incidencia de traumatismos bucodentales como consecuencia de accidentes deportivos, en los que se hace referencia a las fracturas dentarias como aquellas más comúnmente producidas dentro de la práctica de este tipo de deportes. Descripción del caso clínico: Se presenta el caso clínico de un paciente varón de 18 años de edad, sin antecedentes médicos de interés, remitido al servicio de Cirugía Bucal del Hospital Viamed Virgen de la Paloma de Madrid, quién presentaba una lesión de tejidos blandos, además de luxación palatina del sector dentario anterosuperior, como consecuencia de un traumatismo durante un partido de rugby, para el cual se prescribió tratamiento farmacológico combinado con una ferulización, permitiéndose así la cicatrización espontánea de los tejidos. Discusión y conclusiones: Se observa una alta incidencia de lesiones producidas durante la práctica del rugby debido al escaso equipamiento protector usado por los jugadores, donde la cara y sus tejidos blandos constituyen las zonas con mayor frecuencia de afectación, pudiendo considerarse como el deporte de alto impacto con mayor prevalencia de lesiones de cabeza y cuello. (AU)

Introduction: Participation in rugby has increased over the years, especially in countries where the practice of this sport was not common, which has resulted in an increase in the incidence of injuries given its high-impact nature. Various epidemiological studies have evaluated the incidence of oral trauma as a result of sports accidents, in which dental fractures are referred to as those most commonly produced within the practice of this type of sports. Description of the clinical case: We present the clinical case of an 18-yearold male patient, with no relevant medical history, referred to the Oral Surgery Service of the Virgen de la Paloma Viamed Hospital in Madrid, who presented a soft tissue lesion in addition to a palatal dislocation of the dental sector anterosuperior as a result of trauma during a rugby match, for which drug treatment combined with splinting was prescribed, thus allowing spontaneous tissue healing. Discussion and conclusions: A high incidence of injuries produced during rugby practice is observed due to the scarce protective equipment used by the players, where the face and its soft tissues constitute the areas with the highest frequency of affectation and can be considered as the high-impact sport with the highest prevalence of head and neck injuries. (AU)

Clinical Evaluation of Dental Implants with a Double Acid-Etched Surface Treatment: A Cohort Observational Study with Up to 10-Year Follow-Up.

BACKGROUND AND OBJECTIVES: The main purpose of this study was to evaluate the survival and success rates of dental implants with a double acid-etched surface treatment with evaluation times up to 10 years post-loading. Materials and Methods: This study was conducted at a hospital oral surgery and implantology unit. It included 111 dental implants with a double acid-etched surface. Three groups were created: Group 1 (1-3 years loading), Group 2 (3-5 years loading), and Group 3 (over 5 years loading). Probing depth, resonance frequency analysis (ISQ value), and marginal bone loss were evaluated. Results: The data obtained underwent statistical analysis. Overall, 78 patients were included in the study, who received, in total, 111 dental implants, all replacing single teeth. Mean probing depth was 3.03 mm and mean ISQ was 65.54. Regarding marginal bone loss, in Group 1, 67.6% of implants did not undergo any thread loss, in Group 2, 48.3%, and in Group 3, 59.6%; 59.10% of all implants did not present thread loss with a mean bone loss of 0.552 mm. The implant survival rate was 99.1%, and the success rate was 96.37%. Conclusions: Implants with a double acid-etched surface showed excellent success rates in terms of marginal bone loss, ISQ, and probing depth after up to 10 years of loading, making them a clinically predictable treatment option. Future studies are needed to compare this implant surface with other types in different restorative situations.

Surgical approach combining implantoplasty and reconstructive therapy with locally delivered antibiotic in the treatment of peri-implantitis: A prospective clinical case series.

BACKGROUND: Nonsurgical treatment, resective surgery, reconstructive surgery, or combined approaches have been proposed for the treatment of peri-implantitis, with variable results. PURPOSE: To evaluate the 1-year clinical and radiographic outcomes following combined resective and reconstructive surgical treatment with topical piperacillin/tazobactam antibiotic in the management of peri-implantitis. MATERIAL AND METHODS: Forty-three patients diagnosed with peri-implantitis were included. Surgical treatment consisted of implantoplasty of the supra-crestal component of the defect, the application of a topical antibiotic solution over the implant surface, and subsequent reconstruction of the intra-osseous component of the peri-implant defect. The primary outcome was disease resolution, defined as the absence of bleeding on probing (BoP) and/or suppuration on probing (SoP), a peri-implant pocket probing depth (PPD) ≤5 mm, and no bone loss >0.5 mm 1 year after surgery. Secondary outcomes included changes in BoP, PPD, SoP, and peri-implant marginal bone levels. One implant per patient was included in the analysis. RESULTS: The treatment success rate of the 43 dental implants included in the study was 86% at 1 year after surgery. Mean PPD and BoP decreased from 6.41 ± 2.11 mm and 100% at baseline to 3.19 ± 0.99 mm (p < 0.001) and 14% (p < 0.001) at 1 year, respectively. SoP was significantly reduced from 48.8% at baseline to 0% 1 year after surgery (p < 0.001). Radiographically, a mean defect fill of 2.64 ± 1.59 mm was recorded (p < 0.001). CONCLUSIONS: The combination of a resective and reconstructive surgical approach together with locally delivered antibiotic achieved a high disease resolution rate after 1 year of follow-up and constitutes a viable option for the management of peri-implantitis.

Use of Phentolamine Mesylate in Implant Surgery: Analysis of Adverse Effects and Haemodynamic Changes.

The clinical application of phentolamine mesylate (PM) as an anaesthetic reversal agent has been documented in the paediatric population and in conservative dentistry, but no studies have been conducted regarding dental implant surgery. A prospective randomised study was conducted on 60 patients eligible for mandibular implant treatment, randomly divided between a control group (CG) and an experimental group (EG), to whom PM was administered. Haemodynamic changes, adverse effects and patient satisfaction were assessed. No statistically significant differences in haemodynamic changes and postoperative pain were found between CG and EG (p < 0.05), except for systolic blood pressure (SBP), which increased slightly in EG, without posing a risk to patients. There were no differences in the occurrence of adverse effects between the two groups, except for greater difficulty in chewing and biting (p < 0.05) in CG and greater pain in the injection area (p = 0.043) in EG. Among EG patients, 83.3% reported that they would request PM again for future dental treatment. The use of PM offers an alternative to implant surgery, thereby increasing patients' quality of life without increasing the risks.