Straight and tilted implants for supporting screw-retained full-arch dental prostheses in atrophic maxillae: A 2-year prospective study.

BACKGROUND: To evaluate, over a 2-year period, the treatment outcomes for maxillary full-arch fixed dental prostheses (FDPs) supported by a combination of both tilted and axially-placed implants and to compare the marginal bone loss (MBL) and implant survival rates (SR) between tilted and axial implants. MATERIAL AND METHODS: A retrospective study has been carried out. Thirty-two patients (16 males and 16 females) treated with maxillary full-arch FDPs were included in this retrospective study. A total of 187 implants were inserted to rehabilitate the fully edentulous maxillary arches: 36% of them were tilted (T group, n = 68) and the remaining 64% were axially placed (A group, n = 119). From the total, 28% of the implants (n=53) were immediately loaded with screw-retained provisional acrylic restorations, whereas 72% underwent conventional delayed prosthetic loading 6 months post-operatively. Definitive restorations were hybrid implant prostheses (metal framework covered with high-density acrylic resin) and metal-ceramic screw-retained implant prostheses, and were placed 6 months after surgery. Such definitive restorations were checked for proper function and aesthetics every three months for two years. Peri-implant marginal bone levels were assessed by digital radiographs immediately after surgery and MBL was assessed at definitive implant loading (baseline) and 2 years afterwards. RESULTS: The 2-year implant SR were 100% for axially placed implants and 98.5% for tilted implants. No significant differences were found amongst the A and T implant groups. Marginal bone loss measured at 2 years after definitive prosthetic loading was of -0.73 ± 0.72 mm (maximum MBL of 1.43 mm) for axially positioned implants vs. -0.51 ± 0.92 mm for tilted implants (maximum bone 1.45 mm). Differences in MBL were statistically significant when comparing immediately and delayed loaded implants. CONCLUSIONS: Based on the results of this retrospective clinical study, full-arch fixed prostheses supported by a combination of both tilted and axially placed implants may be considered a predictable and viable treatment modality for the prosthetic rehabilitation of the completely edentulous maxilla.

¿Existe relación entre enfermedad cardiovascular Y periodontitis? / Are there relation between cardiovascular disease and periodontitis?

La hipótesis infecciosa de la aterosclerosis ha permitido un rápido avance en el conocimiento sobre los mecanismos patogénicos de la enfermedad coronaria. Más aun, el concepto de la enfermedad coronaria como una enfermedad inflamatoria ha abierto nuevos caminos para la investigación en el campo de la cardiopatía isquémica. Estudios recientes han sugerido que el empleo de marcadores de inflamación ayudaría en la identificación de pacientes con alto riesgo de padecer eventos cardiovasculares. También los estudios epidemiológicos han implicado a la periodontitis como un factor de riesgo para el desarrollo de la enfermedad cardiovascular. La enfermedad periodontal proporciona una fuente de bacterias o de sus productos, y citoquinas de respuesta hiperinflamatoria del huésped por largos periodos de tiempo. Dada la cronicidad de la enfermedad cardiovascular y de la enfermedad periodontal probablemente comparten algunos caminos de común etiología (AU)

The infectious theory to explain atherosclerosis has allowed researchers to advance quickly on the knowledge about pathogenia of cardiovascular disease. Even more, the concept of coronary disease as an inflammatory disease has developed new pathways for investigating the ischaemic cardiac. Recent investigations suggest that the use of inflammatory markers may help for early detecting patients who present high risk of cardiovascular strokes appearance. Also, epidemiological essays have revealed that periodontitis is a risk factor for cardiovascular disease to develop. Periodontitis is a source of bacterias or their wastes, and provoke a hyperinflammatory response on the hostage, liberating cytokines for long periods. Due to chronicity of both cardiovascular and periodontal disease, they may have some similar ethilogycal ways (AU)