Is it possible to predict neurosensory alterations in impacted lower third molar removal based on preoperative imaging procedures? A prospective cohort study / ¿Es posible predecir alteraciones neurosensoriales en la extracción del tercer molar inferior impactado basándose en procedimientos de imagen preoperatorios? Un estudio de cohorte prospectivo

Background: Surgical extraction of the lower third molar (LTM) may trigger neurosensory injury of the inferioralveolar nerve, making extraction a real challenge. This study set out to assess whether is it possible to predictneurosensory alterations from preoperative imaging.Material and Methods: A total of 99 patients underwent 124 impacted lower third molar (ILTM) surgeries. Priorto surgery, panoramic and CBCT images were evaluated in an attempt to predict a neurosensory disturbance.Preoperative data (ILTM position, panoramic radiograph signs, inferior alveolar nerve (IAN) location and its con-tact with the ILTM roots) and intra/postoperative findings (extraction difficulty and sensitivity alterations) wererecorded. Descriptive and bivariate data analysis was performed. Statistical comparison applied the chi-squaretest, Fisher test, and one-way ANOVA test. Statistical significance was established with a confidence interval (CI)of 95%.Results: In 4.03% of cases, patients experienced neurosensory alterations. Of 124 ILTM positions in panoramicradiographs, 76 cases were considered to exhibit a potential neurosensory risk as they presented two or more typesof superimposed relationships between ILTM and mandibular canal. Of these, alterations were reported in onlythree cases (3.95%). Of the 48 remaining ILTM images presenting only one sign, neurosensory alterations wereobserved in two cases (4.17%). No permanent alterations were recorded in any of the five cases observed.Conclusions: Within the limitations of the present study, prediction of neurosensory alterations prior to ILTMextraction by means of preoperative imaging did not show a significant statistical correlation with post-surgicalincidence. Nevertheless, interruption of the canal´s white line (ICWL) or a diversion of the canal (DC) may predictan increased risk of IAN injury.(AU)

Comparison of the effectiveness of two manual toothbrushes: Conventional design versus double-sided toothbrush design. A pilot study.

OBJECTIVES: Dental hygiene is the most effective method in the prevention of oral diseases. However, most patients do not use the recommended teeth brushing techniques and/or time brushing is insufficient. With this objective, modifications in conventional toothbrushes have been developed to deal with these findings. The aim of this study was to compare plaque removal effectiveness of a manual toothbrush with a modified head (MTMH) with a wrap-around design versus a conventional manual toothbrush. METHODS: This pilot prospective clinical study was designed according to STROBE guidelines. The patients suspended oral hygiene habits for 24 h (baseline). Subsequently, the teeth were brushed for 60 s. Both toothbrushes followed the same study procedure, separated by 1 month. Plaque-removing effectiveness was measured before and after tooth brushing using the modified O'Leary Plaque Index (PI). RESULTS: Seven patients were included in this pilot study. The mean age was 37.66 ± 10.68 years. PI mean differences between baseline and after brushing were 51.99% ± 16.43 for MTMH and 27.93 ± 6.85, for conventional toothbrush (p = 0.0013). After brushing, mean PI values were 18.36% ± 6.95%, and 37.61% ± 10.57% respectively (p < 0.001). CONCLUSION: Within the limitations of the present study, it can be concluded that the effectiveness of plaque removal by using MTMH is significantly higher than the conventional manual toothbrush.

Effect of time-dependent ibuprofen administration on the post operatory after impacted third molar extraction: a cross-over randomized controlled trial.

PURPOSE: To evaluate time-dependent administration of ibuprofen in a lower third molar extraction model. METHODS: Eleven patients requiring bilateral surgical removal of lower third molars were recruited and randomized into a blinded crossover randomized controlled trial. For 3 days after surgery, the control group was prescribed ibuprofen 400 mg every 8 h. On the other hand, the experimental group received also ibuprofen 400 mg at breakfast and lunch, replacing the dinner intake with a placebo. Pain measurements (Visual Analog Scale from 0 to 10) were recorded at baseline, 24, 48, and 72 h postoperatively. Facial swelling and trismus were also measured at baseline, 24, and 72 h postoperatively. RESULTS: Postoperative swelling and pain perception did not show significative difference between the control and experimental groups at 24, 48, and 72 h. Trismus was significantly lower in the control group than in the experimental group at 72 h postoperatively (p = 0.008). Rescue medication consumption seemed to be comparable between groups. CONCLUSION: Eliminating night time ibuprofen might be insignificant for pain control after third molar extraction.

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.

Patient-reported outcomes in patients with severe maxillary bone atrophy restored with zygomatic implant-supported complete dental prostheses: a systematic review.

Introduction and Objective: Zygomatic implants (ZI) offer a good and predictable alternative to reconstructive procedures of atrophic maxillae. The main objetive of this systematic review was to assess the effect of rehabilitation with zygomatic implants on patient's quality of life (QLP) using Patient Reported Outcomes Measures (PROMs).Materials and Methods: This review followed PRISMA guidelines. An automated electronic search was conducted in four databases supplemented by a manual search for relevant articles published until the end of January 2021. The Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa Quality Assessment Scale were used to assess the quality of evidence in the studies reviewed.Results: General findings of this systematic review showed substantial increases in Oral health-related quality of life (OHRQoL) among patients restored with ZI and high scores in terms of general satisfaction, especially in chewing ability and esthetics. An overall survival rate of ZI was 98.3% after a mean follow-up time of 46.5 months was observed. Occurrence of 13.1% biological complications and 1.8% technical complications were reported.Conclusions: Patients rehabilitated with zygomatic implant-supported complete dental prostheses showed substantial improvements in OHRQoL and general satisfaction with the treatment received.

Utilización de dentina autóloga como material de regeneración. Rehabilitación de un paciente mediante tratamiento quirúrgico y prostodóncico con flujo digital / Utilization of autologous dentin as regeneration material. A patients’ rehabilitation by surgical and prosthodontic treatment with digital workflow

Introducción: Existen numerosos procedimientos para conseguir un lecho óseo adecuado para colocar implantes tras la pérdida de dientes naturales. En los últimos años se han propuesto técnicas para la preservación del lecho tras la extracción dental. Los injertos de dentina autóloga ofrecen un sustrato conveniente con propiedades osteoinductivas y osteogénicas óptimas para la regeneración alveolar. Objetivo: Se presenta un caso clínico de un paciente rehabilitado mediante un tratamiento quirúrgico y prostodóntico, y una actualización de la bibliografía en relación con los injertos de dentina autóloga. Caso clínico: Varón de 64 años sin antecedentes médicos ni hábitos patológicos, que presenta desgastes severos, inestabilidad oclusal y problemas estéticos. Se realiza una rehabilitación integral del paciente combinando una técnica quirúrgica de preservación alveolar con injerto de dentina autóloga, tras la cual se procede a la colocación de implantes, con un tratamiento protésico de coronas de zirconio, incrustaciones de disilicato de litio y reconstrucciones de composite. El tratamiento protésico se realiza en dos fases, pasando por una fase de provisionalización previa a la colocación de las restauraciones definitivas, empleando el flujo digital. A los 6 meses el paciente se encuentra satisfecho y con una función y estética óptima. Conclusiones: El injerto de dentina autóloga parece una alternativa eficaz y predecible como material de regeneración alveolar. Combinando esta técnica de preservación con una planificación digital, se puede maximizar el resultado del tratamiento rehabilitador, consiguiendo una mayor satisfacción del paciente. (AU)

Introduction: There are multiple procedures to achieve an adequate bone site for implant placement after teeth loss. In the last years, numerous techniques have been proposed for alveolar preservation. Dentin autologous grafts offer a convenient substrate with osteoinductive and osteogenic properties, which are optimum for alveolar regeneration. Objective: In this article, a clinical case of a patient rehabilitated by surgical and prosthodontic treatment, and a review of the literature regarding autologous dentin grafts is presented. Case report: 64 years old male, with no medical records or parafunctional habits, presents severe wear, occlusal instability and aesthetic problems. An integral rehabilitation is performed combining a surgical preservation technique with autologous dentin graft, after which the placement of the implants takes place, and a prosthodontic treatment with zirconium crowns, lithium disilicate inlays and composite restorations. The prosthodontic treatment is accomplished in two phases, going through a provisionalization phase previous to the placement of the definitive restorations, and digital workflow is used. 6 months later, the patient is satisfied, and function and aesthetic are optimum. Conclusions: Dentin autologous graft offers a predictable and effective alternative as a material for alveolar regeneration. Combining this preservation technique, with a good digital planification, results can be maximized and satisfaction for the patient can be increased. (AU)

Socket shield technique: A systematic review of human studies.

BACKGROUND AND PURPOSE: Alveolar bone resorption after dental extraction frequently leads to situations in which long-term function and esthetic success of rehabilitations with dental implants is a challenge. Socket shield has been described as an alternative technique to maintain the alveolar ridge when placing immediate implants. The aim of this review is to evaluate the medium- and long-term clinical outcomes of the socket shield technique in human studies. MATERIAL AND METHODS: This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Cochrane Collaboration tool, the Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. RESULTS: Six articles were included in this review. The studies analysed showed lower rates of horizontal and vertical alveolar bone resorption, better maintenance of the buccal plate, less marginal bone loss and better esthetic results than simple placement of immediate implants. However, a lack of homogeneity was found in evaluation methods of the different outcomes, surgical procedures and prosthetic management. CONCLUSIONS: Based on the results of this review, it is possible to suggest that socket shield technique could be a good alternative in terms of alveolar bone maintenance, marginal bone stability and aesthetic outcomes in immediate implant treatment. However, it is not possible to recommend this technique as an alternative treatment with the same long-terms predictability as conventional immediate implants.

Clinical performance of alveolar ridge augmentation with xenogeneic bone block grafts versus autogenous bone block grafts. A systematic review.

INTRODUCTION: This systematic literature review aimed to evaluate the feasibility of xenogeneic bone blocks for ridge augmentation compared with autogenous blocks by analyzing block survival rates, block resorption, subsequent implant survival rate, post-surgical complications, and histomorphometric findings. MATERIALS AND METHODS: Electronic searches were conducted in the Medline (PubMed), Web of Science and Cochrane databases, complimented by a manual search in specialist journals, for relevant articles published up to March 2020. Inclusion criteria were human studies in which the outcomes of xenogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant survival rates. RESULTS: Sixteen articles fulfilled the inclusion criteria and were analyzed. 333 patients were recruited with a total of 337 xenogeneic bone blocks and 82 autogenous bone blocks, showing block failure rates of 6.82% and 6.1%, respectively. Bone gain, in both height and width, was similar among xenogeneic and autogenous bone blocks, but autogenous bone blocks suffered greater resorption. Implant survival rates were slightly lower for xenogeneic bone blocks. Histological and histomorphometric analysis observed more bone formation and less residual bone substitute with autogenous bone blocks than xenogeneic bone blocks. CONCLUSIONS: Atrophic alveolar crest reconstruction with xenogeneic bone block grafts would appear to offer a viable alternative to autogenous bone block grafts, obtaining similar block graft failure rate, fewer sensitive postoperative complications but a slightly lower implant survival rate. Further investigations generating long term data are needed to confirm the feasibility of xenogeneic bone blocks in different clinical scenarios.

Effectiveness of the bone ring technique and simultaneous implant placement for vertical ridge augmentation: a systematic review.

BACKGROUND: Dimensional changes after dental extraction frequently lead to situations in which bone augmentation procedures are required prior to dental implant placement. Bone ring technique (BRT) has been described as a one-stage approach to restore vertical alveolar ridge defects, in which an autogenous or allogeneic cortico-cancellous bone block graft is stabilized with a dental implant inserted simultaneously. The objective of this systematic review was to evaluate the clinical performance of BRT. MATERIALS AND METHODS: This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. RESULTS: Sixteen studies with a total of 186 patients treated with 219 bone rings bocks were included in the review. The studies showed a mean bone gain of 4.94 mm, mean bone resorption of 0.83 mm, and mean marginal bone loss of 0.57 mm after a mean follow-up period of 13.35 months. A mean bone ring survival rate of 97.26% and implant survival rate of 94.97% were recorded. CONCLUSIONS: BRT would appear to be an adequate alternative technique for restoring single vertical alveolar ridge defects with simultaneous dental implant placement. However, further studies comparing this technique with other vertical ridge augmentation procedures in different clinical scenarios are needed to confirm the present results.

Placing Dental Implants through Impacted Teeth to Support a Fixed Partial Denture in a Geriatric Patient as an Alternative to Invasive Extraction Surgeries.

Multiple dental impactions not associated with craniofacial syndromes are a rare condition and present the dentist with a therapeutic challenge when it comes to performing surgical/restorative treatments in adult patients. This case report describes a geriatric patient with multiple impacted teeth restored by means of two different protocols. In the second quadrant, an impacted tooth was extracted followed by regeneration and placement of an implant. In the third quadrant, implants were placed though impacted teeth for restoration with a fixed partial prosthesis. Placing dental implants through impacted teeth may offer a possible therapeutic option for implant-supported restorations in middle-aged or elderly patients, for whom surgery and orthodontic traction are not possible, and/or patients who refuse to undergo more invasive extraction surgery.

Material de injerto en elevación de seno atraumática: ¿es necesario? Parte I / Graft material in atraumatic sinus lift elevation: ¿is it necessary? Part I

INTRODUCCIÓN: la reabsorción vertical de la zona posterior del maxilar supone un reto terapéutico para el profesional, ya que son necesarias técnicas regenerativas para poder colocar implantes den-tales. La elevación de seno atraumática permite la colocación de implantes dentales de manera simultánea al procedimiento regenerativo, pero hay controversia en la necesidad o no de emplear materiales de injerto asociados a esta técnica. Ganancia ósea: al comparar la utilización o no de materiales de injerto en elevaciones de seno atraumáticas, se obtiene una ganancia ósea de 1-6.8 mm cuando no se emplean biomateriales, y 3.07-8.5 mm al utilizarlos. Pérdida ósea marginal: los estudios reflejan una pérdida ósea marginal de 0.5-1.54 mm al no emplear materiales de injerto, respecto a 0.7-1.67 mm cuando se utilizan. Supervivencia de implantes: ambas técnicas de elevación de seno atraumática presentan tasas de supervivencia imlantarias similares, superiores al 90 %.Complicaciones: la tasa de complicaciones en esta técnica regenerativa es baja, siendo la más frecuente la perforación de la membrana de Schneider, no suponiendo en la mayoría de los casos un impedimento para la colocación de implantes dentales. CONCLUSIONES: la técnica de elevación de seno sin relleno presenta menor ganancia ósea y pérdida ósea marginal en comparación a la técnica de elevación de seno con relleno, pero ambas técnicas presentan tasas de supervivencia implantarias similares, y una baja tasa de complicaciones, por lo que la utilización o no de biomateriales asociados debe decidirse en función de todas estas variables

INTRODUCTION: vertical resorption of posterior maxilla is a therapeutic challenge for dentists, since regenerative techniques are necessary to be able to place dental implants. Atraumatic sinus lift augmentation allows simultaneous dental implants placement to regenerative procedure, but it is not clear nowadays if it is or not necessary to use associated graft materials. Bone gain: scientific evidence reports a bone gain of 1-6.8 mm without using graft materials, versus 3.07-8.5 mm when authors use graft materials in atraumatic sinus lift augmentations procedures. Marginal bone loss: similar bone loss is expected in both techniques, but atraumatic sinus lift augmentation presents 0.5-1.54 mm when graft material is not used, versus 0.7-1.67 mm when graft material is used. Implant survival: both techniques present similar survival implant rates, greater than 90 %.Complications: low complications rate is reported, being the most frequent complication Schneider membrane perforation. Nevertheless, dental implant placement is possible in spite of this complication. CONCLUSIONS: atraumatic sinus lifting without graft materials presents lower bone gain and marginal bone loss in comparison to atraumatic sinus lifting with graft materials. Both techniques present similar survival implant rates and low complication rates, so using or not grafting materials should be decided analyzing all these variables

Utilización de dentina autógena como material de injerto en Cirugía Bucal / Autogenous dentine as graft material in Oral Surgery

Las extracciones dentarias producen una pérdida ósea en sentido horizontal y vertical, que conllevan alteraciones funcionales para los pacientes, y dificultan la colocación de implantes dentales para los profesionales. Para minimizar esta pérdida ósea, se utilizan diferentes materiales de injerto, entre los cuales destaca el injerto autógeno, por cumplir las características de osteogénesis, osteoconducción y osteoinducción. En el año 2010 se describe por primera vez la utilización de dentina como material de injerto autógeno, demostrando que este material puede ser una alternativa terapéutica al resto de materiales de injerto, al permitir la osteoconducción y la osteoinducción, y mostrar la formación de hueso nuevo en un 46-87% del área con injerto de dentina autógena, 3 meses después de su utilización. La última revisión sistemática publicada en el año 2018, concluyó que los implantes colocados en áreas regeneradas en zonas en las que se empleó dentina como material de injerto, presentaron tasas de supervivencia del 97,7% después de 1 año de seguimiento, sugiriendo este nuevo material como una alternativa con resultados prometedores, aunque son necesarios más estudios al respecto

Subsequent to tooth extraction, a reduction of the length and width of alveolar ridge can be observed. It causes functional alterations to patiens, and problems to proper insertion of dental implants. In order to prevent this bone atrophy, different graft materials can be used, being considered autogenous graft the best because allows osteogenesis, osteoconduction and osteoinduction. In 2010 it was first published the use of autogenous dentine as a graft material, showing it could be an ideal graft material, as a material with excellent osteoconduction and osteoinduction. Besides, this graft material is slowly absorbed and replaced by new bone, in 46-87% of the áreas grafted with dentine, 3 months after regeneration. Last systematic review published in 2018 concluded dental implants inserted in regenerated areas with autogenous dentine had survival rates of 97,7% for over a year follow-up, so this new material is considered an alternative with good results, but there are necessary more studies with long term follow-up

Técnicas de reposición del nervio alveolar inferior: transposición y lateralización / Techniques for the reposition of the inferior alveolar nerve: transposition and lateralization

La rehabilitación de los sectores mandibulares con atrofias óseas severas utilizando implantes es objeto de desafío para cualquier profesional debido a las dificultades que presentan. Existen dos técnicas quirúrgicas para llevar a cabo la reposición del nervio dentario que son relativamente seguras y ofrecen una alta tasa de supervivencia de los implantes: la transposición y la lateralización. El objetivo de este trabajo es llevar a cabo una actualización sobre las técnicas de reposición del nervio alveolar inferior, y para ello se ha efectuado una búsqueda de estudios sobre humanos empleando las bases de datos PubMed y Scopus, utilizando como palabras clave: "transposition", "alveolar nerve", "atrophic mandibles" y "nerve complications". Se revisan para ello un total de 22 artículos de casos clínicos y estudios in vitro; 9 de ellos sobre lateralización, 8 sobre transposición y 5 sobre ambas técnicas. Tanto la lateralización como la transposición del nervio dentario presentan riesgos relacionados con complicaciones neurosensoriales y fractura mandibular. Se observa una alta tasa de éxito en la supervivencia de los implantes sin discriminación significativa de la técnica. Las técnicas de reposición del nervio dentario no están exentas de complicaciones. La inserción de los implantes combinados con la técnica de transposición presenta un comportamiento similar a cualquiera de las otras técnicas empleadas en el campo de la implantología, siendo su pérdida ósea marginal similar a la de otras superficies implantarias

The use of dental implants for the rehabilitation of the atrofic posterior mandible has been a challenge due to the complications they may carry. There are two surgical techniques for the reposition of the inferior alveolar nerve which are relatively sure and offer a high survival rate of the implants: transposition and lateralization. A research of studies about human beings is carried out, using PubMed and Scopus data bases. The key words were: "transposition", "alveolar nerve", "atrophic mandibles" and "nerve complications". It is performed a total review of 22 articles of clinical cases and in vitro studies; 9 about lateralization, 8 about transposition and 5 about both techniques. Both lateralization and transposition of the inferior alveolar nerve present risks related with neurosensorial complications and mandibular fracture. A high survival rate of the implants without discrimination of the technique is observed. Complications may appear when reposition technique of the inferior alveolar nerve is performed. It is observed a similar behavior between the use of dental implants with a reposition technique and any other, especially in terms of marginal bone loss

Aumento de tejido blando peri-implantario. ¿Qué momento temporal y técnica quirúrgica debo emplear para conseguir que mis resultados sean predecibles? Revisión de la literatura / Peri-implant soft tissue augmentation. The suitable moment and surgery technique to predict optimum success. A review of the literature

El papel de una anchura adecuada de mucosa queratinizada (MQ) alrededor de los implantes dentales en la estabilidad a largo plazo de los tejidos periimplantarios sigue siendo un tema de debate. El objetivo de esta revisión fue evaluar y describir los resultados sobre las técnicas quirúrgicas disponibles y el momento temporal en el que llevar a cabo el incremento de los tejidos blandos periimplantarios. Para ello se realizó una búsqueda bibliográfica electrónica en las bases de datos PubMed y Medline, y manual de artículos relevantes, considerando el período entre 2012 y 2017 e incluyendo aquellos artículos que trataban sobre diferentes técnicas quirúrgicas realizadas a partir del momento temporal B (desde la colocación de los implantes). Se incluyeron un total de 10 artículos, comparándolos en función del momento temporal en el que se realizó la técnica quirúrgica y analizando las siguientes variables de estudio: anchura de mucosa queratinizada, grosor/espesor de mucosa queratinizada, contracción postoperatoria, tiempo quirúrgico y estética y disconfort postoperatorio. Se puede concluir que el injerto gingival libre ha demostrado obtener las mayores anchuras de mucosa queratinizada. No obstante, existen otros materiales disponibles que reducen la morbilidad del paciente y evitan un segundo sitio quirúrgico como la matriz de colágeno xenogénica que podría ser tan efectiva y predecible como éste. Tanto la matriz de colágeno xenogénica como el injerto de tejido conectivo ofrecen resultados estéticos superiores a los conseguidos con el injerto gingival libre

The role of an adequate width of keratinized mucosa (KM) around dental implants in the long-term stability of peri-implant tissues is still controversial. The aim of this study was to evaluate and describe the results of the surgical techniques available and the moment in which the increase of the peri-implant soft tissues should take place. An electronic bibliographic search was carried out in the PubMed and Medline databases, considering the period between 2012 and 2017 and including those articles that dealt with different surgical techniques performed from time B (from the implants fitting). A total of 10 articles were included, comparing them according to the time when the surgical technique was performed and analyzing the following study variables: width of keratinized mucosa, thickness of keratinized mucosa, postoperative contraction, surgical and aesthetic time and postoperative discomfort. It can be concluded that the free gingival graft has been shown to obtain the largest widths of keratinized mucosa. However, there are other materials available that reduce the morbidity of the patient and avoid a second surgical site such as the xenogeneic collagen matrix which can be as effective and predictable as the free gingival graft. Both the xenogeneic collagen matrix and the connective tissue graft offer superior aesthetic results to those obtained with the free gingival graft

Tratamiento odontológico en pacientes con patología hormonal paratiroid / Dental treatment in patients with hormonal pathology paratiroidea

Las glándulas paratiroides son glándulas endocrinas que se encuentran situadas en la parte anterior del cuello, rodeando a la tráquea y a la laringe. Secretan hormonas que van a desempeñar funciones esenciales para el desarrollo del organismo. La alteración en la secreción de dichas hormonas va a producir patologías de cierta importancia que deberán tenerse en cuenta a la hora de realizar los tratamientos odontológicos. Antes de realizar cualquier actuación terapéutica en odontología, se debe valorar el control de las diferentes patologías y, en el caso de que estén bien controladas, se tendrán en cuenta una serie de consideraciones para evitar complicaciones derivadas de las mismas (AU)

The parathyroid glands are endocrine glands that are located in the anterior part of the neck, surrounding the trachea and the larynx. They secrete hormones that are going to have essential functions for the development of the organism. The alteration in the secretion of hormones to produce pathologies of a certain importance that can be taken into account when performing dental treatments. Before carrying out any action, in dentistry, the control of the different pathologies must be assessed and, if they are well controlled, a series of considerations must be taken into account to avoid derivatives of them (AU)

Sinusitis maxilar en implantes cigomáticos: revisión sistemática / Maxillary sinusitis with zygomatic implants: a systematic review

Introducción. La utilización de implantes cigomáticos es actualmente una alternativa terapéutica predecible y consolidada en la rehabilitación de pacientes con maxilares atróficos. Sin embargo, como toda técnica quirúrgica, presenta una serie de complicaciones que no deben obviarse. Objetivo. El objetivo de este estudio es analizar la frecuencia y las causas de sinusitis maxilar producida por el tratamiento con implantes cigomáticos. Material y método. Se realizó una revisión bibliográfica en diferentes bases de datos analizando la prevalencia y las causas de la sinusitis maxilar tras el tratamiento con implantes cigomáticos. Resultados. La mayoría de los estudios citan la sinusitis como la complicación postoperatoria que aparece con mayor frecuencia, con una frecuencia de 4,93 por cada 100 implantes colocados. Discusión. El hecho de que la sinusitis se relacione con la técnica intrasinusal ha supuesto el desarrollo de técnicas con el fin de evitarla, tales como la colocación extrasinusal de los implantes o la utilización de técnicas quirúrgicas combinadas como la elevación de seno simultánea a la colocación del implante o la cobertura con la bola adiposa de Bichat. Conclusiones. A pesar de ser la complicación más frecuente, la prevalencia es bastante baja, hecho que corrobora el éxito del tratamiento con implantes cigomáticos (AU)

Introduction. The use of zygomatic implants is now a predictable and consolidated therapeutic alternative in the rehabilitation of patients with atrophic maxilla. However, like any surgical technique, it has a few complications that should not be ignored. Objective. The aim of this study is to analyse the frequency and causes of maxillary sinusitis caused by treatment with zygomatic implants. Material and method. A systematic review was performed using different databases, searching the prevalence and causes of maxillary sinusitis due to treatment with zygomatic implants. Results. Most studies cite sinusitis as one of the most common post-operative complications, finding 4.93 cases per 100 zygomatic implants placed. Discussion. The fact that sinusitis is related to the intra-sinusal technique has led to the development of techniques in order to avoid it, such as the extra-sinusal approach of implants or the use of combined surgical techniques such as simultaneous sinus lift with implant placement or coverage with buccal fat pad. Conclusion. Despite being the most common complication, the prevalence is quite low; a fact that confirms the success of treatment with zygomatic implants (AU)

Osteoporosis como factor de riesgo para la colocación de implantes dentales / Osteoporosis as a risk factor for dental implant placement

El envejecimiento de la población española, y la afectación de ciertas enfermedades metabólicas que afectan al metabolismo óseo, pueden interferir en la colocación de implantes. La osteoporosis afecta a la calidad y cantidad ósea, por lo que la colocación de implantes puede ser arriesgada. Los estudios asocian la pérdida de implantes dentales y la osteoporosis de manera directa, aunque no de forma estadísticamente significativa. A pesar de que en la osteoporosis la cantidad y calidad ósea se ven afectadas, se ha demostrado una formación adecuada de hueso alrededor del implante y con un porcentaje de contacto óseo con la superficie del implante similar en sujetos sanos frente a sujetos con osteoporosis. Además, no se ha encontrado relación entre la pérdida de hueso marginal y la presencia de osteoporosis. hasta el momento no existen datos que contraindiquen la colocación de implantes en pacientes con osteoporosis, aunque son necesarios más estudios al respecto (AU)

The aging of the Spanish population and the impact of some metabolic diseases that affect bone metabolism may interfere in the placement of dental implants. Osteoporosis affects bone quantity and quality; therefore, dental implant placement could be risky. Studies report direct association between dental implant failure and osteoporosis, but it is not significant. Despite in osteoporosis quantity and quality are affected, it is seen an appropriate bone formation around the implant and the percentage of bone-to-implant contact is similar in both healthy and osteoporotic subjects. Furthermore, there is no relationship between marginal bone loss and the presence of osteoporosis. There is no information that contraindicate dental implant placement in osteoporotic patients, although more studies are necessary (AU)