Endodontic variables in patients with SARS-CoV-2 infection (COVID-19) in relation to the severity of the disease.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. It has been hypothesized oral health may be related to the severity and complications of COVID-19. The aim of this study was to analyze the prevalence of apical periodontitis and the frequency of root canal treatment in a sample of patients with SARS-CoV-2 infection (COVID-19), correlating them with the severity of the disease. MATERIAL AND METHODS: This retrospective study was conducted following the Strengthening Reporting Observational Studies in Epidemiology (STROBE) guidelines. The study examined 280 patients with positive real time PCR COVID-19 test whose treatment was performed in our hospital. Fifty-two patients aged 52.3 ± 17.3 years, including 30 males and 22 females, who had an orthopantomography in their clinical record, performed in the last 2 years, were included. Patients with SARS-CoV-2 infection were grouped as mild or moderate (MM) and severe or critical (SC) illness groups, according to the NIH COVID-19 Treatment Guidelines (Wu & McGoogan 2020). Radiographic records were analyzed and apical periodontitis (AP) was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score (PAI). Student's t test, χ2 test and multivariate logistic regression were used in the statistical analysis. RESULTS: The number of carious teeth was significantly higher in the SC group (3.4 ± 4.1), which showed more than twice as many teeth with carious lesions than the MM group (1.4 ± 1.8) (p = 0.02). Multivariate regression analysis showed association between the number of carious teeth and the severity of SARS-CoV-2 disease (OR = 1.5; 95% CI = 1.1-2.1; p = 0.017). Endodontic status (OR = 7.12; 95% CI = 1.2-40.9; p = 0.027) also correlated with the disease severity. CONCLUSIONS: The results suggest that the oral health status of COVID-19 patients correlated with the severity of the SARS-CoV-2 virus infection. Significant association has been found between the severity of COVID-19 disease and the presence of a greater number of teeth with caries lesions, as well as with endodontic status.

Prevalence of endodontic infection in patients with Crohn´s disease and ulcerative colitis.

BACKGROUND: Previous studies have linked apical periodontitis (AP) to inflammatory bowel disease (IBD). The aim of this study was to compare the prevalence of AP and root canal treatment (RCT) in patients with ulcerative colitis (UC) and Crohn´s disease (CD). MATERIAL AND METHODS: A cross-sectional study, including 28 patients with Crohn´s disease and 26 with ulcerative colitis, was conducted. AP was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score (PAI). Student's t test, 2 test and multivariate logistic regression were used in the statistical analysis. RESULTS: Multivariate logistic regression run with age, gender, number of teeth, number of RFT, periodontal disease and the type of IBD as covariates, taking as dependent variable and outcome "periapical status" (0 = no tooth with RPL; 1 = at least one tooth with RPL), showed that both UC and CD patients had the prevalence apical periodontitis (OR = 1.03; C.I. 95% = 0.25 - 4.31; p = 0.97). The multivariate analysis, including all the above covariates, shows that both in UC and CD patients the prevalence of RCT was similar (OR = 0.76; C.I. 95% = 0.17 - 7.31; p = 0.73). Periapical status was significantly associated with endodontic status (OR = 42.72; C.I. 95% = 3.87 - 472.15; p = 0.002), regardless of IBD type. CONCLUSIONS: The results of the present study show similar frequency of AP and RFT in both UC and CD patients. The type of IBD does not appear to affect the prevalence of radiographically detectable periapical lesions or the prevalence of root canal treatment.

Cardiovascular diseases and apical periodontitis: association not always implies causality.

BACKGROUND: Several studies published in the last two decades have found an association between the prevalence of apical periodontitis (AP) or root canal treatment (RCT) and cardiovascular diseases (CVDs). However, the demonstration of association does not prove by itself the existence of a cause-effect relationship. Two diseases can appear as statistically related without any of them directly affecting the values of the other, resulting in a non-causal relationship. The aim of this narrative review is to summarize the current state of knowledge regarding the association between AP and CVDs, analysing it according to the Hill's causality criteria. MATERIALS AND METHODS: Epidemiological studies carried out on the association between CVDs and AP or RCT published in English until 8 December 2019 were identified. Forty-four articles were selected and its results were analysed. RESULTS: Numerous cross-sectional epidemiological studies have found significant relationship between CVDs and AP. The odds ratio values range 1.6 - 5.4. However, other studies have not found significant association. Respect to RCT, some studies found correlation, but others found no association or even found that RCT is a protective factor against CVDs. CONCLUSIONS: The results are inconsistent and a causal relationship between CVDS and endodontic disease cannot be stablished. The risk factors common to both diseases can act as confounding factors, biasing the results. To reach definitive conclusions about the type of association (causal or non-causal) between both diseases, longitudinal epidemiological studies must be carried out to establish the temporal relationship and the dose-response gradient.

Reduction rate by decompression as a treatment of odontogenic cysts.

BACKGROUND: Odontogenic cysts are defined as those cysts that arise from odontogenic epithelium and occur in the tooth-bearing regions of the jaws. Cystectomy, marsupialization or decompression of odontogenic cyst are treatment approach to this pathology. The aim of this study was to evaluate the effectiveness of the decompression as the primary treatment of the cystic lesions of the jaws and them reduction rates involving different factors. MATERIAL AND METHODS: 23 patients with odontogenic cysts of the jaws, previously diagnosed by anatomical histopathology (follicular cysts (7) and radicular cysts (16)) underwent decompression as an initial treatment. Clinical examination and pre and post panoramic radiograph were measured and analyzed. In addition, data as gender, age, time reduction and location of the lesion were collected. RESULTS: Significant results were obtained in relation to the location of lesions and the reduction rate (p<0.01). In a higher initial lesion, a greater reduction rate was observed (p<0.05). CONCLUSIONS: Decompression as an initial treatment of cystic lesions of the jaws was effective; it reduces the size of the lesions avoiding a possible damage to adjacent structures. Cystic lesions in the mandible, regardless of the area where they occur will have a higher reduction rate if it is compared with the maxilla. Similar behavior was identified in large lesions compared to smaller.

Correlation between periodontal disease management and metabolic control of type 2 diabetes mellitus. A systematic literature review.

BACKGROUND: Diabetes and periodontal disease share common features in terms of inflammatory responses. Current scientific evidence suggests that treatment of periodontal disease might contribute to glycemic control. The objective of the study is a review of the last three years. MATERIAL AND METHODS: A literature search was performed in the MEDLINE (PubMed), Cochrane, and Scopus databases, for articles published between 01-01-2013 and 30-06-2015, applying the key terms "periodontal disease" AND "diabetes mellitus". The review analyzed clinical trials of humans published in English and Spanish. RESULTS: Thirteen clinical trials were reviewed, representing a total of 1,912 patients. Three of them had samples of <40 patients, making a total of 108 patients and the remaining ten samples had >40 patients, representing a total of 1,804. Only one article achieved a Jadad score of five. Seven articles (998 patients, 52.3% total), presented a statistically significant decrease in HbA1c (p<0.05) as a result of periodontal treatment. In the six remaining articles (representing 914 patients, 47.8% of the total), the decrease in HbA1c was not significant. Patient follow-up varied between 3 to 12 months. In three articles, the follow-up was of 3, 4, and 9 months, in two 6 and 12 months. CONCLUSIONS: The majority of clinical trials showed that radicular curettage and smoothing, whether associated with antibiotics or not, can improve periodontal conditions in patients with diabetes mellitus. However, few studies suggest that this periodontal treatment improves metabolic control. However, there is no clear evidence of a relation between periodontal treatment and improved glycemic control in patients with type 2 diabetes mellitus.

Sobredentaduras mandibulares sobre dos implantes en pacientes edéntulos totales. Un estudio a tres años / Mandibular overdentures over two implants in totally edentulous patients. A 3-year study

INTRODUCCIÓN: En la actualidad, la implantología oral constituye una modalidad terapéutica en el tratamiento prostodóncico de los pacientes mayores edéntulos totales. El estudio muestra la evaluación del tratamiento con sobredentaduras mandibulares mediante la carga precoz de implantes dentales. MÉTODOS: Treinta pacientes edéntulos totales fueron tratados con 60 implantes con superficie arenada y grabada Galimplant(R) en la mandíbula para su rehabilitación prostodóncica con sobredentaduras. Dos implantes fueron insertados en cada paciente. Los implantes fueron cargados funcionalmente tras un periodo de tiempo de 6 semanas con retenedores de fricción. Los hallazgos clínicos (implantológicos y prostodóncicos) se han seguido durante al menos 24 meses. RESULTADOS: Los resultados indican una supervivencia y éxito de los implantes del 98,3%. Durante el periodo de cicatrización libre de carga funcional, se perdió un implante por movilidad. La pérdida de hueso marginal media fue de 0,4 mm (0-1,1 mm). El 100% de los pacientes fueron tratados mediante una sobredentadura implantorretenida con anclajes de fricción. En cuatro pacientes se realizaron cambios en los componentes plásticos de los ataches. El seguimiento clínico medio fue de 40,8 meses (24-60 meses). CONCLUSIONES: Los resultados del presente estudio indican que la rehabilitación prostodóncica mediante la carga precoz con sobredentaduras con implantes de los pacientes edéntulos mandibulares representa una terapéutica implantológica con éxito

INTRODUCTION: Today, oral implantology constitute a therapeutic modality in the prosthodontic treatment of totally edentulous patients. This study reports the evaluation of treatment with overdentures in the mandible by early loading of dental implants. METHODS: 30 edentulous patients were treated with 60 Galimplant(R) sand-blasted and acid-etched surface implants for prosthodontic rehabilitation with overdentures in the mandible. Two implants were inserted in each patient. Implants were loaded after a healing free-loading period between 6 weeks with locator attaches. Clinical findings (implant and prosthodontics) were followed during at least 24 months. RESULTS: Clinical results indicate a survival and success rate of implants of 98,3%. One implant was lost during the healing period. Media marginal bone loss was 0.4 mm (0-1.1 mm). 100% of patients were treated with overdentures retained with 2 implants with locator attaches. Changes in plastic components of attaches were reported in 4 patients. The media follow-up was of 40.8 months (24-60 months). CONCLUSIONS: Clinical results of this study indicate that prosthodontic rehabilitation in the mandible of edentulous patients with early loading of overdentures supported by implants is a successful implant treatment

La elevación del seno maxilar en el tratamiento con implantes dentales. Un estudio a 4 años / Sinus floor augmentation in the treatment with dental implants. A 4-year study

INTRODUCCIÓN: El objetivo del presente estudio era mostrar los resultados de la elevación del seno maxilar con biomateriales en el tratamiento con implantes del maxilar posterior. MÉTODOS: 70 pacientes edéntulos parciales fueron tratados con 181 implantes Galimplant(R) con superficie arenada y grabada con ácidos para la rehabilitación del maxilar posterior mediante la técnica de elevación de seno y relleno con betafosfato tricálcico (Osteoblast(R)). Los implantes fueron cargados después de un periodo de cicatrización de 6-8 meses. RESULTADOS: Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 98,4%. Tres implantes se perdieron durante el periodo de cicatrización. El 85,1% de los implantes fueron insertados simultáneamente a la elevación del seno maxilar. Después de un periodo medio de carga funcional de 57,4 meses, no ha habido complicaciones tardías. El 22,4% de los implantes fueron restaurados con coronas unitarias y el 77,6% con puentes fijos. CONCLUSIONES: Este estudio indica que la rehabilitación del maxilar posterior con implantes mediante la técnica de elevación del seno maxilar constituye un tratamiento dental exitoso

INTRODUCTION: The aim of this study was to report the outcomes of sinus augmentation with a biomaterial in implant therapy of posterior maxilla. METHODS: 70 partial edentulous patients were treated with 181 Galimplant(R) sandblasted-etched surface implants for rehabilitation of posterior maxilla by sinus floor augmentation with betatricalcium phosphate (Osteoblast(R)). Implants were loaded after a healing free-loading period of 6-8 months. RESULTS: Clinical results indicate a survival and success rate of implants of 98,4%. 3 implants were lost during the healing period. 85,1% of implants were inserted simultaneously following the sinus floor elevation. After a mean functioning period of 57.4 months, no late complications were reported. Implants were restored with single crowns (22.4%) and fixed bridges (77.6%). CONCLUSIONS: This study indicate that rehabilitation of posterior maxilla with implant therapy by sinus floor augmentation technique constitute a successful dental treatment

El tratamiento con implantes dentales en los pacientes adultos mayores / Dental implant treatment in elderly patients

En las últimas décadas, la implantología oral ha representado una técnica creciente en gerodontología. En este sentido, la edad avanzada no es una contraindicación para la implantología oral. Desde un punto de vista integral, es necesario la valoración de las condiciones médicas del paciente mayor, un diagnóstico oral, y una correcta planificación de tratamiento, con un estricto protocolo quirúrgico y prostodóncico. Muchos pacientes candidatos para la cirugía de implantes son mayores, y su perfil médico puede ser complejo. La comunicación con su médico puede ser importante para minimizar los riesgos quirúrgicos. Después de la fase quirúrgica, el éxito a largo plazo de los implantes dentales exige una buena reacción de los tejidos blandos y duros periimplantarios. Prótesis fijas y removibles pueden estar indicadas en los pacientes mayores edéntulos, según diferentes protocolos de carga funcional. El mantenimiento por el paciente y las revisiones periódicas por el dentista son muy importantes. Las prótesis implanto soportadas mejoran la calidad de vida oral y el bienestar psicosocial de los pacientes ancianos edéntulos (AU)

During last decades, implant dentistry has been an increased technique in geriatric dentistry. Aging is not a contraindication for oral implantology. From a comprehensive point of view, are necessary a medical assessment of the aged patient, an oral diagnosis, a correct treatment planning, with a strict protocol of surgical and prosthetic procedures. Many patients for dental implant surgery are elderly, and their overall medical condition may be complex. Consultation with the patient´s physician is important to ensure that surgical risks are minimized. After the surgical step, a good reaction of hard and soft tissues is necessary for long-term success of dental implants. Fixed and removable prostheses supported by dental implants were been indicated in edentulous older patients, according several functional loading protocols. Maintenance by the patient and periodical follow-up by the dentist are very important. Implant-supported prostheses improve oral quality of life and psychosocial well-being of edentulous aged patients (AU)

Sistemas ultrasónicos para la irrigación del sistema de conductos radiculares / Ultrasonic devices for root canal system irrigation

La eliminación de los restos de tejido pulpar vital y necrótico y de los microorganismos del sistema de conductos radiculares, es esencial para el éxito en endodoncia. La desinfección del canal radicular mediante la irrigación e instrumentación es el factor más importante en la prevención y tratamiento de la periodontitis apical. Al ser imposible con la instrumentación llegar a todas las áreas del sistema de conductos, la irrigación cobra especial importancia. Por este motivo, en la última década se han desarrollado una serie de sistemas de dispensación y agitación de irrigantes, tales como los ultrasonidos. En concreto, en este artículo de revisión se evalúa la información disponible de los diez últimos años sobre la efectividad de los sistemas ultrasónicos para eliminar bacterias, tejido pulpar, restos de dentina y barrillo dentinario, la capacidad de estos dispositivos para hacer que el irrigante penetre en el sistema de conductos radiculares y la seguridad en su uso. Los resultados de la revisión muestran que los sistemas ultrasónicos son más eficaces en el desbridamiento químico, biológico y físico del sistema de conductos radiculares que los sistemas de irrigación convencional, a la vez que son seguros (AU)

Removal of vital and necrotic remnants of pulp tissues and microorganisms from the root canal system is essential for endodontic success. Disinfection of the root canal by irrigation and instrumentation are the most important factors in the prevention and treatment of apical periodontitis. As it is impossible for the instruments to reach all the areas of the root canal system, the irrigation has gained special importance. Due to this fact, technological advances during the last decade have brought new delivery and agitation devices, such as ultrasonic devices. Particularly, this review article assesses the available information from the last ten years about the effectiveness of ultrasonic devices to remove bacteria, pulp tissue, dentin debris and smear layer, and the ability of these devices to make the irrigant solution penetrate into the root canal system and the safety of its use. Nowadays scientific literature reveals that ultrasonic devices are more effective on chemical, biological and physical debridement of the root canal system than conventional technique and being safety devices at the same time (AU)

Patología implanto-endodóncica: concepto, tipos, diagnóstico, tratamiento y prevención / Endodontic-implant pathology: concept, types, diagnosis, treatment and prevention

La patología implanto-endodóncica (PIE) está descrita en la literatura implantológica como una de las causas de periimplantitis apical, entendida como la lesión osteolítica en la región apical del implante, con normal osteointegración de su porción coronal, provocada por la infección por contigüidad a partir de la lesión periapical del diente adyacente. Pero el concepto de PIE no sólo abarca la periimplantitis retrógrada por contaminación diente-a-implante, sino también los procesos inflamatorios periapicales en dientes adyacentes al implante por contaminación implante-a-diente, cuando la colocación del implante provoca la necrosis del diente adyacente y la consiguiente periodontitis apical. Incluso podríamos incluir dentro de la PIE los casos de periimplantitis apical en implantes postextracción provocada por la infección residual presente en el alvéolo de un diente extraído con periodontitis apical. En definitiva, la PIE incluye las lesiones endodóncicas e implantarias apicales que son el resultado de infecciones residuales o por contigüidad entre diente e implante. En esta revisión bibliográfica se define y clasifica la PIE, repasándose la casuística publicada así como su influencia en el resultado del tratamiento implantológico

The implant-endodontic pathology is described in the literature as a cause of apical periimplantitis, understood to be an osteolytic lesion that appears in the apical region of the implant during the coronal osseointegration normally. This implant-endodontic pathology researches the relation of endodontic and implants apical lesions leading to infection contiguity between teeth and implants. The first way of contamination is implant-tooth, when the implant placement causes necrosis of the adjacent tooth and subsequent contamination of the implant; the second way is tooth-implant, when there is an exacerbation of latent apical lesion in a tooth, root canal or not, after placing an implant adjacent to it, resulting in apical periimplantitis later. In this work we have summoned the cases of occurring periimplantitis by apical residual infection present in the socket of an extracted tooth with apical periodontal pathology and replaced by an implant. This review aims to make an update of the relationship between periimplantitis and endodontics

Diabetes mellitus, periapical inflammation and endodontic treatment outcome.

The possible connection between chronic oral inflammatory processes, such as apical periodontitis and periodontal disease (PD), and systemic health is one of the most interesting aspects faced by the medical and dental scientific community. Chronic apical periodontitis shares important characteristics with PD: 1) both are chronic infections of the oral cavity, 2) the Gram-negative anaerobic microbiota found in both diseases is comparable, and 3) in both infectious processes increased local levels of inflammatory mediators may have an impact on systemic levels. One of the systemic disorders linked to PD is diabetes mellitus (DM); is therefore plausible to assume that chronic apical periodontitis and endodontic treatment are also associated with DM. The status of knowledge regarding the relationship between DM and endodontics is reviewed. Upon review, we conclude that there are data in the literature that associate DM with a higher prevalence of periapical lesions, greater size of the osteolityc lesions, greater likelihood of asymptomatic infections and worse prognosis for root filled teeth. The results of some studies suggest that periapical disease may contribute to diabetic metabolic dyscontrol.

Implantología oral guiada asistida por ordenador en el tratamiento del paciente edéntulo mandibular / Computer-guided implant dentistry in the treatment of mandibular edentulous patient

Introducción. El objetivo del presente trabajo era presentar el protocolo diagnóstico y quirúrgico y protésico del tratamiento con implantes mediante la técnica guiada en el tratamiento de la mandíbula. La cirugía guiada y la carga inmediata de los implantes para la rehabilitación de la mandíbula incluye el diagnóstico por imagen (TAC) con un programa interactivo 3D para la planificación del tratamiento. Las imágenes interactivas 3D fueron obtenidas para la planificación del tratamiento. Según las imágenes 3D, una férula estereolitográfica fue confeccionada para realizar una técnica quirúrgica sin colgajo. Después de un fresado preciso algunos implantes fueron insertados de acuerdo al protocolo clínico. La prótesis fija inmediata provisional fue realizada y ajustada sobre los pilares, evaluando su oclusión. La prótesis fija definitiva se realizó después de un periodo de 3 meses. Conclusiones. Este estudio indica que la implantología oral guiada puede constituir una terapéutica exitosa de la mandíbula edéntula (AU)

Introduction. The aim of this paper was to present the diagnosis, surgical and prosthetic protocol of implants by guided technique in the treatment of mandible. Guided surgery and immediate functional loading of dental implants for rehabilitation of mandible include an imaging diagnosis (dental scan) with 3D interactive software for planning treatment. According 3D imaging, stereolitographic template were fabricated for a flapless surgical technique. After a accuraced drilling some implants are inserted with a distribution according treatment planning. Immediate transitional fixed prosthesis were realized and adjusted with the abutment and finally, occlusion is evaluated. Definitive fixed prosthesis is realized after a 3 month-period of time. Conclusions. This paper indicate that guided implant dentistry may constitute a successful treatment of edentulous mandible (AU)

Endodoncia preventiva: Protección pulpar mediante la técnica de eliminación de la caries en etapas (stepwise excavation) / Preventive endodontics: pulp protection using stepwise caries removal procedure

El tratamiento de la caries dentinaria profunda en dientes permanentes se ha venido realizando, generalmente, mediante la remoción completa y en una sola sesión de la dentina cariada, incluyendo la dentina blanda desmineralizada, sin tener en cuenta el potencial regenerador de la pulpa dental. Una complicación frecuentemente ligada a esta actitud es la exposición pulpar intraoperatoria que, en muchos casos, termina en tratamiento de conductos. Varios estudios han demostrado que la eliminación de la caries dentinaria profunda por etapas, en dos visitas con varios meses de diferencia, protege a la pulpa, disminuyendo la frecuencia de exposiciones pulpares, a la vez que permite la formación de dentina terciaria, con la consiguiente disminución del porcentaje de casos que requieren tratamiento endodóncico. En este artículo se analiza el estado del conocimiento y la evidencia científica sobre este tema (AU)

The treatment of deep dentine carious lesions in permanent teeth has included, generally, complete removal of affected dentin in a single session, including soft demineralized dentin, regardless of the regenerative potential of dental pulp. One complication often linked to this attitude is the pulp exposure, in many case sending in root canal treatment. Several studies have shown that the elimination of deep dentine caries instages, in two visits to several months apart, protects the pulp, reducing the frequency of pulp exposures, while allowing the development of tertiary dentin, with the consequent decrease in the percentage of cases requiring endodontic treatment. This article discusses the state of knowledge and scientific evidence on this topic (AU)

Asociación entre la diabetes mellitus y las infecciones crónicas orales de origen endodóncico / Association between diabetes mellitus and chronic oral infectious processes of endodontic origin

La evidencia científica disponible en la actualidad aporta abundantes datos a favor de la existencia de una relación entre la diabetes mellitus (DM) y dos infecciones crónicas orales de muy alta prevalencia, la enfermedad periodontal (EP) y la periodontitis apical crónica. Ambas infecciones crónicas orales comparten dos características importantes: 1) una microbiota anaerobia Gram negativa común y 2) en ambas aumentan los niveles locales de mediadores inflamatorios, pudiendo repercutir sobre los niveles sistémicos. La interrelación DM – infecciones crónicas orales se produciría a través del eje inflamación-estrés oxidativo. La DM se asocia a formas agresivas de enfermedad periodontal y a una mayor prevalencia de lesiones periapicales, a un mayor tamaño de las lesiones, a una mayor probabilidad de infecciones periapicales asintomáticas y a un peor pronóstico para los dientes tratados endodóncicamente. Por otra parte, la periodontitis apical crónica podría contribuir al descontrol metabólico del paciente diabético (AU)

The literature provides evidence on the relationship between diabetes mellitus (DM) and two chronic oral infections of high prevalence: periodontal disease (PD) and chronic apical periodontitis. Both infectious processes of the oral cavity share two characteristics: 1) a common gram-negative anaerobic microbiota and 2) increased local levels of cytokines and inflammatory mediators, which may affect the systemic levels. The interaction between DM and chronic oral infections is based in the inflammation-oxidative stress axis. DM is associated to aggressive forms of PD, higher prevalence and greater sizes of periapical lesions, and to worse prognosis for endodontically treated teeth. The results of some studies suggest that apical periodontitis could contribute to metabolic dyscontrol on diabetic patients (AU)

Regeneración ósea guiada con implante unitario con nanosuperficie y betafosfato tricálcico / Guided bone regeneration with nanosurface single-tooth implant and beta-tricalcium phosphate

Introducción. El objetivo del presente caso clínico era mostrar los resultados del tratamiento con implantes dentales mediante regeneración ósea guiada. Caso clínico. Un varón de 32 años es valorado para tratamiento implantológico del incisivo central superior derecho perdido. El plan de tratamiento comprende la eliminación de un quiste periapical residual, inserción de forma sumergida de un implante unitario con nano superficie Galimplant® y regeneración ósea guiada con membrana de colágeno reabsorbible BioGide® y betafosfato tricálcicoKeraOs® como material de injerto. Después de 8 meses se realiza una segunda cirugía con colocación de un tornillo de cicatrización. Después de 2 semanas, se realiza la carga funcional del implante con una corona unitaria cementada. Después de un periodo de carga funcional de 12 meses, no ha habido complicaciones. Conclusiones. Este caso clínico indica que el tratamiento con implantes dentales mediante la técnica de regeneración ósea guiada constituye una terapéutica implantológica con éxito (AU)

Introduction. The aim of this clinical case was to report the outcome of treatment with a dental implant by guided bone regeneration. Clinical case. A 32-year man is diagnosed for implant treatment of the upper central right incisiveloss. Treatment planning including elimination of residual periapycal cyst, submerged insertion of a Galimplant® nanosurface implant and guided bone regeneration with BioGide® resorbable collagen membrane and betatricalcium phosphate KeraOs® grafting. After a time period of 8 months, a second surgical stage were realized with the healing screw. After two weeks, implant were loaded with acemented fixed single-crown. Not complications were observed after a 12 months follow-up. Conclusions. This clinical case indicate that treatment with dental implant by guided bone regeneration constitute a successful treatment (AU)

La eficacia clínica de la carga convencional, precoze inmediata en sobredentaduras mandibulares con implantes dentales. Un estudio comparativo a cinco años / The clinical efficacy of conventional, early and immediate in mandibular overdentures with dental implants. A 5-year comparative study

Introducción. El estudio muestra la evaluación de los pacientes edéntulos totales tratados con sobredentaduras mandibulares con implantes dentales mediante diferentes tipos de carga funcional. Métodos. 33 pacientes edéntulos totales fueron tratados con 127 implantes en la mandíbula para su rehabilitación prostodóncica con sobredentaduras. Todos los implantes fueron insertados en la cirugía y fueron cargados de forma convencional, precoz o inmediata. Resultados. Después de un seguimiento clínico medio de 67,5 meses (rango: 36-108 meses), los resultados indican un éxito de los implantes del 96,9% porque 4 implantes fracasaron. El 100% delos pacientes fueron tratados con una sobredentadura implantosoportada, el 60,9% con retenedores de bolas y el 31,9% mediante barras .Conclusiones. El estudio indica que la rehabilitación oral de los pacientes edéntulos con sobredentaduras mandibulares implantosoportadas mediante su carga convencional, precoz o inmediata pueden obtener la oseointegración y representar una terapéutica odontológica con éxito (AU)

Introduction. This study reports the evaluation of edentulous patients treated with overdentures in the mandible by different loading protocols of dental implants. Patients and Methods. 33 edentulous patients were treated with 127 implants for prosthodontics rehabilitation with overdentures in the mandible. All implants were inserted in one-stage and were loaded with conventional, early and immediate protocols. Results. After a mean follow-up of 67,5 months (range: 36-108 months), clinical results indicate a success rate of implants of 96,9%. Four implants were lost. 100% of patients were treated with overdentures, 60,9% with ball attachments and 39,1% with bar retained. Conclusions. This study indicate that oral rehabilitation in the mandible of edentulous patients with overdentures supported by implants can achieve osseo integration and were loaded conventionally, early and immediately as a successful dental treatment (AU)

La utilización del betafosfato tricálcico como biomaterial en implantología oral / Implant treatment by fixed prostheses in completely edentulous mandible patients

Introducción. El objetivo del presente estudio era mostrar los resultados del tratamiento con implantes dentales insertados en diversas situaciones clínicas utilizando un biomaterial de relleno óseo. Métodos. 43 pacientes con pérdidas dentales fueron tratados con 171 implantes Microdent®.En todos los casos, como biomaterial para regeneración ósea se utilizó el beta-fosfato tricálcico KeraOs®. Los implantes fueron cargados después de un periodo de cicatrización de 6meses.Resultados. Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 98,8%.2 implantes se perdieron durante el periodo de cicatrización. En el 67,4% de los pacientes se realizó técnica de elevación sinusal, en el 18,6% de los pacientes se realizaron implantes postextracción y en el 14%, los implantes fueron insertados en rebordes alveolares atróficos. Después de un periodo de carga funcional de 12 meses, no ha habido complicaciones tardías. El54% de las prótesis realizadas fueron puentes fijos; el 28% coronas unitarias; el 14% rehabilitaciones completas fijas y el 4% sobre dentaduras. Conclusiones. Este estudio indica que el beta-fosfato tricálcico puede ser utilizado con éxito como material de regeneración ósea en el tratamiento con implantes dentales (AU)

Introduction. The aim of this study was to report the outcome of treatment with dental implants inserted indifferent clinical situations with use of biomaterial ofbone regeneration. Methods. 43 patients with tooth loss were treated with171 Microdent®. In all cases, beta-tricalcium phosphateKeraOs® were used. Implants were loaded after a healing free-loading period of 6 months. Results. Clinical results indicate a survival and success rate of implants of 98,8%. 2 implants were lost during the healing period. After a functioning period of 12months, no late complications were reported. 54% of implant-supported prostheses were fixed bridges; 28%were single crowns; 14% were fixed rehabilitations and4% were overdentures. Conclusions. This study indicate that beta-tricalciumphosphate can be used with success as biomaterial of bone regeneration in treatment with dental implants (AU)

La carga inmediata con implantes Microdent en el maxilar superior. II. Aspectos prostodóncicos / Immediate loading with microdent implants in maxilla. II. Prosthetic step

Introducción. El objetivo del presente trabajo era valorar el protocolo protésico de la carga inmediata en el tratamiento con implantes oseointegrados del maxilar superior. La fase protésica de la carga inmediata con implantes para el tratamiento del maxilar edéntulo constituye un complejo protocolo que incluye el objetivo de minimizar los riesgos de cargas oclusales adversas que incrementen la remodelación ósea. El implantólogo debe evaluar la magnitud, la duración y el tipo de las fuerzas, especialmente las situaciones parafuncionales y el bruxismo. La prótesis fija inmediata provisional puede ser elaborada utilizando la férula quirúrgica perforada y rellenada con resina acrílica. Posteriormente, la prótesis es ajustada sobre los implantes y finalmente es evaluada la oclusión. Conclusiones. Este trabajo indica que el protocolo prostodóncico del tratamiento del maxilar superior mediante la carga inmediata de los implantes puede constituir una terapéutica exitosa (AU)

Introduction. The aim of this paper was to present prosthodontic aspects of immediate loading of implants in the treatment of maxilla. Prosthetic phase of immediate functional loading of dental implants for rehabilitation of maxilla constitute a complex protocol that include the goal of decrease the risk of occlusal overload that increase the remodelling rate of bone. The dentist must evaluate magnitude, duration and type of forces, especially parafunction and bruxism. Immediate transitional fixed prosthesis may be fabricated by the dentist with a perforated surgical template used for the implant insertion with acrylic material. After, temporary prosthesis is adjusted with the abutment and finally, oclussion is evaluated. Conclusions. This paper indicate that prosthodontic step of treatment of maxilla by immediate loading with osseointegrated implants may constitute a high successful treatment (AU)

La carga funcional inmediata con implantes en pacientes edéntulos mandibulares. Técnica de Maló / Inmediate implant loading in mandible edentulous patients. Technique of Maló

Introducción. El objetivo del presente estudio era valorar los resultados clínicos de la carga inmediata en el tratamiento con implantes oseointegrados de la mandíbula edéntula. Pacientes y métodos. Los pacientes edéntulos completos fueron tratados con implantes Microdent® con superficie con chorreado de arena y grabada con ácidos para la rehabilitación de la mandíbula edéntula mediante la colocación de 4 implantes en el sector anterior con carga funcional inmediata. Los implantes fueron evaluados durante 1 año. Resultados. 10 pacientes (6 varones y 4 mujeres) fueron tratados con 40 implantes (20 rectos y 20 inclinados) de 14-16 mm de longitud y fueron cargados de forma inmediata con una prótesis completa de resina atornillada. Los hallazgos clínicos indican una supervivencia y éxito de los implantes del 100% ya que ningún implante se ha perdido durante el año de seguimiento clínico. Conclusiones. Este estudio indica que la carga inmediata de los implantes en el tratamiento de la mandíbula edéntula constituye un tratamiento odontológico con una elevada tasa de éxito (AU)

Introduction. The aim of this study was to assess the clinical outcome of immediate loading in the treatment with osseointegrated implants of edentulous mandible. Methods. Edentulous patients were treated with Microdent® sandblasted-etched surface implants for rehabilitation of mandible by insertion of 4 implants in anterior area with immediate loading. A follow-up were of 12 months. Results. 10 patients (6 men and 4 women) were treated with 40 implants (20 straight and 20 inclined) with a length of 14-16 mm and were loaded immediately with a acrylic screw full denture. Clinical findings showed a survival and success rate of implants of 100%. No implants were lost during the follow-up period. Conclusions. This study indicate that immediate loading of implants in the treatment of edentulous mandible constitute a dental treatment treatment with a high success rate success (AU)