Role-playing para la mejora de las habilidades comunicativas en estudiantes de grado de Odontología. Un ensayo clínico no aleatorizado / Role-playing for the improvement of communication skills in Dentistry undergraduate students. A non-randomized clinical trial

Introducción: Se trata de analizar el impacto de una secuencia formativa en la autopercepción del alumnado sobre las habilidades comunicativas. Secundariamente, se pretende conocer el grado de satisfacción del alumnado en relación con las actividades propuestas. Mètodos: Es un estudio cuasi experimental realizado sobre cuatro de los subgrupos de prácticas de la asignatura obligatoria de cuarto curso Cirugía Bucal Clínica e Implantología. Dos de los subgrupos recibieron una secuencia formativa específica para la mejora de sus habilidades comunicativas (n = 40) y los otros dos actuaron como controles (n = 47). Al inicio y al final del estudio, los participantes respondieron el cuestionario validado SE-12 de autopercepción sobre comunicación odontólogo-paciente. La estrategia evaluativa fue continua y formativa. Se analizaron y compararon las puntuaciones de los distintos indicadores e instrumentos de evaluación empleados.Resultados: A excepción de un alumno del grupo de control, todos los estudiantes participaron de forma activa en el proyecto. En ambos grupos se observó una mejora estadísticamente significativa en la percepción de las habilidades comunicativas (p < 0,001). No obstante, los alumnos asignados al grupo experimental percibieron una mejora significativamente mayor (diferencia de medias = 0,96 puntos; intervalo de confianza al 95% = 0,66-1,27; p < 0,001). Los alumnos valoraron la secuencia con un 8,56 (desviación estándar = 1,14).Conclusiones: La implementación de la secuencia formativa produjo una mejora en la percepción que tienen los estudiantes sobre sus habilidades comunicativas. Es necesaria la inclusión de programas longitudinales de formación en comunicación en los planes de estudio para acreditar la consecución de las competencias comunicativas.(AU)

Introduction: To analyze the impact of a training-learning sequence on students' self-perception of communication skills. Secondarily, to know the degree of student satisfaction in relation to the proposed activities.Methods: A quasi-experimental study was carried out on four of the clinical practice subgroups of Clinical Oral Surgery and Implantology (fourth year of study). Two of the subgroups received a specific training-learning sequence to improve their communication skills (n = 40) and the other two served as controls (n = 47). At the beginning and end of the study, the participants answered the validated SE-12 self-perception questionnaire on dentist-patient communication. The evaluation strategy was continuous and formative. The scores of the different indicators and evaluation instruments used were analyzed and compared.Results: Except for one student in the control group, all students participated actively in the project. In both groups, a statistically significant improvement was observed in the perception of communication skills (p < 0.001). However, the students assigned to the experimental group perceived a significantly greater improvement (difference in means = 0.96 points; 95% confidence interval = 0.66-1.27; p < 0.001). The students valued the training-learning sequence with an 8.56 (standard deviation = 1.14).Conclusions: The implementation of the training-learning sequence produced an improvement in the perception that students have about their communication skills. It is necessary to include longitudinal training programs in communication in the curricula to prove the achievement of communication skills competences.(AU)

Tracking soluble and nanoparticulated titanium released in vivo from metal dental implant debris using (single-particle)-ICP-MS.

BACKGROUND: This work studies the presence of the Ti, Al and V metal ions and Ti nanoparticles released from the debris produced by the implantoplasty, a surgical procedure used in the clinic, in rat organs. METHODS: The sample preparation for total Ti determination was carefully optimized using microsampling inserts to minimize the dilution during the acid attack of the lyophilized tissues by a microwave-assisted acid digestion method. An enzymatic digestion method was optimized and applied to the different tissue samples in order to extract the titanium nanoparticles for the single-particle ICP-MS analysis. RESULTS: A statistically significant increase was found for Ti concentrations from control to experimental groups for several of the studied tissues, being and particularly significant in the case of brain and spleen. Al and V concentrations were detected in all tissues but they were not different when comparing control and experimental animals, except for V in brain. The possible presence of Ti-containing nanoparticles mobilized from the implantoplasty debris was tested using enzymatic digestions and SP-ICP-MS. The presence of Ti-containing nanoparticles was observed in all the analyzed tissues, however, differences on the Ti mass per particle were found between the blanks and the digested tissue and between control and experimental animals in some organs. CONCLUSION: The developed methodologies, both for ionic and nanoparticulated metal contents in rat organs, have shown the possible increase in the levels of Ti both as ions and nanoparticles in rats subjected to implantoplasty.

Dynamic and static computer-assisted implant surgery for completely edentulous patients. A proof of a concept.

OBJECTIVES: To assess the accuracy and patient reported outcome measures (PROMs) of the computer-guided "double factor" technique for treating fully edentulous patients. METHODS: A proof of concept prospective study was designed. Ten consecutive patients requiring full arch dental implant supported rehabilitation in a private practice were enrolled between October 2021 and March 2022. All patients were treated by means of an All-on-four®, and implants were planned and placed according to the "double factor" technique. This technique merges the static and dynamic computer-guided surgical approach in the same surgery. The primary outcome was the accuracy of implant placement, measured by overlapping post- and pre-operative cone-beam computerized tomography with the implant planning. Additionally, PROMs and patient quality of life after surgery were evaluated using different questionnaires. Descriptive and bivariate data analyses were performed. Statistical significance was considered for p < 0.05. RESULTS: A total of 48 implants were placed using the "double factor" technique, and 12 full-arch immediate loading prostheses were delivered. The mean angular deviation was 3.74° (standard deviation [SD]: 2). The total linear deviation at the apex and platform of the implant was 1.25 mm (SD: 0.55) and 1.42 mm (SD: 0.64), respectively. No statistically significant differences were found between tilted and axial implants, the upper and lower jaw, or the right and left side. High self-reported satisfaction was registered, and the Oral Health Impact Profile-14 (OHIP-14) score improved postoperatively (p = 0.002). CONCLUSIONS: The "double factor" technique is a valid and accurate treatment approach for fully edentulous patients. CLINICAL SIGNIFICANCE: The double factor technique merges the advantages of both the dynamic and static computer assisted surgery approaches, affording accurate and predictable results when treating fully edentulous patients in a minimally invasive manner.

Ion release and local effects of titanium metal particles from dental implants: An experimental study in rats.

BACKGROUND: The objective of this study was to evaluate the accumulation of ions in blood and organs caused by titanium (Ti) metal particles in a mandibular defect in rats, together with a description of the local reaction of oral tissues to this Ti alloy debris. METHODS: Twenty Sprague-Dawley rats were randomly distributed into three groups: an experimental group with a mandibular bone defect filled with metallic debris obtained by implantoplasty; a positive control group; and a negative control group. Thirty days after surgery, the rats were euthanized and perilesional tissue surrounding the mandibular defect was removed, together with the lungs, spleen, liver, and brain. Two blood samples were collected: immediately before surgery and before euthanasia. The perilesional tissue was histologically analyzed using hematoxylin-eosin staining, and Ti, aluminum, and vanadium ion concentrations in blood and organs were measured by TQ-ICP-MS. Descriptive and bivariate analyses of the data were performed. RESULTS: All rats with implanted metal debris showed metal particles and a bone fracture callus on the osseous defect. The metal particles were surrounded by a foreign body reaction characterized by the presence of histiocytes and multinucleated giant cells (MNGCs). The experimental group had a significant higher concentration of Ti ions in all studied organs except lung tissue (p < 0.05). In addition, there were more V ions in the brain in the experimental group (p = 0.008). CONCLUSIONS: Although further studies are required to confirm the clinical relevance of these results, Ti metal particles in the jaw might increase the concentration of metal ions in vital organs and induce a foreign body reaction.

Dynamic and static computer-guided surgery using the double-factor technique for completely edentulous patients: A dental technique.

A novel computer-assisted surgery (CAS) technique that merges dynamic and static CAS approaches to treat completely edentulous patients with dental implants is described. Radiographic and surgical stents are designed with specific fiducial markers that are recognized by the static and dynamic CAS software program. During the surgical procedure, implants are placed following the static surgical guide and the indications from the dynamic navigation system. This technique combines the advantages of static and dynamic CAS approaches to allow accurate and predictable minimally invasive implant placement.

Short time guided bone regeneration using beta-tricalcium phosphate with and without fibronectin - An experimental study in rats

BACKGROUND: The aim of this histomorphometric study was to assess the bone regeneration potential of beta-tricalcium phosphate with fibronectin (Beta-TCP-Fn) in critical-sized defects (CSDs) in rats calvarial, to know whether Fn improves the new bone formation in a short time scope. MATERIAL AND METHODS: CSDs were created in 30 Sprague Dawley rats, and divided into four groups (2 or 6 weeks of healing) and type of filling (Beta-TCP-Fn, Beta-TCP, empty control). Variables studied were augmented area (AA), gained tissue (GT), mineralized/non mineralized bone matrix (MBM/NMT) and bone substitute (BS). RESULTS: 60 samples at 2 and six weeks were evaluated. AA was higher for treatment groups comparing to controls (p < 0.001) and significant decrease in BS area in the Beta-TCP-Fn group from 2 to 6 weeks (p = 0.031). GT was higher in the Beta-TCP-Fn group than in the controls expressed in % (p = 0.028) and in mm2 (p = 0.011), specially at two weeks (p=0.056). CONCLUSIONS: Both Beta-TCP biomaterials are effective as compared with bone defects left empty in maintaining the volume. GT in defects regeneration filed with Beta-TCP-Fn are significantly better in short healing time when comparing with controls but not for Beta-TCP used alone in rats calvarial CSDs

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Bone regeneration in diabetic patients. A systematic review

Background: Oral bone regeneration techniques (OBRT) attempt to provide the appropriate bone volume and density to correctly accomplish dental implant treatments. The objective was to determine whether differences exist in the clinical outcomes of these techniques between diabetic and non-diabetic patients, considering the level of scientific evidence. Material and Methods: A systematic review following PRISMA statements was conducted in the PubMed, Scopus and Cochrane databases with the search terms: "Diabetes Mellitus", "guided bone regeneration", "bone regenera-tion", "alveolar ridge augmentation", "ridge augmentation", bone graft*, "sinus floor augmentation", "sinus floor elevation", "sinus lift", implant*. Articles were limited to those published less than 10 years ago and in English. Inclusion criteria were: human studies of all bone regeneration techniques, including at least 10 patients and the using OBRT in diabetic and non-diabetic patients. Non-human studies were excluded. They were stratified according to their level of scientific evidence related to SORT criteria (Strength of Recommendation Taxonomy). Results: The initial search provided 131 articles, after reading the abstracts a total of 33 relevant articles were selected to read the full text and analyzed to decide eligibility. Finally, seven of them accomplished the inclusion criteria: two controlled clinical trials, one cohort study and four case series. Conclusions: A low grade of evidence regarding the use of OBRT in diabetic patients was found. The recommendation for this intervention in diabetic patients is considered type C due to the high heterogeneity of the type of diabetic patients included and the variability of the techniques applied

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Efficacy of different methods used for dry socket prevention and risk factor analysis: A systematic review

Background: Dry socket is one of the most common complications that develops after the extraction of a permanent tooth, and its prevention is more effective than its treatment. Objectives: Analyze the efficacy of different methods used in preventing dry socket in order to decrease its incidence after tooth extraction. Material and Methods: A Cochrane and PubMed-MEDLINE database search was conducted with the search terms 'dry socket', 'prevention', 'risk factors', 'alveolar osteitis' and 'fibrynolitic alveolitis', both individually and using the Boolean operator 'AND'. The inclusion criteria were: clinical studies including at least 30 patients, articles published from 2005 to 2015 and written in English. The exclusion criteria were case reports and nonhuman studies. Results: 30 publications were selected from a total of 250. Six of the 30 were excluded after reading the full text. The final review included 24 articles: 9 prospective studies, 2 retrospective studies and 13 clinical trials. They were stratified according to their level of scientific evidence using SIGN criteria (Scottish Intercollegiate Guidelines Network). Conclusions: All treatments included in the review were aimed at decreasing the incidence of dry socket. Locally administering chlorhexidine or applying platelet-rich plasma reduces the likelihood of developing this complication. Antibiotic prescription does not avoid postoperative complications after lower third molar surgery. With regard to risk factors, all of the articles selected suggest that patient age, history of previous infection and the difficulty of the extraction are the most common predisposing factors for developing dry socket. There is no consensus that smoking, gender or menstrual cycles are risk factors. Taking the scientific quality of the articles evaluated into account, a level B recommendation has been given for the proposed-procedures in the prevention of dry socket (AU)

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Knowledge, aptitudes, and preferences in implant dentistry teaching/training among undergraduate dental students at the University of Barcelona

Background: Oral implant rehabilitation should be considered a treatment option for any edentulous patient and Implant Dentistry is currently a discipline taught in the undergraduate formation. The level of knowledge acquired and how the students perceive the quality of training in Implant Dentistry could assess to know if it is necessary to improve the syllabus. Material and Methods: A questionnaire was developed with 11 questions: Basic knowledge (7); Perception of training received (2); Ways in which students would receive training (2) to be responded anonymously and voluntarily for undergraduates students in the Faculty of Dentistry (University of Barcelona, Spain). Results: One hundred and seven students, 76 third year (Group A) and 31 fourth year (Group B) answered the questionnaire. In Group A, 98.68% of students and in Group B 93.54% believed they were poorly informed; 100% of both groups would prefer to receive more training as part of the degree or as postgraduate training through modular courses imparted by experts (A: 71,05%, B: 70,96%) Training through postgraduate programs or training given by private businesses were the least desirable options (A: 42%, B: 64.51%). Questions about basic knowledge acquired received varying responses, which might indicate a certain level of confusion in this area. Conclusions: The undergraduate syllabus must be revised to include sufficient content and training to allow the student to indicate implant-based treatments based on evidence. Students would prefer training to be included in the undergraduate syllabus (AU)

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Efficacy of different methods used for dry socket management: A systematic review

BACKGROUND: Dry socket is one of the most common complications occurring after the extraction of a permanent tooth, but in spite of its high incidence there is not an established treatment for this condition. OBJECTIVES: Analyze the efficacy of different methods used in the management of dry socket regarding results of pain's relief and alveolar mucosa healing compared to conventional surgical treatment of curettage and saline irrigation. MATERIAL AND METHODS: A Cochrane and PubMed-MEDLINE database search was conducted with the search terms "dry socket", "post-extraction complications", "alvogyl", "alveolar osteitis" and "fibrynolitic alveolitis", individually and next, using the Boolean operator "AND". The inclusion criteria were: clinical studies including at least 10 patients, articles published from 2004 to 2014 written in English. The exclusion criteria were case reports and nonhuman studies. RESULTS: 11 publications were selected from a total of 627. Three of the 11 were excluded after reading the full text. The final review included 8 articles: 3 prospective studies, 2 retrospective studies and 3 clinical trials. They were stratified according to their level of scientific evidence using the SORT criteria (Strenght of Recommendation Taxonomy). CONCLUSIONS: All treatments included in the review have the aim to relief patient's pain and promote alveolar mucosa healing in dry socket. Given the heterogeneity of interventions and the type of measurement scale, the results are difficult to compare. Curettage and irrigation should be carried out in dry socket, as well as another therapy such as LLLT, zinc oxide eugenol or plasma rich in growth factors, which are the ones that show better results in pain remission and alveolar mucosa healing. Assessment alveolar bone esposure must be a factor to consider in future research. Taking into account the scientific quality of the articles evaluated, a level B recommendation is given for therapeutic interventions proposed for the treatment of dry socket

Efficacy of different methods used for dry socket management: A systematic review.

BACKGROUND: Dry socket is one of the most common complications occurring after the extraction of a permanent tooth, but in spite of its high incidence there is not an established treatment for this condition. OBJECTIVES: Analyze the efficacy of different methods used in the management of dry socket regarding results of pain's relief and alveolar mucosa healing compared to conventional surgical treatment of curettage and saline irrigation. MATERIAL AND METHODS: A Cochrane and PubMed-MEDLINE database search was conducted with the search terms "dry socket", "post-extraction complications", "alvogyl", "alveolar osteitis" and "fibrynolitic alveolitis", individually and next, using the Boolean operator "AND". The inclusion criteria were: clinical studies including at least 10 patients, articles published from 2004 to 2014 written in English. The exclusion criteria were case reports and nonhuman studies. RESULTS: 11 publications were selected from a total of 627. Three of the 11 were excluded after reading the full text. The final review included 8 articles: 3 prospective studies, 2 retrospective studies and 3 clinical trials. They were stratified according to their level of scientific evidence using the SORT criteria (Strenght of Recommendation Taxonomy). CONCLUSIONS: All treatments included in the review have the aim to relief patient's pain and promote alveolar mucosa healing in dry socket. Given the heterogeneity of interventions and the type of measurement scale, the results are difficult to compare. Curettage and irrigation should be carried out in dry socket, as well as another therapy such as LLLT, zinc oxide eugenol or plasma rich in growth factors, which are the ones that show better results in pain remission and alveolar mucosa healing. Assessment alveolar bone esposure must be a factor to consider in future research. Taking into account the scientific quality of the articles evaluated, a level B recommendation is given for therapeutic interventions proposed for the treatment of dry socket.

Materials and prognostic factors of bone regeneration in periapical surgery: A systematic review

OBJECTIVES: Analyse the effectiveness of different materials and techniques used in guided tissue regeneration (GTR) applied in periapical surgery, comparing the success rate obtained in 4-wall defects and in through-and-through bone lesions as well as to establish prognostic factors. MATERIAL AND METHODS: A Cochrane, PubMed-MEDLINE and Scopus database search (October 2012 to March 2013) was conducted with the search terms "periapical surgery", "surgical endodontic treatment", "guided tissue regeneration", "bone regeneration", "bone grafts", "barrier membranes" and "periapical lesions" individually and next, using the Boolean operator "AND". The inclusion criteria were the use of GTR (bone graft and/or membrane barrier), clinical studies including at least 10 patients, 10 years aged articles published in English or French. The exclusion criteria were case reports and nonhuman studies. RESULTS: 34 publications were selected from a total of 483. 9 of the 34 were excluded. Finally, the systematic review included 25 articles: 2 metaanalysis, 8 reviews, 13 prospective studies and 2 retrospective studies. They were stratified according to their level of scientific evidence using the SORT criteria. The 4-wall periapical and through-and-through lesions improve more their prognosis by combining bone grafts and barrier membranes than using these materials exclusively, respect to the control groups. The results show lower failure rates in in 4-wall le-sions than in through-and-through lesions using GTR. CONCLUSIONS: The combined GTR technique (filling material and membranes) obtains a greater success rate both in 4-wall lesions and in through-and-through lesions, respect to the control groups. The use of regeneration materials seems to be more necessary in through-and-through lesions, > 5mm lesions, lower teeth and apicomarginal lesions as they have the worst healing prognosis. In function of the articles scientific quality, a type B recommendation is given in favour to the use of GTR in association of periapical surgery in case of 4-wall and through-and-through lesions

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Identification of the mental neurovascular bundle: a comparative study of panoramic radiography and computer tomography.

OBJECTIVES: To compare the images of the mental canal in panoramic radiography (PR) and computed tomography (CT) by analyzing the concordance with diagnostic tests and examiners. MATERIAL AND METHODS: The position of the mental foramen (MF), distance to the lower mandibular border, anterior length of the mental loop (ML), agreement between examiners and diagnostic concordance were registered in 50PR and 50CT. RESULTS: ML was identified (34.5/41%, PR/CT). PR magnification was 36.6% higher than in CT. The anterior extension and distance to the inferior border of the MF was higher for PR (2-6.2 mm). Inter-examiner agreement on CT was good (κ = 0.628) and very good on PR (κ = 0.845). CONCLUSION: There is a magnification (36.6%) of the images in PR with respect to the CT. Identification of MF and ML is not related to the bone quality. Inter-examiner agreement is better on PR.

Assessment of osteointegrative response around dental implants using technetium 99-methylene diphosphate scintigraphy: a comparison of two implant surfaces in a rabbit model.

PURPOSE: To compare the metabolic activity at the bone-implant interface of implants with machined and rough surfaces using bone scintigraphy during the in vivo process of osseointegration in a rabbit model, as well to establish a correlation between activity index (AI) and the bone-implant contact percentage (%BIC). MATERIALS AND METHODS: Twenty-four implants were placed (12 with a machined surface and 12 with a rough titanium oxide surface) in 12 New Zealand White rabbits. Preoperatively and during the postoperative period (at 15 days and at monthly intervals), animals underwent bone scintigraphy with technetium 99m-methylene diphosphate (Tc-99m-MDP), and the AI for each implant was calculated by planar and pinhole collimator scintigraphy. A total of 240 AIs were obtained; after animal sacrifice at 105 days postsurgery, the %BIC was measured by scanning electron microscopy in 10 samples of each implant surface type. RESULTS: The activity-time curve showed a similar morphology for both implant types and both scintigraphy techniques. The maximum mean AI appeared after 15 days of implantation and was higher in machined implants. Significant differences were not found in the %BIC according to implant type. A significant correlation between the mean activity registered in the first postoperative scintigraph and the mean %BIC at the end of the study was observed for machined implants only. CONCLUSIONS: Tc-99m-MDP is useful for the assessment of osseous metabolic activity associated with different microsurfaces. The association between mean AI and %BIC was only demonstrated for machined implants in the first postoperative scintigraphy image.

Complications of guided surgery and immediate loading in oral implantology: A report of 12 cases

Objectives: The growing interest in minimally invasive surgery, together with the possibility of fitting prostheseswith immediate function, have led to the development of software capable of planning and manufacturing a surgicalguide and prosthesis that can be placed upon conclusion of the implant surgery step.The present study evaluates the surgical and prosthetic complications of implant treatment with the guided surgerytechnique, together with patient comfort during and after treatment.Patients and methods: A retrospective observational study was made of 19 patients with partially or totally edentulousupper and/or lower maxillae, involving the placement of a total of 122 implants. All cases were planned andoperated upon with the guided surgery technique.Results: A total of 122 implants were placed in 14 males and 5 females. The intraoperative surgical complicationscomprised a lack of primary stability, while the postoperative complications consisted of infections and a lack ofimplant osteointegration. Ten implants failed. The prosthetic complications in turn comprised loosening of theprovisional prosthesis screws, prosthesis tooth fracture, and a lack of passive fit of the immediate prosthesis. Thedegree of patient satisfaction was evaluated using a verbal scale.Conclusions: Implant restoration with the guided surgery technique and immediate functional loading is a predictableprocedure, provided patient selection and the surgical technique are adequate, affording lesser postoperativemorbidity and increased patient satisfaction thanks to the immediate restoration of esthetics and function (AU)

Complications of guided surgery and immediate loading in oral implantology: a report of 12 cases.

OBJECTIVES: The growing interest in minimally invasive surgery, together with the possibility of fitting prostheses with immediate function, have led to the development of software capable of planning and manufacturing a surgical guide and prosthesis that can be placed upon conclusion of the implant surgery step. The present study evaluates the surgical and prosthetic complications of implant treatment with the guided surgery technique, together with patient comfort during and after treatment. PATIENTS AND METHODS: A retrospective observational study was made of 19 patients with partially or totally edentulous upper and/or lower maxillae, involving the placement of a total of 122 implants. All cases were planned and operated upon with the guided surgery technique. RESULTS: A total of 122 implants were placed in 14 males and 5 females. The intraoperative surgical complications comprised a lack of primary stability, while the postoperative complications consisted of infections and a lack of implant osteointegration. Ten implants failed. The prosthetic complications in turn comprised loosening of the provisional prosthesis screws, prosthesis tooth fracture, and a lack of passive fit of the immediate prosthesis. The degree of patient satisfaction was evaluated using a verbal scale. CONCLUSIONS: Implant restoration with the guided surgery technique and immediate functional loading is a predictable procedure, provided patient selection and the surgical technique are adequate, affording lesser postoperative morbidity and increased patient satisfaction thanks to the immediate restoration of esthetics and function.

Histomorphometric study of ion implantation and diamond-like carbon as dental implant surface treatments in beagle dogs.

PURPOSE: Improvements in the bone-implant interface can provide clinical benefits, such as increasing the amount of bone in contact with the implant and shortening the time required to achieve sufficient bone appositioning to allow early prosthetic loading. The present study describes the results obtained with 2 new surface treatments: (a) CO ion implantation; and (b) diamond-like carbon (DLC) coating. MATERIALS AND METHODS: Each group (ion implantation, DLC, and the control group, turned titanium) consisted of 12 samples. Beagle dogs subjected to previous partial edentulation were used. Dual histologic evaluation was made of percentage bone-implant contact (% BIC) of all samples based on conventional histomorphometric analysis and environmental scanning electron microscopy (ESEM). RESULTS: The results obtained after 3 and 6 months of dental implant placement showed greater and faster bone integration in the CO ion implantation group (61% and 62% BIC, respectively) compared with the DLC group (47% and 50%); the data corresponding to the ion implanted samples were statistically significant compared with the control group (33% and 49% BIC after 3 and 6 months, respectively). CONCLUSIONS: The results showed improved % BIC for implants with ion-implanted surfaces in comparison to DLC coating and machined controls. Furthermore, bone integration appeared to be accelerated in the ion implantation group, since high % BIC values were recorded in the early stages after in vivo implantation.

Periimplantitis / Periimplantitis

La rehabilitación bucodentaria mediante implantes proporciona un porcentaje de éxito muy elevado. En este trabajo se describen algunas de las complicaciones de esta técnica, como la enfermedad periimplantaria y, dentro de ella, la periimplantitis, una reacción inflamatoria donde coexiste, junto con la inflamación, una pérdida del soporte óseo del implante. La etiología de la enfermedad está condicionada por el estado del tejido periimplantario, el diseño del implante, el desajuste de sus componentes, la morfología externa del mismo y la sobrecarga mecánica. Los microorganismos más relacionados con el fallo de integración de un implante son las espiroquetas y las formas móviles Gramnegativo anaerobias, salvo que el origen sea debido a una sobrecarga mecánica pura. El diagnóstico se basa en los cambios de coloración de la encía, sangrado y profundidad del sondaje de las bolsas periimplantarias, supuración, radiología y pérdida progresiva de la altura ósea que rodea al diente. El tratamiento será diferente según se trate de una mucositis o una periimplantitis. Se basará en corregir los defectos técnicos, aplicar un tratamiento quirúrgico y utilizar técnicas de descontaminación (arenado con partículas de carbono, ácido cítrico, tetraciclinas de aplicación tópica y láser quirúrgico). En este trabajo también se expone un estudio microbiológico de la periimplantitis efectuado en la Facultad de Odontología de la Unniversidad de Barcelona que determina que el antibiótico que demostró una mayor eficacia, en el antibiograma, fue la asociación de amoxicilina con ácido clavulánico (AU)

Orodental rehabilitation through the use of implants offers very high success rates. In this paper, we describe some of the complications involved with this technique, such as periimplant disease and, within this category, periimplantitis, an inflammatory reaction in which there is a loss of the bony support of the implant accompanied by inflammation. The aetiology of the disease is conditioned by the status of the tissue surrounding the implant, implant design, degree of roughness, the poor alignment of implant components, external morphology and excessive mechanical load. The microorganisms most commonly associated with implant failure are spirochetes and mobile forms of Gram-negative anaerobes, unless the origin is the result of simple mechanical overload. Diagnosis is based on changes of colour in the gum, bleeding and probing depth of periimplant pockets, suppuration, x-ray and gradual loss of bone height around the tooth. Treatment will differ depending upon whether it is a case of mucositis or periimplantitis. Therapeutic objectives focus on correcting technical defects by means of surgery and decontamination techniques (abrasion with carbon particles, citric acid solution, topical tetracycline application and laser surgery). This study also presents a microbiological study of periimplantitis conducted by the Barcelona School of Dentistry that determined that the antibiotic therapy proven to be most efficacious in the antibiogram was the association of amoxycillin and clavulanic acid (AU)