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1.
Clin Oral Investig ; 2021 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-33893557

RESUMO

PURPOSE: This paper aims to review the evidence comparing low-speed drilling without irrigation versus conventional drilling for dental implant osteotomy preparation. MATERIALS AND METHODS: A systematic review was carried out based on the PRISMA statement. Four databases and gray literature were searched up to November 2020. In vitro, animal, and clinical studies were included. The variables were temperature change, drilling time, quantity of harvested bone, osteotomy precision, marginal bone loss, implant success rate, osseointegration, and the histomorphologic characteristics and cellularity of the osteotomy and of the harvested bone. Different tools for the assessment of bias were applied for each study design. RESULTS: A total of 626 articles were identified, of which 13 were included. Both low-speed drilling without irrigation (test group) and conventional drilling (control group) maintained temperatures below the critical temperature of 47 °C. The test group yielded a greater quantity and more beneficial cellular and histomorphologic properties of harvested bone, with a longer drilling time and greater osteotomy precision (p < 0.05). No significant results were obtained regarding drill wear, osseointegration, marginal bone loss, implant success rate, and histomorphology of the dental implant osteotomy (p > 0.05). The results, in particular on the osteotomy precision and quantity of harvested bone chips, should be interpreted with caution because outcomes are based in only one in vitro study. CONCLUSIONS: Low-speed drilling without irrigation seems to be comparable to conventional drilling in preparing dental implant osteotomies. In some situations, low-speed drilling without irrigation might offer advantages over conventional drilling. The results should be interpreted with caution due to the low percentage of clinical human studies. Accordingly, more clinical studies are needed to improve the scientific evidence on this topic. CLINICAL RELEVANCE: The low-speed drilling without irrigation is a valid technique for dental implant osteotomy preparation. Its higher quantity and quality of harvested autologous bone might be particularly beneficial in cases of dental implant placement with minor simultaneous bone regeneration.

2.
BMC Oral Health ; 21(1): 143, 2021 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-33752651

RESUMO

BACKGROUND: Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest. METHODS: An electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The methodological quality of the included studies was appraised using the ROBINS-I tool and the overall meta-evidence certainty using the GRADE approach. A single means random-effects meta-analysis was performed to obtain the weighted mean for 95% confidence interval. A meta-regression of covariates and subgroup analysis was conducted. The nullity Qh test and I2 index for heterogeneity was estimated. RESULTS: 2560 potentially relevant articles were recorded from which 29 studies were selected for the qualitative analysis, including 17,321 teeth. Seventeen studies considered the facial bone crest, and 12 the CEJ as a reference point for their measurements. Mean FAB thickness was ≤ 1 mm in maxillary incisors and canines (0.75-1.05 mm) and 1-2 mm in premolars. Patients over 50 years of age, females and thin gingival phenotype was associated with thinner FAB at some apico-coronal locations of maxillary incisors and canines. The geographical setting was an effect modifier that could explain up to 87% of the heterogeneity in FAB thickness, being Asian populations that showed the lowest FAB thickness values. The CEJ-bone crest distance was 2-2.5 mm in all teeth analyzed. Population over 50 years of age exhibited greater CEJ-bone crest distances, and males also showed a trend for greater distance. Evidence certainty has shown moderate quality in most analysis subsets. CONCLUSIONS: Facial alveolar bone at anterior maxillary teeth is thin, heterogeneous in width along its apico-coronal dimensions, and increases in thickness in maxillary premolars. The CEJ-bone crest distance presented homogeneous and similar values in all teeth analyzed.


Assuntos
Processo Alveolar , Maxila , Processo Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Incisivo/diagnóstico por imagem , Masculino , Maxila/diagnóstico por imagem , Colo do Dente
3.
Int J Implant Dent ; 7(1): 13, 2021 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-33615421

RESUMO

BACKGROUND: The socket seal surgery (SSS) technique is a common alternative for the management of the post-extraction sockets that requires a primary closure of the wound to promote proper regeneration and ridge preservation. OBJECTIVE: To learn about the effect of different SSS techniques on alveolar ridge preservation MATERIAL AND METHODS: Two independent and calibrated reviewers conducted an electronic search in PubMed, Cochrane, and Web of Science for randomized clinical trials (RCT) published up to June 2020. The evaluation of the risk of bias in the included studies was carried out following the Cochrane manual for interventions of systematic reviews, version 5.1.0. A meta-analysis of ridge width changes at - 1, - 3, and - 5 mm cutoff points from bone crest was conducted using a random-effects model. The risk of types I and II errors against accrued data was appraised obtaining the required information size using a trial sequential analysis package (TSA). RESULTS: A total of 135 sockets located in the esthetic zone were evaluated with a minimum of a 3-month follow-up after tooth extraction in 6 RCTs. The evaluated SSS techniques were free gingival graft (FGG), collagen matrix (CM), collagen sponge (CS), acellular dermal matrix (ADM), and polytetrafluoroethylene membrane (PTFEm). The FGG in sockets without bone filling showed significant results in preserving both buccal and lingual bone height (- 1.42 mm in the experimental group versus - 0.01 in the control group). The comparison of CM and FGG with bone filling did not show clinical differences in terms of dimensional bone changes. No clinical differences were found in either width or gingival thickness when comparing CM and CS. The meta-analyses of RW changes comparing CM versus FGG showed no significant differences, but a trend for lessening horizontal reduction at - 1, - 3, and - 5 mm in favor of FGG. The TSA showed that accrued data did not reach the required information size, and more evidence is required for clinical significance inferences. CONCLUSIONS: There are several predictable SSS techniques to improve clinical results in ridge preservation. More clinical studies in the form of clinical trials are required to demonstrate the superiority of one technique over another.

4.
Clin Oral Investig ; 25(4): 1613-1626, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33474623

RESUMO

OBJECTIVE: This review aimed to evaluate the effects of enamel matrix derivative (EMD) in association with coronally advanced flap (CAF) or CAF + connective tissue graft (CTG) when compared with CAF alone or CAF + CTG for the treatment of gingival recessions (GR) in maxillary teeth. METHODS: Five databases and gray literature were searched up to April 2020, to find randomized clinical trials comparing the clinical effects of CAF + EMD versus CAF alone (first group) or CAF + CTG + EMD versus CAF + CTG (second group) in the treatment of Miller class I and II or Cairo type I gingival recessions (GR). Random effects model of mean differences was used to determine the GR reduction, gain in keratinized tissue width (KTW), and gain in clinical attachment level (CAL). The trial sequential analysis (TSA) was implemented to determine the optimal information size (OIS) and imprecision using the GRADE approach. Bayes factors were calculated as complementary statistical evidence of p value. RESULTS: From 1349 titles identified, 9 trials representing 336 GR were included. The meta-analysis showed a statistically significant difference for GR reduction and CAL gain in favor CAF + EMD (p ≤ 0.05). The additional effect of EMD showed a statistically significant difference in GR reduction in favor CAF + CTG + EMD (p ≤ 0.05). The differences in KTW gain proved to be not statistically significant in both comparison groups. The OIS were not met among meta-analyses. Evidence certainty according the GRADE approach proved to be moderate for GR reduction and gain in CAL, but very low for gain in KTW. CONCLUSION: The adjunctive application of EMD in the treatment of GR in maxillary teeth either with CAF or CTG provided moderate certainty evidence in favor of their use for reduction in GR and gain in CAL at 6 and 12 months. However, their effect on the increase in keratinized tissue band height showed very low evidence certainty for its use. CLINICAL RELEVANCE: To know if EMD could improve the results for root coverage.


Assuntos
Proteínas do Esmalte Dentário , Retração Gengival , Teorema de Bayes , Tecido Conjuntivo , Gengiva , Retração Gengival/cirurgia , Gengivoplastia , Humanos , Raiz Dentária , Resultado do Tratamento
5.
J Clin Exp Dent ; 12(11): e1091-e1095, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33262877

RESUMO

An apicomarginal defect can be explained as a total loss of buccal alveolus extending from the original crestal bone to the apex of the tooth. This study presents a case of an apicomarginal defect in a first left molar subjected to periapical surgery with vestibular cortex block replacement and A-PRF + membrane coating approximately one year ago. One-year clinical follow-up was performed, with no evidence of recurrence. This case report discusses periapical surgical treatment and the importance of an interdisciplinary approach to the management of teeth with apicomarginal defects. Key words:Periapical surgery, apicomarginal defect, A-PRF+, bone graft.

6.
J Clin Exp Dent ; 12(10): e972-e978, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33154800

RESUMO

Background: A systematic review of clinical studies with at least one year of follow-up was done to assess the success rate of endodontic surgery including endoscopy for magnification and illumination. Material and Methods: Five electronic databases were searched, including MEDLINE (via PubMed), Embase, Web of Science, Scopus and the Cochrane Library of the Cochrane Collabora-tion (CENTRAL). There were no language restrictions, and the search covered the period up to October 2019. The risk of bias was evaluated with the Cochrane Collaboration tool for randomized clinical trials and the ROBINS-I tool for non-randomized studies of inter-ventions. Results: From the 278 initially identified titles, finally 2 randomized controlled trials and 3 non-randomized studies met the inclusion criteria. All the included studies analyzed the success rate of endodontic surgery performed with the help of endoscope for magnifica-tion and illumination. The risk of bias was high for allocation sequence concealment and blinding of participants and personnel in the randomized controlled trials. The nonran-domized studies showed limitations in terms of confounding bias and blinding of outcome assessment. Endodontic surgery with the help of an endoscope is associated with high success rates (88.9-94.9%). Conclusions: The endoscope was associated with high success rates of endodontic sur-gery in the included studies. Future studies on this topic are warranted, due to the meth-odological issues and the scarce number of randomized clinical trials. Key words:Endodontic surgery, magnification, endoscope, success.

7.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e634-e643, sept. 2020. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-196519

RESUMO

BACKGROUND: Hemostasis is of critical importance in endodontic surgery. Studies on bleeding control in maxillary molars are scarce. The present study compares the efficacy of two hemostatic techniques in controlling bleeding in endodontic surgery. MATERIAL AND METHODS: A randomized two-arm pilot study involving 30 patients with peri-radicular lesions in maxillary molars (first and second molars) was carried out including the following hemostatic agents: polytetrafluoroethylene (PTFE) strips as an adjunct to epinephrine impregnated gauze (test group; n = 15) and aluminum chloride (Expasyl(TM)) (control; n = 15). Bleeding control was independently assessed by the surgeon and by two blinded observers before and after application of the hemostatic agent, and was classified as either adequate (complete bleeding control) or inadequate (incomplete bleeding control). RESULTS: Bleeding control was similar in both groups. Simple binary logistic regression analysis failed to identify variables affecting bleeding control. Only the height of the keratinized mucosal band (≥ 2 mm) suggested a decreased risk of inadequate bleeding control of up to 89% (OR = 0.11; p = 0.06). CONCLUSIONS: No difference in the efficacy of bleeding control was observed between PTFE strips as an adjunct to epinephrine impregnated gauze and aluminum chloride in maxillary molars


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hemostasia Cirúrgica/métodos , Raiz Dentária/cirurgia , Cavidade Pulpar/cirurgia , Hemostáticos/uso terapêutico , Dente Molar/cirurgia , Politetrafluoretileno/uso terapêutico , Epinefrina/uso terapêutico , Cloreto de Alumínio/uso terapêutico , Tratamento do Canal Radicular/métodos , Perda Sanguínea Cirúrgica/prevenção & controle , Modelos Logísticos , Resultado do Tratamento , Maxila/cirurgia
8.
Oral Maxillofac Surg ; 24(4): 403-410, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32535762

RESUMO

PURPOSE: To study the influence of the access window dimensions on the healing at the antrostomy and within the augmented maxillary sinus. MATERIAL AND METHODS: A maxillary sinus augmentation was performed in twenty-four albino New Zealand rabbits. Antrostomies of 3 × 6 mm (small) or 5 × 6 mm (large) in dimensions were randomly prepared in each animal. A collagenated cortico-cancellous porcine bone was used to fill the elevated region, and an equine collagen membrane was placed on the antrostomies. Three different groups were formed, based on the time of euthanasia, i.e., 2, 4, and 8 weeks from surgery. RESULTS: No relevant changes of the height of the augmented sinus were detected over time. Mineralized bone increased between 2 and 4 weeks of healing while remained stable between 4 and 8 weeks. The highest amounts of new bone were found close to the sinus bone walls. No antrostomies were found healed with an even layer of corticalized bone, while large amounts of connective tissue were occupying the antrostomy in both groups. CONCLUSION: Antrostomies of different dimensions resulted in similar outcome in bone formation both in the antrostomy regions and within the elevated sinus.


Assuntos
Levantamento do Assoalho do Seio Maxilar , Animais , Colágeno , Cavalos , Maxila , Seio Maxilar/cirurgia , Coelhos , Suínos , Cicatrização
9.
Int J Implant Dent ; 6(1): 9, 2020 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-32128632

RESUMO

AIM: To study the influence on the healing of the placement of particulate autogenous bone in the antrostomy and in the subjacent region after maxillary sinus elevation. MATERIAL AND METHODS: Sixteen New Zealand rabbits were undergone to bilateral maxillary sinus floor augmentation with 4 × 4 mm antrostomy dimension. The sinus mucosa was elevated, and the space obtained was filled with xenograft. In the test site (treated sites), autogenous bone was harvested from the tibia and was placed either in the antrostomy and the subjacent region while the control site was left untreated. Antrostomy was covered bilaterally with collagen membranes. Animals were euthanized after 1 and 8 weeks of healing, with 8 rabbits in each group. Histomorphometric evaluations were done. The Wilcoxon test is used for statistical analysis, for a 5% statistical significance. RESULTS: After 1 week of healing, the new bone proportion in the antrostomy was 7.7 ± 11.2% and 6.1 ± 6.4% in the treated and untreated sites, respectively. In the subjacent region (close-to-window region), hardly any new bone was assessed. In the elevated region, 2.7-2.8% of total new bone was found in both sites. In the antrostomy region, after 8 weeks of healing, 35.5 ± 20.9% of new bone in the treated sites, and 28.6 ± 24.1% in the untreated sites was observed (p = 0.499). In the close-to-window region, the respective proportions were 25.8 ± 16.1% and 17.6 ± 16.3% (p = 0.018). In the elevated region, the total new bone reached fractions of 27.9 ± 12.9% and 23.6 ± 15.2% in the treated and untreated sites, respectively (p = 0.128). CONCLUSIONS: The placement of autogenous bone in the antrostomy and the subjacent region after maxillary sinus elevation, slightly enhanced bone formation compared with sites only grafted with xenograft. Though, only the subjacent close-to-window region showed a statistical significance at 8 weeks of healing. Despite the limitations of the present study, due to its preclinical nature, findings should be extrapolated to humans with caution.

10.
Med. oral patol. oral cir. bucal (Internet) ; 25(2): e233-e239, mar. 2020. tab, graf, ilus
Artigo em Inglês | IBECS | ID: ibc-196253

RESUMO

BACKGROUND: To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction. MATERIAL AND METHODS: An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized clinical trials. The Cochrane risk of bias assessment tool was used for methodological appraisal. A random-effects meta-analysis was conducted of pain perception and trismus. RESULTS: From the initially 1314 screened studies, only 11 were included in the qualitative synthesis, and 5 in the meta-analysis. There were no statistically significant differences in pain between the envelope and triangular flap designs over time, except on the sixth postoperative day, when the envelope flap proved more painful. Regarding trismus, statistically significant differences were observed on the seventh postoperative day, with greater mouth opening in the envelope flap group than in the triangular flap group. There were no clear differences in swelling and osteitis among the flap designs. CONCLUSIONS: Despite its limitations, the present meta-analysis found no clear differences in patient morbidity between the different flap designs


No disponible


Assuntos
Humanos , Dente Impactado/cirurgia , Extração Dentária/métodos , Retalhos Cirúrgicos , Dente Serotino/cirurgia , Dente Impactado/complicações , Extração Dentária/efeitos adversos , Morbidade , Resultado do Tratamento , Percepção da Dor , Trismo/etiologia , Alvéolo Seco/etiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-32086875

RESUMO

INTRODUCTION: Traumatic bone cyst is a pseudocyst which is characterized as an asymptomatic unilocular single lesion with an empty cavity without epithelial lining. Its etiology is still debated, it is more frequent among young people and it is often localized in the posterior mandible zone. A case report is described about diagnosis and conservative treatment of a traumatic bone cyst in anterior zone of lower mandible. CASE PRESENTATION: The report describes a 22-year-old female with a traumatic bone cyst in anterior mandible as accidental discovery from a routine orthopantomography. A conservative approach was conducted to treat the lesion through a submarginal incision, an osteotomy with ultrasound, a filling of the cavity with advanced platelet-rich fibrin membranes, and repositioning of the cortical bone. The radiological follow-up to 6 months confirmed the healing of the lesion. CONCLUSION: The conservative approach through submarginal incision, osteotomy with ultrasound, filling with A-PRF+ membranes and repositioning of cortical bone ensures optimal bone healing and avoids gingival recessions at six months follow-up, showing to be a good alternative for satisfactory defect resolution in similar clinical cases.

12.
Int J Oral Maxillofac Implants ; 35(1): 107-119, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923293

RESUMO

PURPOSE: A systematic review was performed of the dimensional changes in facial cortical bone following implant placement into healed ridges, with the aim of establishing a minimum bone thickness that limits such changes. The influence of such bone remodeling upon the soft tissues and implant survival was also evaluated. MATERIALS AND METHODS: A search was done of two electronic databases (MEDLINE via PubMed and CENTRAL), complemented by a manual search and lists of references. The risk of bias and methodological quality were assessed using the Cochrane Collaboration tool, the Methodological Index for Non-randomized Studies (MINORS), and the Quality Appraisal Checklist for Case Series. RESULTS: The search yielded 536 publications, of which 11 (four randomized clinical trials, two non-randomized clinical trials, and five case series) were entered in the review. All the included studies reported vertical and horizontal implant facial bone resorption. Decreased facial bone thickness was correlated with increased vertical bone resorption, which in turn was associated with slight soft tissue retraction. A meta-analysis could not be performed, due to the heterogeneity of the study designs and measurement sites. CONCLUSION: No minimum facial bone thickness was seen that would completely avoid peri-implant bone loss and maintain soft tissue stability. However, a thickness of approximately 2 mm was associated with diminished vertical bone resorption and less peri-implant mucosal recession.


Assuntos
Implantação Dentária Endo-Óssea , Implantes Dentários , Gengiva , Maxila
13.
Med. oral patol. oral cir. bucal (Internet) ; 25(1): e34-e48, ene. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-196194

RESUMO

BACKGROUND: A study is made of the association between maxillary sinus pathology and odontogenic lesions in patients evaluated with cone beam computed tomography. MATERIAL AND METHODS: A literature search was made in five databases and OpenGrey. Methodological assessment was carried out using the Newcastle-Ottawa tool for observational studies. The random-effects model was used for the meta-analysis. RESULTS: Twenty-one studies were included in the qualitative review and 6 in the meta-analysis. Most presented moderate or low risk of bias. The periodontal disease showed to be associated with the thickening of the sinus membrane (TSM). Mucous retention cysts and opacities were reported in few studies. The presence of periapical lesions (PALs) was significantly associated to TSM (OR = 2.43 (95%CI:1.71-3.46); I2 = 34.5%) and to odontogenic maxillary sinusitis (OMS)(OR = 1.77 (95%CI: 1.20-2.61); I2 = 35.5%). CONCLUSIONS: The presence of PALs increases the probability of TSM and OMS up to 2.4-fold and 1.7-fold respec-tively. The risk differences suggests that about 58 and 37 of out every 100 maxillary sinuses having antral teeth with PALs are associated with an increased risk TSM and OMS respectively. The meta-evidence obtained in this study was of moderate certainty, and although the magnitude of the observed associations may vary, their direc-tion in favor sinus disorders appearance, would not change as a result


No disponible


Assuntos
Humanos , Masculino , Feminino , Seio Maxilar/patologia , Doenças Periapicais/patologia , Sinusite Maxilar/patologia , Cistos Odontogênicos/patologia , Tomografia Computadorizada de Feixe Cônico , Mucocele/patologia , Fatores de Risco
14.
Clin Oral Investig ; 24(5): 1727-1738, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31612327

RESUMO

BACKGROUND: Clinical evidence of the autologous platelet concentrates effects on the patient-reported outcome measures (PROMs) after endodontic surgery is still limited. OBJECTIVES: To investigate the effect of the advanced platelet-rich fibrin (A-PRF+) membrane application upon patient postoperative pain, and quality of life in endodontic surgery. MATERIALS AND METHODS: A two-parallel-arm randomized clinical trial was made comparing endodontic surgery with or without A-PRF+ as adjunctive treatment. Fifty individuals comprehending 50 apical lesions (second premolar to the second premolar) of upper maxilla were included. Pain perception and quality of life (functional limitations and other symptoms) were assessed 1 week after surgery using a visual analog scale and a Likert scale-based questionnaire. Descriptive analysis was done using χ2 and t test. Binary logistic regression, ANOVA-type statistic, and GEE analysis were used for inferential analysis. RESULTS: Pain perception was mild in both groups [A-PRF+ 12.7 ± 8.5] versus [no A-PRF+ 20.7 ± 16.3]; it proved less variable during the first 4 days in test group, showing lower extreme pain values (p = 0.096). Analgesic use was similar in both groups. Controls reported significantly worse sleep and speech functions (p < 0.05). Bleeding and bad taste/breath were the most discriminative symptoms. CONCLUSIONS: Postoperative pain perception was mild in endodontic surgery of the upper anterior maxilla. Differences in pain perception were not statistically significant. The use of A-PRF+ afforded less variable pain perception than in the controls. Altered quality of life parameters were more prevalent in the control group and prove significant for speech and sleep functions. CLINICAL RELEVANCE: Patient-related outcomes are of utmost importance in clinical practice. The use of A-PRF+ provides an affordable and safe alternative to improve postoperative quality of life in endodontic surgery.


Assuntos
Procedimentos Cirúrgicos Bucais , Dor Pós-Operatória , Fibrina Rica em Plaquetas , Qualidade de Vida , Dente Pré-Molar , Endodontia , Humanos , Percepção da Dor , Inquéritos e Questionários
15.
J Clin Exp Dent ; 11(8): e732-e738, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31598202

RESUMO

Background: The aim of the study was compare the sensitivity and measurements obtained from teeth with apical lesions scheduled for periapical surgery using three different diagnostic methods: periapical radiography (Gendex Expert DC), panoramic radiography (Planmeca® Promax 3D Classic) and cone beam computed tomography (CBCT) (Planmeca® Promax 3D Classic). Material and Methods: This cross-sectional study involved 35 patients (45 teeth) scheduled for periapical surgery in which periapical radiographs, panoramic radiographs and CBCT scans had been obtained. The images were used to analyze the maximum vertical and horizontal dimension and the resulting areas of the periapical lesions based on the three diagnostic methods. Results: The two-dimensional techniques (periapical radiography and panoramic radiography) yielded a sensitivity of 82% versus 100% in the case of CBCT. The mean vertical dimension of the apical areas was 5.48 mm with periapical radiography and 5.04 mm with panoramic radiography - the difference with respect to CBCT being statistically significant (6.36 mm for the coronal sections). There were no significant differences among the three techniques in terms of horizontal dimension (p>0.05) or lesion area. Conclusions: The sensitivity of periapical radiolucencies detected using CBCT was significantly greater than with the two-dimensional imaging techniques. Significant differences between the latter and CBCT were only observed in the case of the vertical measurements. Key words:Periapical lesion, apicoectomy, CBCT, periapical radiography, panoramic radiography.

16.
J Clin Med ; 8(9)2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31547384

RESUMO

: The Biologically Oriented Preparation Technique (BOPT), developed by Ignacio Loi and published in 2008, is a consolidated concept in the modeling and preservation of pericoronal soft tissues. The present study describes the analogical and digital methods allowing adequate design and preparation of the emergence profile of BOPT crowns in the working model, with a view to comparing the workflow and advantages of each method. At present, not all the digital procedures have been fully optimized to completely replace the traditional analogical methods. Nevertheless, it is only a matter of time until dental digitalization technology totally replaces the analogical clinical methods. The digital workflow for this procedure is quickly implemented and optimized, and represents the most realistic option, with possibilities for further development in the immediate future.

17.
Med. oral patol. oral cir. bucal (Internet) ; 24(5): e673-e683, sept. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-185686

RESUMO

Background: To systematically assess studies analyzing peri-implant bone loss in implants placed in crestal and subcrestal position. Material and Methods: Following the recommended methods for systematic reviews and meta-analyses (PRIS-MA), an electronic search was conducted in the PubMed (MEDLINE), EMBASE and LILACS databases to identify all relevant articles published up until April 2017. The search included human studies comparing marginal bone loss (MBL) between a control group and a study group with a minimum of 10 patients and a minimum follow-up of 6 months after prosthetic loading with rough neck implants. Two independent reviewers assessed the risk of bias in the selected studies based on the Newcastle-Ottawa scale for observational studies and the Cochrane Collaboration for clinical trials. Results: Of 342 potentially eligible items, 7 complied with the inclusion criteria. One article was retrieved through the manual search. Eight articles were finally included: five experimental and three observational studies. The risk of bias assessed by the Cochrane Collaboration and Newcastle-Ottawa showed a high risk of bias. The mean follow-up period was 21 months (range 6-36 months). In four studies, implants placed in a crestal position presented higher MBL than subcrestal implants - the differences being significant in one study, while in three studies, implants placed in a subcrestal position presented greater MBL than crestal implants, with significant differences in only one study. Conclusion: Despite its limitations, the present systematic review did not find better outcomes between crestal and subcrestal implant placement, however, new studies will be needed, involving improved designs and the standardization of protocols to allow statistical comparisons and the drawing of firm conclusions


No disponible


Assuntos
Humanos , Perda do Osso Alveolar , Implantes Dentários , Implantação Dentária Endo-Óssea
18.
Med. oral patol. oral cir. bucal (Internet) ; 24(4): e502-e510, jul. 2019. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-185664

RESUMO

Background: To evaluate the effect of two different implant macro-designs on the sequential osseointegration at bicortically installed implants in the rabbit tibia. A further aim is to compare the osseointegration at different topographic zones. Material and Methods: 27 New Zealand rabbits were implemented. Two implants, one for each macro-design (Ticare Inhex(R) or Ticare Quattro(R), Mozo-Grau, Valladolid, Spain), were randomly implanted in the diaphysis or metaphysis of each tibia. The flaps were sutured to allow a submerged healing. The animals were sacrificed after 2, 4 or 8 weeks. Ground sections were prepared and analyzed. Results: No statistically significant differences were found between the two groups for newly formed bone in contact with the implant surface, being about 16%, 19% and 33% in both groups, after 2, 4, and 8 weeks of healing. Bone apposition was slightly higher in the diaphysis, reaching values of 36.4% in the diaphysis, and 29.3% in the metaphysis at 8 weeks of healing. It was observed that the implant position showed a statistical significance regarding BIC values at 4 and 8 weeks (p < 0.05). Multivariate analysis fails to detect statistical significant differences for the interaction between implant designs and topographic site. Ticare Quattro(R) design had a slight better BIC values at diaphysis sites across healing stages, but without reaching a statistical significance. Conclusions: The both implant macro-designs provided similar degrees of osseointegration. Bone morphometry and density may affect bone apposition onto the implant surface. The apposition rates were slightly better in diaphysis compared to metaphysis


No disponible


Assuntos
Animais , Coelhos , Implantes Dentários , Osseointegração , Implantação Dentária Endo-Óssea , Propriedades de Superfície , Tíbia , Titânio
19.
J Endod ; 45(8): 970-976, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31160080

RESUMO

INTRODUCTION: Bleeding control is an important aspect in endodontic surgery. Two hemostatic techniques were compared with regard to their efficacy to bleeding control in endodontic surgery. METHODS: A randomized, 2-arm, parallel pilot study involving 30 patients with periradicular lesions was performed including the following hemostatic agents: polytetrafluoroethylene strips as an adjunct to epinephrine-impregnated gauze (test group, n = 15) and aluminum chloride (control, n = 15). Bleeding control was independently assessed by the surgeon and 2 blinded observers before and after application of the hemostatic agent. Bleeding control was classified either as adequate (complete bleeding control) or inadequate (incomplete bleeding control). RESULTS: Hemostasis in both groups proved similar. Simple binary logistic regression analysis failed to identify variables affecting bleeding control. Only the height of the keratinized mucosa band (≥2 mm) suggested a risk reduction for an inadequate bleeding control up to 79% (odds ratio = 0.21, P > .05). CONCLUSIONS: No differences in the efficacy of bleeding control were observed between polytetrafluoroethylene strips as an adjunct to epinephrine-impregnated gauze and aluminum chloride.


Assuntos
Cloreto de Alumínio , Implantação Dentária Endo-Óssea , Epinefrina , Hemostáticos , Cloreto de Alumínio/uso terapêutico , Epinefrina/uso terapêutico , Técnicas Hemostáticas , Hemostáticos/uso terapêutico , Humanos , Projetos Piloto , Politetrafluoretileno
20.
J Periodontal Res ; 54(6): 573-588, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31231802

RESUMO

The present systematic review and meta-analysis was carried out to determine the extent to which supracrestal tissue attachment (STA) thickness affects marginal bone loss (MBL) around dental implants. An electronic search was conducted in PubMed (MEDLINE), EMBASE, and complementary sources covering the period up to June 2018. The studies were meta-analyzed based on implant position with respect to the alveolar bone crest (crestal/supracrestal). The MBL values were categorized according to STA width (thick/thin). Of the 1062 eligible titles, nine articles were included in the review. The implants were positioned crestal or supracrestal with respect to the alveolar ridge. The difference between (thin/thick) STA was statistically significant among analytical subsets in terms of lesser MBL (crestal-positioned: weighted mean difference [WMD] = 0.52, 95% CI [0.03-1.01]; P = 0.036; supracrestal-positioned: WMD = 1.26; 95% CI [1.12-1.39]; P = 0.00; pooled analysis: WMD = 0.73; 95% CI [0.033-1.13]; P < 0.01). Implant positioning and patient age showed statistical significance in the meta-regression analysis. The heterogeneity explained by age was R2  = 39.8%. Despite its limitations, the present study demonstrates that implants with thin STA result in greater MBL. There is moderate certainty of the evidence for a large effect of MBL prevention "in favor" of a thick STA environment in crestal-positioned implants and the pooled analysis, but lesser certainty when only supracrestal-positioned implants are considered. No trials studying this topic in subcrestal-positioned implants were found.


Assuntos
Perda do Osso Alveolar , Implantação Dentária Endo-Óssea , Implantes Dentários , Processo Alveolar , Planejamento de Prótese Dentária , Humanos
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