Cirugía de elevación del seno maxilar: "Utilidad de las diferentes técnicas. "Caso clínico de elevación de seno y colocación de implantes Phibo TSH y TSA / Maxillary sinus lift surgery: "Usefulness of different techniques. "Clinical case of sinus lift and placement Phibo TSH and TSA implants

Se realizó una revisión bibliográfica sobre los procedimientos para el aumento o elevación del seno maxilar para la colocación posterior o conjunta de implantes endoóseos. Nuestro objetivo es presentar un caso clínico y revisar la literatura existente. Se puede apreciar que el tema ha sido tratado ampliamente por distintos especialistas, describiendo las distintas técnicas, y también que es un procedimiento con un alto porcentaje de éxito. Por otro lado, habitualmente se puede realizar en consulta ambulatoria, respetando los conceptos de asepsia que se ha de cuidar en los procedimientos de cirugía oral: correcta preparación del equipo, esterilización del instrumental y desinfección del campo quirúrgico. Es decir, todo el instrumental en bolsas herméticas previamente esterilizadas, campos quirúrgicos y guantes estériles, mesa y equipamiento debidamente todo desinfectado. Además de que tanto el equipo de asistencia como el cirujano deben contar con gorros y batas desechables quirúrgicas estériles. Es importante resaltar que al manejar rellenos óseos deben también con los máximos protocolos de esterilización envasado para su utilización. (AU)

A bibliographic review was carried out on the procedures for the augmentation or elevation of the maxillary sinus for the posterior or/and placement of endosseous implants. Our objective is to present a clinical case and review the existing literature. It can be seen that the subject has been extensively treated by different specialists, describing the different techniques, and also that it is a procedure with a high percentage of success. On the other hand, it can usually be performed in a common dental office with the appropriate aseptic measures; that means: correct preparation of the equipment, sterilization of the instruments and disinfection of the surgical field. That is, all the instruments should be packed in hermetic bags previously sterilized, surgical fields and sterile gloves, table and equipment all properly disinfected. In addition to the fact that both the surgical-nurse team and the surgeon must have disposable sterile surgical caps and gowns. It is important to highlight that when handling bone fillers, they must also comply with the maximum packaging sterilization protocols for their use. (AU)

Profilaxis antibiótica del paciente con prótesis corporal sometido a cirugía bucal: Reporte de un caso clínico / Antibiotic prophylaxis of the patient with body prostheses undergoing oral surgery: A case report

Resumen Introducción: En Chile, según el último censo 2017 del Instituto Nacional de Estadísticas (INE), la población con 65 años o más, corresponde al 11,4% del total de los chilenos. Esto refleja un claro envejecimiento de sus ciudadanos, al ser comparado con versiones anteriores del censo. Estos cambios demográficos conllevan a un aumento de las patologías osteoarticulares, tendencia que puede apreciarse a nivel global. Objetivo: Junto a una revisión narrativa de la literatura, se presenta el caso de un paciente de sexo femenino. Método: Paciente de 82 años, con prótesis de cadera, que acude a la clínica de Cirugía Bucal de la Universidad Andrés Bello de Santiago de Chile. Fue derivada para realizar exodoncia de caninos inferiores por indicación protésica. Al realizar la anamnesis remota personal, la paciente relata haber sido sometido de artroplastia de reemplazo de cadera total hace 5 meses producto de un traumatismo. En el intraoperatorio, se realizó la exodoncia lo menos traumática posible y se aplicaron medidas de hemostasia locales. Conclusión: Según las últimas guías realizada por diversas sociedades del ámbito médico y odontológico, se sugiere el uso de profilaxis antibiótica únicamente en el caso de pacientes con patología sistémica descompensada, polimedicados, sistema inmunológico debilitado y/o con antecedentes de infección protésica.

Abstract Introduction: In Chile, according to the last census 2017, performed by the National Statistics Institute (INE), the population with 65 years or older, accounts for 11,4% of Chileans. This reflects an apparent aging of its citizens, in comparison to previous versions of the census. These demographical changes imply an increase in the numbers of osteoarticular pathologies, tendency that may be observed globally. Objective: Alongside with a narrative review of the literature regarding patients with hip prostheses, a case of a female patient. Method: 82 years old patient, attends the surgery clinic of the Andrés Bello University of Santiago de Chile, to perform extraction of lower canines by prosthetic indication. During the anamnesis, the patient reports a total hip replacement arthroplasty 5 months ago due to trauma. Intrasurgically, the extraction was performed as little traumatic as possible and local hemostasis measures. Conclusion: According to the latest guidelines reported by diverse medical and dental societies, it is suggested that the application of antibiotic prophylaxis only in patients with an uncontrolled systemic pathology, polymedicated, weakened immune system, and/or with a history of prosthetic infection.

The Effect of Pain and Swelling Related to Third Molars on Oral Health-Related Quality of Life

ABSTRACT Objective: To evaluate the effect of pain and swelling related to third molars on patients' quality of life prior to third molar surgery. Material and Methods: The effects on quality of life with reference to oral health of 246 healthy patients seeking treatment of third molars were analyzed using the 14-item Oral Health Impact Profile (OHIP) questionnaire before surgery. The patients' sociodemographic characteristics, medical and dental history, reasons for third molar removal were recorded. Adverse effects of pain and swelling on oral health-related quality of life were recorded. Results: The mean age of the patients included in the study was 23.15 years, with maximum male patients and the mean OHIP-14 score of 8.01 ± 7.51. About 36.97% of patients reported that their chief complaint was pain/swelling due to third molar infection, and 27.9% of subjects reported one or more of the 14 OHIP items. The odds of reporting for age with ≥25 years was approximately 2 times greater than age with ≤25 years (OR=1.56, 95% CI: 1.01-2.57) and tooth loss due to traumatic history (OR=3.14, 95% CI: 2.12-6.54). Conclusion: Adverse influences on quality of life were seen in a significant number of patients seeking third molar removal. The probabilities increased by 3-fold for patients who had experienced pain or swelling than asymptomatic individuals.

Comparison of Microscopic Endodontic Techniques: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To evaluate the success rates of resin-based endodontic surgery (RES) and endodontic microsurgery (EMS), and compare their results. Material and Methods: A total of 19 and 34 full-text papers were reviewed, and finally, 2 and 6 studies were selected for RES and EMS, respectively. The stages of the study selection process were illustrated in Figure 1. The demographic characteristics were also described using the IBM SPSS Software, and the meta-analysis was fulfilled via Stata V.14. Results: A total number of 811 teeth were analyzed in this systematic review and meta-analysis, with a mean follow-up of 38.63 months. Besides, the results of the meta-analysis indicated that both methods not only differed in terms of implementation but also produced varying outcomes. Accordingly, EMS demonstrated a higher success rate likelihood with a significant difference from that of RES. Conclusion: An excellent proof was made available through this meta-analysis regarding the resin-based endodontic surgery success rate likelihood (79.9%) and an update for the endodontic microsurgery success rate possibility (100%).

Patterns of Mandibular Third Molar Impaction in an Iranian Subpopulation

Abstract Objective: To assess the patterns of mandibular third molar impaction in an Iranian subpopulation. Material and Methods: This retrospective descriptive study evaluated 1000 panoramic radiographs retrieved from the archives of a private radiology clinic in Kermanshah city, Iran. Depth of impaction, position of impacted mandibular third molar relative to the mandibular ramus according to Pell and Gregory's classification and angle of impacted tooth according to Winter's classification were determined. Data were analyzed using the Chi-square and Wilcoxon tests. Results: Of 1000 radiographs, 230 (23%) showed an impaction of at least one mandibular third molar. Mandibular third molar impaction was more common in females (60%). Mesioangular (35.9%) and vertical (34.8%) impactions were the most common angles of impaction in the right and left sides, respectively. Level C (40.3%) and Class I (63.7%) were the most common types of impaction in terms of depth of impaction and position relative to ramus, respectively. No significant difference was observed between the right and left sides of the mandible in terms of patterns of mandibular third molar impaction (p>0.05). Conclusion: Mandibular third molar impaction was relatively common in the studied population. The mesioangular, level C and Class I impaction patterns were the most frequent.

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

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

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

Bionic mechanical design and 3D printing of novel porous Ti6Al4V implants for biomedical applications.

In maxillofacial surgery, there is a significant need for the design and fabrication of porous scaffolds with customizable bionic structures and mechanical properties suitable for bone tissue engineering. In this paper, we characterize the porous Ti6Al4V implant, which is one of the most promising and attractive biomedical applications due to the similarity of its modulus to human bones. We describe the mechanical properties of this implant, which we suggest is capable of providing important biological functions for bone tissue regeneration. We characterize a novel bionic design and fabrication process for porous implants. A design concept of "reducing dimensions and designing layer by layer" was used to construct layered slice and rod-connected mesh structure (LSRCMS) implants. Porous LSRCMS implants with different parameters and porosities were fabricated by selective laser melting (SLM). Printed samples were evaluated by microstructure characterization, specific mechanical properties were analyzed by mechanical tests, and finite element analysis was used to digitally calculate the stress characteristics of the LSRCMS under loading forces. Our results show that the samples fabricated by SLM had good structure printing quality with reasonable pore sizes. The porosity, pore size, and strut thickness of manufactured samples ranged from (60.95± 0.27)% to (81.23±0.32)%, (480±28) to (685±31) µm, and (263±28) to (265±28) µm, respectively. The compression results show that the Young's modulus and the yield strength ranged from (2.23±0.03) to (6.36±0.06) GPa and (21.36±0.42) to (122.85±3.85) MPa, respectively. We also show that the Young's modulus and yield strength of the LSRCMS samples can be predicted by the Gibson-Ashby model. Further, we prove the structural stability of our novel design by finite element analysis. Our results illustrate that our novel SLM-fabricated porous Ti6Al4V scaffolds based on an LSRCMS are a promising material for bone implants, and are potentially applicable to the field of bone defect repair.

[Evaluation of dental medical devices: Focus on the definition of needs]. / Évaluation des dispositifs médicaux dentaires pour un appel d'offres : privilégier la haute définition des besoins.

OBJECTIVES: As a university teaching hospital, the call for tender for dental medical devices (dental implants and consumables) is done with the help of a team of hospital pharmacists and users. In order to optimize the definition of needs and evaluation criteria, an exhaustive review of the products was carried out. METHODS: Dental medical devices suppliers were consulted in 2017 for reviewing their products. Their technical, clinical and economic data were compared. The products have been gathered into categories and its results had been submitted to a commission of dental experts of our university hospital for clinical opinion. RESULTS: More than 30,000 references from 30 different suppliers were analyzed (orthodontics, dental implants, membranes and bone substitutes, various dental consumables). Relating to oral implantology, the opinions converged on clinical studies. On the contrary, diverging opinions have been proffered on the systematic use of single-use drills and customized guides for surgery and on the implant's choice. The definition of needs has been specified for orthodontics and consumables. Other criteria played a great role: single packaging (unit doses), product's sterility, paediatric needs, presence of allergens, traceability of devices and supplier diversity. CONCLUSIONS: This review led to the identification of new needs in more precise terms. The complexity and diversity of dental products and techniques requires this careful review and a better collaboration with practitioners.

Contribution of cone-beam computed tomography in the decision of surgical management for bone lesions of the maxillofacial region.

The aim of this study was to evaluate the contribution of cone-beam computed tomography (CBCT) in the decision of surgical management for bone lesions of the maxillofacial region. It is a retrospective cross-sectional observational study that includes a sample of panoramic radiography (PR) and CBCT from patients with some type of bone lesion in the maxillofacial region. PR and CBCT images were evaluated by three previously assessed examiners, specialists in oral and maxillofacial surgery. Each image was evaluated randomly, and a surgical procedure was suggested, initially in PR and then in CBCT. The obtained results were submitted to the McNemar test to evaluate the frequencies of changes in the surgical management between the first and the second evaluation in PR and CBCT, and intra-examiner and inter-examiner agreements were analyzed by the Cohen's kappa test. The level of significance was set at 5% (p < 0.05). Intra-examiner agreement increases when CBCT is used. Inter-examiner agreement was low, independently of the evaluated exam, which shows that the choice of treatment plan is examiner-dependent and not exam-dependent. CBCT increases the certainty of the professional in the evaluation of the bone lesions of the maxillofacial region; however, it does not change the indication of the treatment type.

Recommended Drilling Parameters of Tungsten Carbide Round Drills for the Most Optimal Bone Removals in Oral Surgery.

BACKGROUND: High temperatures during drilling can cause thermal osteonecrosis and abnormal wound healing. According to our best knowledge, a widely accepted recommendation for optimal drilling parameters in routine oral surgery bone removals does not exist. PURPOSE: Our aim was to investigate the correlations of different drilling parameters, including axial load and revolution speed on drilling temperatures and preparation times. MATERIALS AND METHODS: Standard, 5 mm deep cavities were drilled in 20 PCF (lb/ft3) dens polyurethane blocks with 3 mm (50PCF) cortical layer using new and worn, 3.1mm in diameter tungsten carbide round drills. Worn drills were used in 50 impacted third molar operations before. Axial loads of 3N, 10N, and 25N and speeds of 4.000-8.000-16.000-40.000 revolutions per minute (rpm) were tested. Temperature differences of drilling parameters were calculated by 1-way ANOVA, followed by Tukey's HSD post hoc tests. Time differences and differences among "optimal" and "suboptimal" groups (with the cut-off value of 3°C and 3s) were estimated by Kruskal-Wallis test with pairwise comparisons. P<0.05 was considered significant. RESULTS: The highest mean temperatures with new and worn drills were 4.64±0.53°C and 6.89±1.16°C, while drilling times varied between 0.16±0.02s and 22.77±5.45s. A 3°C and 3s cut-off value classified drillings significantly to (1) optimal [3N and 8000-16000-40000 rpm or 10N and 4000-8000-16000-40000 rpm] or suboptimal due to (2) high temperatures or (3) long preparation times. Using worn drills, the following parameters should be avoided: 3N with 4.000-8.000 rpm, 10N with 40000 rpm, and 25N at any revolutions. DISCUSSION: The study extensively mapped the drilling temperatures and preparation times of tungsten carbide round drills. Temperatures did not exceed 10°C during drillings with maximal amount of cooling, as well as the drilling parameters, which kept temperatures and preparation times in the most optimal range which were clearly established.

Characterization of an artificial skull cap for cranio-maxillofacial surgery training.

Cranial grafts are favored to reconstruct skeletal defects because of their reduced resorption and their histocompatibility. Training possibilities for novice surgeons include the "learning by doing" on the patient, specimens or simulators. Although the acceptance of simulators is growing, the major drawback is the lack of validated bone models. The aim of this study was to create and validate a realistic skull cap model and to show superiority compared to a commercially available skull model. Characteristic forces during machinery procedures were recorded and thickness parameters from the bony layers were obtained. The thickness values of the bone layers of the developed parietal bone were comparable to the human ones. Differences between drilling and sawing forces of human and artificial bones were not detected using statistical analysis. In contrast the parameters of the commercially available skull model were significantly different. However, as a result, a model-based simulator for tabula externa graft lift training, consisting of a brain, skull bone cap and covering soft tissues was created. This simulator enables the training of all procedural steps of a "split thickness graft lift". In conclusion, an artificial skull cap suitable for parietal graft lift training was manufactured and validated against human parietal bones.

Dr Coupland 4 May 1901 - 12 May 1936.

Little is known about Dr Coupland, despite the use of his instruments in everyday dental practice. The aim of this article is to inform the reader about the life, works and inventions of Dr Coupland.

Caso Clínico: Neumomediastino Anterior, Secundario a Procedimiento Dental / Case Report: Anterior Pneumomediastinum, Secondary to Dental Procedure

INTRODUCCIÓN: El neumomediastino es la presencia de aire en el mediastino, tiene incidencia variable que oscila entre 1/80 000 y 1/42 000 a nivel mundial, genera una diversidad de características clínicas, puede ser secundario a entidades torácicas o extra torácicas; dentro de las causas extratorácicas, podemos asociarlo a procedimientos dentales siendo de vital importancia considerar la posibilidad y la asociación a dichos procedimientos para su diagnóstico y tratamiento adecuado. CASO CLÍNICO: Paciente de sexo femenino de 23 años, que 24 horas previas a su ingreso, se realizó procedimiento dental tipo exodoncia del tercer molar inferior izquierdo, en el que se usó instrumental manual y neumático, que debió ser suspendido; la paciente presentó dolor intenso más dificultad respiratoria, posterior a ello dolor torácico opresivo, mandibular y en cuello de lado izquierdo, acompañado de enfisema subcutáneo en hemicara izquierda, cuello bilateralmente y subclavicular izquierdo. EVOLUCIÓN: Paciente es ingresada con diagnóstico de neumomediastino secundario a procedimiento dental para tratamiento antibiótico de amplio espectro y vigilancia, durante su hospitalización por tres días permanece estable, afebril con mejoría clínica general. CONCLUSIÓN: El neumomediastino es una complicación poco frecuente tras intervenciones odontológicas, se debe sospechar por el uso de instrumental neumático que disecan los tejidos blandos faciales, del cuello y tórax; la paciente tuvo una evolución favorable en base al diagnóstico y tratamient

BACKGROUND: Neumomediastinum is defined as the presence of air in the mediastinum, It has variable incidence that oscillates between 1/80000 and 1/420000, generates a diversity of clinical characteristics. It can be secondary to thoracic or extra thoracic entities, within extrathoracic causes; it can be associated with dental procedures, being of vital importance consider the possibility and the association to this procedure to get to an adequate diagnosis and treatment. CASE REPORT: A 23-year-old female patient who, 24 hours prior to admission, underwent a dental procedure such as a third-molar left third molar extraction, in which manual instruments and pneumatics dental lathe were used, which had to be suspended; the patient presented severe pain plus respiratory difficulty, after that she presented oppressive chest pain, mandibular and left side neck, accompanied by subcutaneous emphysema in the left side of the face, neck bilaterally and left subclavicular EVOLUTION: The patient was hospitalize with a diagnosis of neumomediastinum secondary to dental procedure to receive treatment with broad spectrum antibiotic and surveillance, during her hospitalization for three days she remains stable, afebrile with general clinical improvement. CONCLUSIONS: The neumomediastinum is a rare complication after odontological interventions. It should be suspected when pneumatic instrument lathe are used that dissect facial, neck and thorax soft tissues; the patient had a favorable evolution based on the diagnosis and early treatment proposed by the doctors according to the patients symptoms.

Comparison of Nasal Intubations by GlideScope With and Without a Bougie Guide in Patients Who Underwent Maxillofacial Surgeries: Randomized Clinical Trial.

BACKGROUND: Nasotracheal intubation is commonly performed to provide a secure airway for the maintenance of general anesthesia in maxillofacial surgeries. Routine nasotracheal intubation is performed under general anesthesia by direct laryngoscopy, frequently with the aid of Magill forceps. This method can be time-consuming and may cause bleeding in the field of view. A gum elastic bougie (GEB) is a cheap, slender, and flexible device that could expedite nasotracheal intubation. The aim of this study was to evaluate the use of a GEB during nasotracheal intubation to facilitate the procedure and reduce the rate of complications. METHODS: In this randomized clinical trial study, 110 patients with American Society of Anesthesiologists (ASA) physical status I-II from 15 to 65 years of age were randomized into 2 equal groups. In both groups, a GlideScope and armored tube were used. In the GEB group, GEB was used to facilitate nasal intubation while the nasal intubation was performed without the aid of GEB in the routine group. The difficult intubation (defined as >1 attempt for intubation) was the primary outcome, and the duration of the intubation, the presence of traces of bleeding, the need for a tube replacement, and the usage of Magill forceps were the secondary outcomes. RESULTS: The incidence of bleeding in the GEB group was 1.81% vs 43.63% in the routine group (P < .001). In 5.5% of the GEB group, Magill forceps were used to advance the tube versus 67.3% in the routine group (P < .001). The mean time for intubation in GEB group was 48.63 ± 8.53 vs 55.9 ± 10.76 seconds in the routine group (P < .001). CONCLUSIONS: The GEB is a useful aid to nasotracheal intubation, reducing bleeding, the requirement for Magill forceps and, to a small degree, intubation time. A case exists for its routine use for this purpose.

High-intensity laser application in Orthodontics

ABSTRACT Introduction: In dental practice, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) are mainly used for dental surgery and biostimulation therapy. Within the Orthodontic specialty, while LLLT has been widely used to treat pain associated with orthodontic movement, accelerate bone regeneration after rapid maxillary expansion, and enhance orthodontic tooth movement, HILT, in turn, has been seen as an alternative for addressing soft tissue complications associated to orthodontic treatment. Objective: The aim of this study is to discuss HILT applications in orthodontic treatment. Methods: This study describes the use of HILT in surgical treatments such as gingivectomy, ulotomy, ulectomy, fiberotomy, labial and lingual frenectomies, as well as hard tissue and other dental restorative materials applications. Conclusion: Despite the many applications for lasers in Orthodontics, they are still underused by Brazilian practitioners. However, it is quite likely that this demand will increase over the next years - following the trend in the USA, where laser therapies are more widely used.

An Efficient Method for Hair Containment During Head and Neck Surgery.

The authors present a simple technique for operations around hair-bearing areas such as during a rhytidectomy. Hair surrounding the surgical field is twisted into bundles and clipped with duckbill clips. The authors repeat the procedure for each strand of hair. Between 5 and 7 duckbill clips may be required per surgery.The clippers are faster, easily applicable, and well performing. They can be used with different hair lengths, and they do not require any additional trimming or shaving; clips also keep the hair firmly in place, and they do not loosen up in the process.This technical note explains a very simple, economical, and less time-consuming method to control hair located around the surgical site. It may be applied to all procedures within the field of the hair-bearing scalp, including craniofacial and maxillofacial surgery.

In vitro studies of nanosilver-doped titanium implants for oral and maxillofacial surgery.

The addition of an antibacterial agent to dental implants may provide the opportunity to decrease the percentage of implant failures due to peri-implantitis. For this purpose, in this study, the potential efficacy of nanosilver-doped titanium biomaterials was determined. Titanium disks were incorporated with silver nanoparticles over different time periods by Tollens reaction, which is considered to be an eco-friendly, cheap, and easy-to-perform method. The surface roughness, wettability, and silver release profile of each disc were measured. In addition, the antibacterial activity was also evaluated by using disk diffusion tests for bacteria frequently isolated from the peri-implant biofilm: Streptococcus mutans, Streptococcus mitis, Streptococcus oralis, Streptococcus sanguis, Porphyromonas gingivalis, Staphylococcus aureus, and Escherichia coli. Cytotoxicity was evaluated in vitro in a natural human osteoblasts cell culture. The addition of nanosilver significantly increased the surface roughness and decreased the wettability in a dose-dependent manner. These surfaces were significantly toxic to all the tested bacteria following a 48-hour exposure, regardless of silver doping duration. A concentration of 0.05 ppm was sufficient to inhibit Gram-positive and Gram-negative species, with the latter being significantly more susceptible to silver ions. However, after the exposure of human osteoblasts to 0.1 ppm of silver ions, a significant decrease in cell viability was observed by using ToxiLight™ BioAssay Kit after 72 hours. Data from the present study indicated that the incorporation of nanosilver may influence the surface properties that are important in the implant healing process. The presence of nanosilver on the titanium provides an antibacterial activity related to the bacteria involved in peri-implantitis. Finally, the potential toxicological considerations of nanosilver should further be investigated, as both the antibacterial and cytotoxic properties may be observed at similar concentration ranges.