Libros

Vertical ridge augmentation has less long-term predictability than horizontal ridge augmentation due to common complications with vertical Guided Bone Regeneration (GBR), including early exposure of the barrier membrane and decreased bone stability. Objective: The purpose of this study was to evaluate the primary stability of short implants versus conventional implants, in vitro. Methods: Two groups of implants with reverse concave neck and neck micro threads (ULT, Ditron Dental, CA) were studied; short implants (Ø 6.0mm x 7mm) and conventional implant (Ø 3.75mm x 10mm). A total of 80 implants were placed by the same calibrated clinician at 800RPM, 40 short implants and 40 conventional implants. Each implant was placed in dense (type II) and soft (type IV) bone. Implant primary stability was recorded using insertion torque (IT), Resonance Frequency Analysis (RFA), and Periotest values. Statistical comparison with Analysis of Variance were completed to compare differences between groups. Results: The comparison of IT, RFA and Periotest of the two groups of implants showed statistical significance (P<0.0001) favoring the short implants (Ø 6.0mm x 7mm) in both the soft and dense bone qualities. Conclusion: Within the limitations of this study, short implants with wide diameter seem to have a higher level of implant stability compared to narrow implants with conventional length. Palabras clave: implant stability; reverse concave neck; short implants

The release of titanium nanoparticles during implant placement in dense bone is a significant concern, as it can potentially have adverse effects on the peri-implant tissues and an impact on the etiology of peri-implant diseases. The objective of this study was to examine the presence of titanium nanoparticles at the bone-implant interface during implant placement utilizing the bone condensation technique in vitro. Artificial Type IV bone slices (4mm thick) were securely held in place with a vice. Two groups of implants were placed. One group (test group) was placed under the condensation technique using cylindrical osteotomes. The other group (control group) was placed following the traditional surgical protocol. Implants were placed in parallel between bone slices held in a vice. Three groups of implant designs (6 implants in each group) were inserted into the bone. Two implant designs consisted of implants made of pure titanium (grade 4), while the third implant design group was constructed of titanium alloy (Ti6Al4V). Subsequently, the blocks were separated, and the peri-implant bone interface was qualitatively evaluated for titanium presence using X-ray-fluorescence spectrometry (XFS) at the coronal, middle, and apical thirds of osteotomies (n=12/ implant system). Descriptive statistical analysis showing the mean values (+/-SD) of titanium nanoparticles was performed. No detectable titanium levels were identified in the control group of titanium alloy-implants compared to pure titanium-implants. In contrast, the test group of all implant systems showed presence of titanium nanoparticles in coronal, middle, and apical thirds. Our results indicate that bone condensation technique is associated with titanium release during implant placement in vitro. These findings were shown for both pure titanium- and titanium alloy-dental implants. Palabras clave: condensation, interface, primary stability, titanium nanoparticles

Purpose: To investigate whether the wettability of two zirconia (Zr) implant disk surfaces is affected by glycine and erythritol air polishing using the following wetting solutions as test mediums: saline, bovine serum albumin (BSA), bovine thrombin, and bovine artificial blood. Materials and Methods: The two types of Zr disks used were SDS (Swiss Dental Solutions; n = 6) and Patent (Zircon Medical AG; n = 6). Surface parameters (Sa, Sz, Sdr, Ssk, Sku, and Spd) were measured to determine their initial surface roughness. Air polishing was completed using glycine or erythritol powders using the AIRFLOW PERIO device (EMS Dental). The wettability of the disk surfaces was evaluated by the contact angle analysis applied to the treated and untreated disks using four wetting solutions, including saline, BSA, bovine thrombin, and bovine artificial blood. In total, 720 contact angle measurements were completed with n = 30 per group. Statistical analysis was performed using one-way ANOVA and the post-hoc Tukey HSD test. Results: The results indicate that SDS has a greater wettability than Patent before and after air polishing. The wettability of surfaces treated with glycine was hydrophobic in some cases. Erythritol increased the surface wettability of Zr disks more than glycine. BSA and bovine artificial blood had lower contact angles than saline and bovine thrombin for both types of untreated disks. Conclusions: The initial wettability of Zr disks differs between manufacturers, and air polishing with erythritol powder increases the wettability of Zr implant disks for saline, bovine serum, bovine thrombin, and bovine artificial blood. Palabras clave: contact angle, erythritol, glycine, wettability, zirconia

This paper is based on lean principles and how they can apply to dental offices for general dental practitioners and specialists. In addition, this paper highlights how to identify and eliminate waste. This information provides value to the process in a dental office, establishing a platform and roadmap for lean thinking and how these principles can be utilized further in health care for reliable, efficient, and sustainable clinical outcomes. Palabras clave: kaizen, lean, practice management

Summary: Most available antiseptic solutions have strong antibacterial effects, but many also possess major cytotoxic effects on gingival fibroblasts, osteoblasts, osteoprogenitor cells, and/or epithelial cells. A novel VEGA Oral Care Recovery Kit (StellaLife) consisting of 16 active ingredients that are monographed in the Homeopathic Pharmacopeia of the United States (HPUS) has gained tremendous momentum as a replacement for more cytotoxic oral rinses such as chlorhexidine. While accumulating evidence has thus far supported its use, little of the gathered data have fully described the properties of the oral formulation. Therefore, the aim of the present review article was 3-fold. First, a biological characterization regarding the active ingredients found in StellaLife Recovery Kit including their biological properties was assessed in 4 predominant categories; 1) antimicrobial resistance, 2) accelerated wound healing, 3) pain management control, and 4) anti-cancer properties. The second aim of this review article was to assess both fundamental and clinical research to date comparing VEGA oral rinse (StellaLife) to the more commonly utilized CHX for differences regarding their effect on decreasing bacterial loads as well as cell viability, survival, proliferation, and expression of both regenerative cytokines and inflammatory markers. Lastly, clinical case examples are presented describing the use of StellaLife remedies in a variety of clinical situations. These include but are not limited to wisdom-tooth extraction, extraction site management, dental implants and ridge augmentation, soft-tissue grafting procedures, frenectomies, and also temporary relief of dry sockets, dry mouth, aphthous ulcers, mucositis, lichen planus, among others. In summary, findings from the present review article provide evidence from basic laboratory experiments that validate clinical studies supporting the use of the StellaLife oral rinse regarding its superior biocompatibility and wound healing properties when compared to common antiseptic solutions such as CHX. Palabras clave: antiseptic solution, cell viability, chlorhexidine, oral rinses, periodontal disease, StellaLife, wound healing

Objective: The present systematic review aimed to assess the efficacy of photobiomodulation (PBM) therapy on neurosensory recovery of patients with inferior alveolar nerve injury following third molar surgery or dental implant placement. Method and materials: An electronic search was carried out in Scopus, Embase, Medline, PubMed, Web of Science, Cochrane Library, and Google Scholar databases. Among 1,122 identified papers, seven articles (three RCTs, one observational study, and three case series) met the inclusion criteria. Results: Time lapse from nerve injury to the onset of PBM therapy varied widely from 2 days to 4 years. The number of patients in each study ranged between 4 and 74. In the majority of the studies, PBM was done using a diode laser at wavelengths ?in the range of 808 to 830 nm with power of 5 to 500 mW and radiation dose of 3 to 244 J/cm2. Two out of three RCTs found significant neurosensory recovery in the patients who received PBM therapy compared to the controls. The observational study and all case series reported significant improvement in the neurosensory status following PBM therapy. The degree of neurosensory recovery was found to be greater in younger patients and those who received the treatment within 6 months following the injury. Conclusions: Due to the limited number of well-designed RCTs and small number of patients in each study, it is not possible to make a clear conclusion about the efficacy of PBM therapy on neurosensory recovery in patients with inferior alveolar nerve injury following third molar or implant procedures. Considering the possibility of spontaneous inferior alveolar nerve recovery during this period, the conclusion based on the studies with no control group should be interpreted with caution. (Quintessence Int 2021;52:140–153; doi: 10.3290/j.qi.a45430) Palabras clave: dental implants, inferior alveolar nerve, low-level light therapy, nerve regeneration, oral surgical procedures, photobiomodulation therapy

Bone regeneration and remodeling are crucial to healing after surgical interventions. Local and systemic factors impact healing. Some well-known medications actively alter bone remodeling. The objective of this report was to increase awareness of less commonly recognized medications that may delay the integration of bone grafts. This case report presents the delayed integration of a bone graft after tooth removal, socket preservation, and ridge augmentation procedures in a patient taking various medications that may have affected bone remodeling. The literature review enables the discussion of evidence regarding delayed bone remodeling associated with selective serotonin reuptake inhibitors (SSRIs), sodium-glucose cotransporter 2 (SGLT2) inhibitors, metformin, and nonsteroidal anti-inflammatory drugs (NSAIDs), and the clinical implications for patients taking these medications. Palabras clave: bone grafting, bone remodeling, delayed osseointegration, dental implant, medication

Die Sofortbelastung von dentalen enossalen Implantaten entwickelte sich innerhalb der letzten 30 Jahre kontinuierlich weiter. Verschiedene Sofortbelastungskonzepte, welche zur Versorgung teilbezahnter sowie zahnloser Patienten sowohl festsitzend als auch herausnehmbar gestaltet wurden, zeigten sich statistisch erwiesen als überzeugende Versorgungsalternative. Eine prothetische Versorgung jenseits von individuell gefertigten Suprakonstruktionen, wie dem Steg, stellt die Versorgung mittels präfabrizierter teleskopierender Pfosten dar. In der vorliegenden Arbeit wird anhand von zwei retrospektiven Studien dieses Sofortbelastungskonzept für den zahnlosen Unterkiefer präsentiert. Die Auswertung mit der Bestimmung der Erfolgsrate nach den Albrektsson-Kriterien ergab bei Spätimplantation einen Wert von 95,16 % und bei Sofortimplantation und Belastung von 89,86 %. Nach Analyse der gesammelten Daten und der Diskussion ermittelter Werte mit bisher in der Literatur beschriebenen Sofortbelastungsstudien kann ein positives Fazit für das untersuchte Konzept erstellt werden. Vorteile sind die Konusverbindung, die Funktion der Prothese als Wundverband, eine Reduktion der Prothesenbasis, die unmittelbare Wiederherstellung von Kaufunktion sowie Ästhetik, der verkürzte Behandlungszeitraum, die optimale Hygienefähigkeit und Wirtschaftlichkeit sowie der hohe Patientenkomfort gerade bei älteren Patienten. Zusammenfassend lässt sich konstatieren, dass die Sofortbelastung dentaler enossaler Implantate mit präfabrizierten teleskopierenden Pfosten als ein erfolgreiches Behandlungskonzept mit hohen Erfolgsraten für den zahnlosen Unterkiefer angesehen werden kann. Manuskripteingang: 25.10.2020, Annahme: 16.12.2020 Palabras clave: Sofortbelastung, Unterkiefer, zahnlos

Purpose: This prospective study aims to evaluate the clinical outcomes of 'All-on-four' rehabilitations in controlled human immunodeficiency virus (HIV)-positive patients. Materials and methods: Edentulous patients requiring an implant prosthetic restoration of one or both jaws were enrolled in the present study. Each patient received at least one fixed full-arch prosthesis. Four implants, immediately loaded, were placed in each jaw using the 'All-on-four' protocol. Marginal bone loss, implant and prosthetic failure, biological and mechanical complications, and serological levels (CD4 cell count, CD4/CD8 ratio, and HIV viral load) were recorded up to 7-year follow-up. Results: A total of 116 implants were placed in 24 patients, and 29 rehabilitations based on the 'All-on-four' concept were achieved. Implant failures were registered in four patients (10 of 116 implants), and the implant survival rate was 91.37%. At the 7-year radiographic evaluation, peri-implant crestal bone loss averaged 1.91 ± 1.3 mm for upright maxillary implants (n = 30 implants) and 1.79 ± 1.28 mm for tilted maxillary implants (n = 30 implants). In the mandible, mean peri-implant crestal bone loss was 1.54 ± 1.27 mm for upright implants (n = 28) and 1.5 ± 1.3 mm for tilted implants (n = 28). No statistically significant correlation was found between serological parameters and marginal bone levels at 6 months, or through 7 years of annual follow-up (P > 0.05). A statistically significant linear correlation (P 0.001) was found between early implant failure and HIV viral load. The CD4/CD8 ratio was significantly correlated with late implant failure (P = 0.009). Conclusions: Within the limitations of this prospective 7-year longitudinal study, HIV-positive patients with a stable immune system can be candidates for the 'All-on-four' treatment concept. Palabras clave: dental implant, HIV-patients, immediate loading, oral rehabilitation, tilted implant Conflict of interest statement: The authors declare there are no conflicts of interest.

The aim of the present study was to consider the long-term midfacial mucosal outcome around final prosthetic restorations on dental implants placed and loaded immediately after tooth extractions. A total of 42 patients requiring tooth extractions were recruited, and 142 teeth were extracted. Based on the amount of keratinized mucosa (KM), implants were categorized into group A (KM ≥ 2 mm; n = 61) or group B (KM 2 mm; n = 62). In both groups, all patients received temporary prosthetic restorations immediately after the surgical procedure. Baseline levels were measured at placement of the final prosthetic restoration and patients were followed for 8 years. After the 8-year follow-up, a survival rate of 98.37% was reported. Two implants were lost due to peri-implantitis after 6 and 7 years of function, respectively. Peri-implantitis occurred at 9 implants (3 from group A and 6 from group B) in 8 patients (7.32%). At the 8-year followup for group A, an increase in midfacial tissue level of 0.14 ± 0.13 mm (screwed restorations) and 0.16 ± 0.09 mm (cemented restorations) was measured. For group B, a decrease in midfacial tissue level of 0.15 ± 0.09 mm (screwed restorations) and 0.17 ± 0.12 mm (cemented restorations) was reported. Statistically significant differences between groups were measured at 2, 5, and 8 years of follow-up (P .01). The results demonstrated that the presence of KM is significantly associated with less mucosal inflammation and less gingival recession, regardless of the type of prosthetic restoration (screwed vs cemented).