Lesiones perirradiculares asociadas a primeros molares superiores tratados endodónticamente: estudio a través de tomografías computadas / Periradicular lesions associated with endodontically treated maxillary first molars: study through computed tomography

Objetivos: Estudiar con tomografías computadas de haz cónico (CBCT) las lesiones perirradiculares de primeros molares superiores tratados endodónticamente; evaluar la lo- calización y, en los que tenían lesión en la raíz mesiovestibu- lar (MV), evaluar la frecuencia del conducto MV2. Materiales y métodos: A partir de una muestra de 179 tomografías, que incluían primeros molares superiores, se seleccionaron y analizaron aquellas en las cuales estos ha- bían recibido un tratamiento endodóntico previo, presentaban lesiones perirradiculares y conservaban una restauración co- ronaria. Las variables analizadas fueron: la localización de áreas radiolúcidas compatibles con lesiones perirradiculares de origen endodóntico y la correlación entre diferentes loca- lizaciones y la calidad del tratamiento realizado (adecuado, defectuoso o sin tratamiento). Los datos fueron analizados mediante la prueba de chi-cuadrado y la prueba de Spearman. Resultados: De las 179 CBCT que incluían primeros molares superiores, 90 reunían las condiciones requeridas. La frecuencia de las lesiones perirradiculares fue significativa- mente mayor en la raíz MV al compararla con las raíces disto- vestibular y palatina (p<0,05). El conducto MV1 presentó un tratamiento adecuado en todos los casos. El conducto MV2 recibió un tratamiento adecuado en 4 casos (4,44%), defec- tuoso en 4 casos (4,44%) y no tratado en 82 casos (91,1%); con una diferencia estadísticamente significativa (p<0,05). Conclusiones: En la muestra analizada, la localización de lesiones perirradiculares postratamiento endodóntico en primeros molares superiores se encontró con mayor frecuencia asociada a la raíz mesiovestibular, donde en la mayoría de los casos el con- ducto MB2 no fue tratado o presentó un tratamiento defectuoso (AU)

Aim: To study with cone-beam computed tomography (CBCT) the periradicular lesions of maxillary first molars with endodontical treatment; to evaluate its localization and, in those with a mesiobuccal root (MB) injury, assess the fre- quency of the MB2 root canal. Materials and methods: From a sample of 179 tomog- raphies (CBCT) that included maxillary first molars, those in which they had received previous endodontic treatment, pre- sented periradicular lesions and had a coronary restoration were selected and analyzed. The analyzed variables were: localization of radiolucent areas compatible with periradic- ular lesions of endodontic origin and the correlation between different localizations and quality of the performed treatment (adequate, defective, or untreated). Data were analyzed by the chi-square test and the Spearman test. Results: Of the 179 CBCT that included maxillary first molars, 90 met the required conditions. The frequency of periradicular lesions was significantly higher in the MB root when compared with distobuccal and palatal roots (P<0,05). The MB1 canal presented an adequate treatment in all cas- es. The MB2 canal received adequate treatment in 4 cases (4.44%), a defective one in 4 cases (4.44%) and was untreated in 82 cases (91.1%). The differences among these frequencies were statistically significant (P<0.05). Conclusions: In the analyzed sample, the localization of periradicular lesions after endodontic treatment in maxillary first molars was associated more frequently with the mesio- buccal root in which in the majority of cases the MB2 canal was untreated or presented a defective treatment

Retratamientos endodónticos: una realidad que preocupa / Endodontic retreatment: a worrying reality

Las evaluaciones radiográficas de tratamientos endodón- ticos realizadas por graduados muestran un alto porcentaje de procedimientos incorrectos. Esta circunstancia lleva a la rea- lización de un elevado número de retratamientos ortógrados y retrógrados, con los inconvenientes y desventajas que conlle- va recurrir a una reintervención endodóntica. Es responsabili- dad de los profesionales, docentes y autoridades universitarias y gubernamentales revertir esta situación que afecta a la salud bucal de la sociedad. En el presente editorial se proponen di- ferentes alternativas para intentar modificar este preocupante panorama (AU)

Radiographic evaluations of endodontic treatments per- formed by graduates show a high percentage of incorrect procedures. This circumstance leads to the performance of a high number of orthograde and retrograde retreatments, with the inconveniences and disadvantages that entails resorting to an endodontic reintervention. It is the responsibility of pro- fessionals, teachers, university and government authorities to reverse this situation that affects the oral health of society. In this editorial, different alternatives are proposed to try to modify this worrying outlook (AU)

Risk factors associated with short dental implant success: a long-term retrospective evaluation of patients followed up for up to 9 years

Abstract: This multicenter study aimed to identify the different implant- and patient-related risk factors for long-term short dental implant success. Through a retrospective chart review of three centers, patient information regarding demographic variables, smoking habits, history of periodontitis, systemic diseases, and medications in addition to the parameters for short implant placement including implant manufacturer, design, anatomical location, diameter and length, and type of placement was collected. For statistical analysis, univariate regression models were used at the implant and patient levels. A total of 460 short implants placed in 199 patients followed up for up to 9 years were reviewed. Survival rates of the short implants were 95.86% and 92.96% and success rates were 90% and 83.41% for implant- and patient-based analysis, respectively. Peri-implantitis was reported as the primary cause of short dental implant failure (34/46, 73.91%). Univariate regression models revealed that female sex was strongly related to short implant success. In addition, smoking and history of periodontitis were found to have a significant negative influence on short implant success at the implant and patient levels. Taken together, these results support the use of short implants as a predictable longterm treatment option; however, smoking and history of periodontitis are suggested to be the potential risk factors for short implant success. Therefore, clinicians need to assess these potential risk factors and make treatment decisions accordingly.

Efetividade de selantes de fossas e fissuras aplicados por estudantes de Odontologia na prevenção de cárie / Effectiveness of pit and fissure sealants applied by Dental students for dental caries prevention

Objetivo: avaliar a efetividade dos selantes aplicados por estudantes do curso de graduação em Odontologia da Universidade do Sul de Santa Catarina (Unisul), Grande Florianópolis, após 6 meses da aplicação, e estimar a prevalência de cárie dos participantes. Sujeitos e método: estudo observacional descritivo com indivíduos das clínicas de Odontologia. A efetividade dos selantes oclusais foi avaliada por roteiro validado na literatura, e a prevalência de cárie, dicotomizada. Os dados foram analisados por estatística descritiva e as associações pelo teste Qui-Quadrado. Resultados: a taxa de resposta do estudo foi de 94,7% (n=18), 2/3 da amostra eram do sexo feminino (72,2% IC 95% 49,1;87,5), 60% dos pacientes recebiam 3 salários mínimos ou menos, maiores proporções de indivíduo tinham selados seus dentes há pelo menos 9 meses. Pouco menos de 2/3 da amostra receberam Fluroshield como material restaurador em seus dentes. Dentre os 57 dentes avaliados, 70,2% apresentavam retenção to-tal. Os dentes mais acometidos pela perda de retenção foram os segundos molares superiores (40%). Mais de 2/3 da amostra não apresentaram cárie (88,9% IC 95% 67,2; 96,9). O isolamento relativo foi o mais prevalente (72,2% IC 95% 49,1;87,5). Conclusão: sob a perspectiva das práticas dos estudantes de Odontologia, metade da amostra de pacientes apresentou alguma perda de retenção dos selantes, mesmo que um número maior de retenções totais e a ausência de recidiva de cárie tenham sido observados. Isso reflete a importância da relação professor-aluno no planejamento e na correta aplicação das técnicas de selamento por estudantes de Odontologia. (AU)

Objective: to evaluate the effectiveness of pit and fissure sealants applied by undergraduate dental students of the University of Southern Santa Catarina (Unisul), SC, Brazil, after 6 months, and to estimate the prevalence of caries in the participants. Subjects and method: observational and descriptive study with individuals from the dental clinics. The effectiveness of pit and fissure sealants was evaluated using a script validated in the literature, and the prevalence of caries was dichotomized. The data were analyzed by descriptive statistics and the associations were made using the chi-square test. Results: the response rate of the study was 94.7% (n=18), 2/3 of the sample consisted of women (72.2% 95%CI 49.1, 87.5), 60% of the patients received three Brazilian minimum wages or less, and a great portion of the participants had sealed their teeth at least 9 months earlier. A little under 2/3 of the sample received Fluroshield as restorative material for their teeth. Among the 57 teeth evaluated, 70.2% presented complete retention. The teeth most affected by loss of retention were maxillary left second molars (40%). More than 2/3 of the sample did not present dental caries (88.9% 95%CI, 67.2, 96.9). Relative isolation was the most prevalent (72.2% 95%CI 49.1, 87.5). Conclusion: from the perspective of the practices of dental students, half of the sample of patients presented some loss of sealant retention, despite the greater number of complete retentions and absence of recurrent caries. This reflects the importance of the teacher-student relationship in the planning and correct application of sealing techniques by dental students. (AU)

A systematic review and meta-analysis of the survival rate of implants placed in previously failed sites

Abstract The aim of this study was to conduct a systematic review and meta-analysis to assess the clinical outcomes of dental implants placed in previously early and late implant failed sites. An electronic literature search was conducted in several databases for articles published up to February 2018. Human clinical trials that received at least one implant in a previously failed site were included. Hence, the PICO question that was aimed to be addressed was: Do patients undergoing implant replacement (second and third attempts) in previous failed sites have survival rates similar to implants placed at first attempts? A random effects model was used to calculate survival weighted means and corresponding 95% Confidence Intervals (CI) among studies. Eleven studies of low to moderate methodological quality were included in this review. Implants placed in sites with history of one and two implant failures had a weighted survival rate (SR) of 88.7% (95%CI 81.7-93.3) and 67.1% (95%CI 51.1-79.9), respectively. Implants placed in sites with a previous early failure revealed a weighted SR of 91.8% (95%CI 85.1-95.6). First implants presented higher SR than implants placed in sites with one or two previous implant failures. In contrast, implants placed in sites with one and two implant failures had similar SR. Within its limitations, this review suggests that replacement implants have moderate SR. Larger prospective studies with well-defined criteria for early and late implant failure are necessary to confirm and expand on these results.

Resultados clínicos de injertos óseos autólogos en bloque / Clinical results of autologous bone block grafts

Introducción: En muchas ocasiones, el sitio edéntulo del paciente no cuenta con el sufi ciente volumen óseo para albergar un implante. El injerto óseo autólogo en bloque (IOAB) es una opción para acondicionar al individuo y poder realizar la colocación del implante. Objetivo: Determinar el porcentaje de éxito y fracaso de los IOAB y sus factores relacionados...

Introduction: Very often, there is insufficient bone volume available in the edentulous site of a patient to allow dental implant placement. One way to prepare such patients for an implant placement is to usean autologous bone block (ABB) graft. Objective: To determine the success and failure rates of ABB grafts and their associated factors...

Stability of smooth and rough mini-implants: clinical and biomechanical evaluation - an in vivostudy

Objective: To compare in vivo orthodontic mini-implants (MI) of smooth (machined) and rough (acid etched) surfaces, assessing primary and secondary stability.Methods:Thirty-six (36) MI were inserted in the mandibles of six (6) dogs. Each animal received six (6) MI. In the right hemiarch, three (3) MI without surface treatment (smooth) were inserted, whereas in the left hemiarch, another three (3) MI with acid etched surfaces (rough) were inserted. The two distal MI in each hemiarch received an immediate load of 1.0 N for 16 weeks, whereas the MI in the mesial extremity was not subject to loading. Stability was measured by insertion and removal torque, initial and final mobility and by inter mini-implant distance.Results:There was no statistical behavioral difference between smooth and rough MI. High insertion torque and reduced initial mobility were observed in all groups, as well as a reduction in removal torques in comparison with insertion torque. Rough MI presented higher removal torque and lower final mobility in comparison to smooth MI. MI did not remain static, with displacement of rough MI being smaller in comparison with smooth MI, but with no statistical difference.Conclusions:MI primary stability was greater than stability measured at removal. There was no difference in stability between smooth and rough MI when assessing mobility, displacement and insertion as well as removal torques.

Objetivo: comparar, in vivo, mini-implantes (MI) com superfície lisa (usinada) e porosa (tratada com ácido), avaliando sua estabilidade primária e secundária.Métodos:trinta e seis MI foram inseridos na mandíbula de seis cães, e cada animal recebeu seis MI. Na hemiarcada direita, foram inseridos três MI sem tratamento da superfície (liso); na esquerda, outros três com a superfície tratada com ácido (poroso). Os dois MI distais de cada hemiarcada receberam carga imediata de 1,0N durante dezesseis semanas, e o MI da extremidade mesial não recebeu carregamento. A estabilidade foi medida pelos torques de inserção e de remoção, pela mobilidade inicial e final, e pela distância inter-MI.Resultados:não houve diferença estatística do comportamento entre os MI lisos e porosos. No entanto, observou-se torque de inserção elevado e mobilidade inicial reduzida em todos os grupos. Para todos os grupos, houve redução dos torques de remoção, em relação ao de inserção. Os MI porosos apresentaram maior torque de remoção e menor mobilidade final, em relação aos MI lisos. Os MI não permaneceram estáticos, sendo o deslocamento dos MI porosos menor em relação aos MI lisos, mas sem diferença estatística.Conclusões:a estabilidade primária dos MI foi maior do que a estabilidade medida na sua remoção; não houve diferença na estabilidade entre os MI lisos e porosos ao avaliar-se a mobilidade, o deslocamento e os torques de inserção e remoção.

Respuesta clínica de 100 implantes en carga oclusal inmediata para pacientes parcialmente desdentados: reporte luego de 12 meses de funcionamiento con restauraciones finales / Clinical response of 100 implants with immediate occlusal loading in partially edentulous patients: report over 12-month functioning with final restorations

Evaluar el rendimiento clínico de 100 implantes SEVEN MIS en protocolos de carga inmediata en pacientes parcialmente desdentados, analizando los criterios de éxito a lo largo de 12 meses. Materiales y métodos: En todos los casos se llevó a cabo el mismo protocolo clínico (quirúrgico y protético) de carga oclusal inmediata. Se utilizaron 100 implantes SEVEN MIS cuya longitud y diámetro se determinó en cada caso según la calidad y cantidad ósea en el sitio quirúrgico.Resultados: Ninguno de los pacientes abandonó el estudio. Todos los implantes fueron clínicamente estables y se correspondieron con los criterios de éxito. Conclusión: Los 100 implantes tuvieron una tasa de éxito de 100 por ciento...