Implant-supported full-arch rehabilitation with immediate loading using two different digital impression techniques: a case report with 2-year follow-up.

Immediate full-arch loading is a highly complex and technique-sensitive procedure. Digital impression techniques aim to replace conventional analog systems to carry out dental treatments in a more predictive, safer, and less time-consuming way. This case report describes a patient with a guarded periodontal prognosis, who was rehabilitated with implant-supported fixed prostheses after full-mouth extractions. Immediate full-arch loading was performed by means of two digital impression systems: photogrammetric technology with PIC dental in the maxillary arch, and MedicalFit in the mandible. Immediate provisional prostheses in acrylic resin (polymethyl methacrylate) were milled and placed within 12 hours after implant placement surgeries. Both provisional structures fitted properly providing adequate esthetics and function. After the implant osseointegration period, final digital impressions were registered, and definitive zirconia full-arch implant-supported prostheses were delivered. The 24-month follow-up did not show biologic or mechanical complications.

Clinical Evaluation of Dental Implants with a Double Acid-Etched Surface Treatment: A Cohort Observational Study with Up to 10-Year Follow-Up.

BACKGROUND AND OBJECTIVES: The main purpose of this study was to evaluate the survival and success rates of dental implants with a double acid-etched surface treatment with evaluation times up to 10 years post-loading. Materials and Methods: This study was conducted at a hospital oral surgery and implantology unit. It included 111 dental implants with a double acid-etched surface. Three groups were created: Group 1 (1-3 years loading), Group 2 (3-5 years loading), and Group 3 (over 5 years loading). Probing depth, resonance frequency analysis (ISQ value), and marginal bone loss were evaluated. Results: The data obtained underwent statistical analysis. Overall, 78 patients were included in the study, who received, in total, 111 dental implants, all replacing single teeth. Mean probing depth was 3.03 mm and mean ISQ was 65.54. Regarding marginal bone loss, in Group 1, 67.6% of implants did not undergo any thread loss, in Group 2, 48.3%, and in Group 3, 59.6%; 59.10% of all implants did not present thread loss with a mean bone loss of 0.552 mm. The implant survival rate was 99.1%, and the success rate was 96.37%. Conclusions: Implants with a double acid-etched surface showed excellent success rates in terms of marginal bone loss, ISQ, and probing depth after up to 10 years of loading, making them a clinically predictable treatment option. Future studies are needed to compare this implant surface with other types in different restorative situations.

Long-Term Clinical Behavior and Complications of Intentionally Tilted Dental Implants Compared with Straight Implants Supporting Fixed Restorations: A Systematic Review and Meta-Analysis.

The aim of this study was to assess the long-term clinical behavior of straight implants in comparison with intentionally tilted dental implants (ITDI) supporting fixed restorations in partial or total edentulous arches, analyzing implant survival and success rates, complications, and marginal bone loss (MBL) after >5 years of function. An electronic search was conducted in five electronic databases (MEDLINE/Pubmed, Embase, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials) supplemented by a manual search. The electronic and manual search identified 1853 articles, of which 8 articles were selected for analysis. Out of a total of 3987 dental implants, 2036 were axial dental implants and 1951 tilted. Similar results were found in implant survival or overall implant success rates. Moreover, no statistically significant differences were found in MBL (p = 0.369; MD 0.116 mm (-0.137; 0.369) 95% CI) The prosthodontic/biological complications reported in the articles were very diverse and irregularly distributed. This systematic review suggests that there is no difference between tilted compared with straight dental implants in the medium-long term (>5 years). However, further research is needed to generate long-term data and confirm the present review's findings.

The key role of the dental practitioner in early diagnosis of periodontal Ehlers-Danlos syndromes: a rare case report of siblings.

Ehlers-Danlos syndromes (EDS) are a group of diverse hereditary connective tissue disorders. Various EDS subtypes present as different diseases. Periodontitis of early onset is a major criterion of periodontal EDS (pEDS). This article reports the clinical case of two siblings, young adults, who came to the clinic for diagnosis and treatment of periodontal disease. The patients had already been diagnosed with pEDS several months earlier after being referred for genetic testing by a dermatologist. It should be noted that in these siblings pEDS had been misinterpreted for years by health care specialists despite the patients' periodontal disease, which had appeared at the age of 3 years. The subsequent effects of periodontal disease in these patients jeopardized the survival prognosis of their teeth. It may be stated that, in spite of pEDS's status as a rare syndrome, the dental practitioner can play a key role in the early diagnosis by responding appropriately to periodontal manifestations at early stages. (Quintessence Int 2021;52:166-174; doi: 10.3290/j.qi.a45263)

Improvement of aesthetics in a patient with tetracycline stains using the injectable composite resin technique: case report with 24-month follow-up.

This case report describes the conservative management of generalised tetracycline stains by means of the injectable composite resin technique. This time-efficient technique obtained optimal and satisfactory aesthetic outcomes. Both the patient and the clinician were very satisfied with the results. Composite veneers realised with injected flowable resin composites are an effective treatment, with minimally invasive possibilities, providing the case selection protocol is correct. In addition, it can be considered as a more economical treatment option.

Comparative analysis of trueness between conventional and digital impression in dental-supported fixed dental prosthesis with vertical preparation.

Biologically oriented preparation technique (BOPT) is a vertical preparation technique without a finish line to create a new anatomic crown with a prosthetic emergence profile. This case report describe the protocol realized digitally in a patient who required a new fixed partial denture (FPD) in the anterior esthetic zone. After time of temporary restoration, definitive conventional (CI) (double-cord retraction and vinyl polysiloxane material), and digital impression (DI) with three different intraoral scanner (IOS) (Trios®, True Definition® and iTero®) were taken. All digital impression were obtained through three different scans: temporary restoration in the mouth after healing period, prepared teeth, and temporary restoration out of the mouth. To establish which of the IOS was the most accurate, it was necessary to compare the STL files obtained from each of the IOS with the STL file of the conventional impression, which was digitized with a laboratory scanner (3Shape D800). All these STL were imported to a software (ExoCAD 2.4 Plovdiv®), and they were superimposed. To establish the difference in trueness with SC, 6 points were chosen, 3 points in teeth, and another 3 points in soft tissue. The mean measurement in terms of trueness in teeth were: STS (0,039 mm), SI (0,054 mm), STD (0,067 mm); and in soft tissue were: STS (0,051 mm), SI (0,09 mm), STD [0,236 mm]. The IOSs showed differences between them in terms of trueness, being the Trios the most accuracy IOS. Final restoration was fabricated and cemented. The patient was examined at 3, 6 and 12 months, without any type of biological or mechanical complications. Digital impression with an IOS seems to be a viable alternative to perform zirconia FPD in the BOPT tecbique. Key words:Intraoral scanners, accuracy, vertical preparation, precision, CAD-CAM, prosthodontics.

Precision and practical usefulness of intraoral scanners in implant dentistry: A systematic literature review.

BACKGROUND: This systematic review aimed to evaluate the efficiency and accuracy of digital impression techniques for implant-supported restorations, and to assess their economic feasibility. MATERIAL AND METHODS: Two independent electronic database searches were conducted in the Pubmed/MedLine, Cochrane Library, and Lilacs databases complimented by a manual search, selecting relevant clinical and in vitro studies published between 1st January 2009 and 28st February 2019. All type of studies (in vivo and in vitro) were included in this systematic review. RESULTS: Twenty-seven studies (8 in vivo and 19 in vitro studies) fulfilled the inclusion criteria. No meta-analysis was performed due to a large heterogeneity of the study protocols. The passive fit of superstructures on dental implants presented similar results between digital and conventional impression techniques. The studies considered that several factors influence the accuracy of implant impression taking: distance and angulation between implants, depth of placement, type of scanner, scanning strategy, characteristics of scanbody, and operator experience. Regarding the economic viability of intraoral scanning systems, only one study reported any benefit in comparison with conventional techniques. CONCLUSIONS: Digital impressions of dental implants can be considered a viable alternative in cases of one or two contiguous dental implants. However, more studies are needed to evaluate the accuracy of digital techniques in full-arch implant-supported restorations. Key words:Intraoral scanner, dental implant, prosthesis, misfit, systematic review.

Osteonecrosis de los maxilares y anticuerpos monoclonales: una revisión bibliográfica / Osteonecrosis of the jaws and monoclonal antibodies: a literature review

El objetivo, establecer si existe una evidencia científica que avale una relación entre la administración de anticuerpos monoclonales y la aparición de osteonecrosis de los maxilares (ONM). En la literatura que revisamos nos muestra determinados casos en los que la ONM está relacionada con los anticuerpos monoclonales (denosumab, sunitib, etc.) siempre y cuando el paciente sea sometido a un tratamiento dental. También se evalúan aquellos artículos en los que se administra anticuerpos monoclonales y bifosfonatos de manera simultánea y se observa que la frecuencia de ONM es más elevada. Como conclusión se establece que no hay evidencia científica suficiente para asegurar una relación entre ONM y anticuerpos monoclonales, aunque sí la hay para demostrar relación entre ONM y anticuerpos monoclonales si se administra junto a los bifosfonatos

The aim is establish if there is a scientific evidence to support a relationship between the administration of monoclonal antibodies and the appearance of osteonecrosis of the jaws (ONJ). In the literature we review shows certain cases in which ONJ is related to monoclonal antibodies (denosumab, sunitib, etc.) as long as the patient undergoes dental treatment. Those articles in which monoclonal antibodies and bisphosphonates are administered simultaneously are also evaluated and it is observed that the frequency of ONJ is higher. As conclusión it is established that there is not enough scientific evidence to ensure a relationship between ONJ and monoclonal antibodies, but there is evidence to show that the relationship between ONJ and monoclonal antibodies if administered with bisphosphonates

Cirugía guiada. Otra herramienta en el tratamiento implantológico en pacientes con enfermedad de Von Willebrand y otras coagulopatías / Guided surgery. Another tool in implantological treatment in patients with Von Willebrand disease and other coagulopathies

La enfermedad de Von Willebrand es un trastorno hemorrágico provocado por la deficiencia o mal funcionamiento del Factor von Willebrand, que afecta a su vez a la estabilización del Factor VIII de la coagulación. El objetivo de este trabajo fue evaluar si la cirugía guiada para la colocación de implantes dentales reduce el sangrado postoperatorio en pacientes con dicha patología. A una mujer de 57 años con enfermedad de Von Willebrand, se le realizó la férula para cirugía guiada con el sistema Nemotec® (Madrid, España) para los implantes 2.4, 2.5 y 2.6. Se emplearon, además de las medidas preventivas para evitar un sangrado (enjuagues con Amchafibrin® 500 mg 10 minutos pre-quirúrgico y durante 48 horas manteniendo 4 minutos 1-1-1) la cirugía guiada con el objetivo de prevenir un futuro sangrado. La paciente no presentó complicaciones. A los 3 meses se comenzó con la fase prostodóntica y al año se citó no presentando ninguna complicación. Como conclusión podemos decir que la cirugía guiada parece ser una ayuda extra, además de las medidas preventivas, para evitar el sangrado excesivo en pacientes con enfermedad de Von Willebrand. Sin embargo, son necesarios más estudios que determinen si realmente es una ayuda (AU)

Von Willebrand disease is a bleeding disorder caused by a deficiency or malfunction of Von Willebrand factor, which in turn affects the stabilization of Factor VIII clotting. The aim of this study was to evaluate whether the guided surgery for dental implants reduces postoperative bleeding in patients with this disease. A 57 year old woman with Von Willebrand disease, he makes the splint with Nemotec® guided surgery system (Madrid, Spain) for implants 2.4, 2.5 and 2.6. It is also the preventive measures used to prevent bleeding (500 mg Amchafibrin® rinses 10 minutes presurgical and maintain for 48 hours 4 minutes 1-1-1) guided surgery in order to prevent further bleeding. The patient had no complications. At 3 months we started with the prosthetic phase and the year was cited not presenting any complications. In conclusion we can say that guided surgery appears to be an extra help besides preventive measures to avoid excessive bleeding in patients with Von Willebrand disease. However, further studies to determine if it really is a help is needed (AU)

Implantes cigomáticos, ¿Cuándo y cómo se pueden emplear? / Zygomatic implants, When and how it can be used?

Mediante esta revisión bibliográfica se pretende evaluar cuáles son las indicaciones de los implantes cigomáticos, además de establecer las diferentes técnicas para llevarlos a cabo. Los implantes cigomáticos poseen unas características especiales que los hacen idóneos para la rehabilitación de maxilares extremadamente atróficos. Ofrecen excelentes ventajas frente a las técnicas convencionales: técnica menos invasiva, más económica, con menor tiempo de duración, y con posibilidad de realizar carga inmediata con muy altos porcentajes de éxito. También presentan ciertas complicaciones. Las técnicas para llevarlas a cabo se basan en función de si el seno es atravesado o no por el implante, intrasinusal o extrasinusal; y ambas técnicas pueden realizarse mediante un protocolo convencional o con cirugía guiada. La revisión realizada muestra una tasa de éxito superior al 96% a medio y largo plazo. Por lo que debe tenerse en cuenta entre las opciones terapéuticas

Through this literature review is to assess what are the indications of zygomatic implants, in addition to establishing the different techniques to accomplish them are. Zygomatic implants have special characteristics that make them suitable for the rehabilitation of extremely atrophic jaws. Offer great advantages over conventional techniques: less invasive technique, more economical, less duration, with the possibility of immediate loading with very high success rates. Also presents certain complications. The techniques for carrying out a function based on whether or not the heart is traversed by the implant, or extrasinusal intrasinusal, and both techniques may be performed by a conventional protocol or guided surgery. The review shows a success rate of over 96% in the medium and long term. It should be noted that among the therapeutic options

Tratamiento con implantes dentales en pacientes irradiados por cáncer de cabeza y cuello. Parte 2 / Dental implant treatment in patients irradiated for head and neck cancer. Section 2

Mediante esta revisión bibliográfica se pretende evaluar si influye la radioterapia al llevar a cabo el tratamiento con implantes y si es así cuáles son los parámetros que debe seguir todo clínico para obtener una buena tasa de éxito a largo plazo. Para ello, se realizó una búsqueda bibliográfica de los últimos años. Se considera que el tratamiento con implantes en un paciente radiado no supone una contraindicación, aunque la tasa de éxito será algo inferior que si el paciente no recibiera radioterapia. Deberán tenerse presente una serie de parámetros. uno de ellos es si el implante se coloca posterior a la radioterapia (protocolo post-radioterapia) o en el mismo acto quirúrgico de la resección (protocolo pre-radioterapia), ofreciéndonos este último excelentes ventajas pero también algún inconveniente. Otra cuestión no solventada es la dosis límite de radiación para garantizar el éxito del implante. El tiempo de espera desde la radioterapia hasta la colocación del implante no parece claro y va desde los 6 hasta los 24 meses. Lo que sí parece claro es que en maxilar la tasa de éxito disminuirá con respecto a la mandíbula, y lo mismo ocurre en el sector posterior frente al anterior. El tipo de implante y de prótesis, influyen aunque no está claro cuál debe emplearse, y en cuanto al tiempo de carga debe aumentarse, pero no se ha establecido cuanto. Deben llevarse a cabo más estudios para poder solventar todas estas cuestiones no aclaradas

Through this literature review is to assess whether radiation affects carrying out implant treatment and if so what are the parameters to be followed by every clinician to obtain a good rate of long term success are. To do this, a literature search was performed in recent years. It is considered that treatment with implants in radiated patients is not a contraindication, although the success rate will be somewhat lower than if the patient did not receive radiotherapy. Account shall be taken a number of parameters. One is if the implant is placed after the radiation therapy (radiotherapy postprotocol) or in the same surgical resection (pre-radiotherapy protocol), the latter offering excellent benefits but also some problems. Another issue is not solved the radiation dose limit to ensure the success of the implant. The waiting time from radiotherapy to implant placement is not clear and ranges from 6 to 24 months. What does seem clear is that the success rate of maxillary decline from the jaw, and so does the posterior from the previous. The kind of implant and prosthetic influence although it is unclear which should be used, and as to the charge time should be increased, but has not been established as. Should be carried out more studies to resolve all these issues not clarified

Tratamiento con implantes dentales en pacientes irradiados por cáncer de cabeza y cuello. Parte 1 / Dental implant treatment in patients irradiated for head and neck cancer. Section 1

Mediante esta revisión bibliográfica se pretende evaluar si influye la radioterapia al llevar a cabo el tratamiento con implantes y si es así cuáles son los parámetros que debe seguir todo clínico para obtener una buena tasa de éxito a largo plazo. Para ello, se realizó una búsqueda bibliográfica de los últimos años. Se considera que el tratamiento con implantes en un paciente radiado no supone una contraindicación, aunque la tasa de éxito será algo inferior que si el paciente no recibiera radioterapia. Deberán tenerse presente una serie de parámetros. Uno de ellos es si el implante se coloca posterior a la a la radioterapia (protocolo post-radioterapia) o en el mismo acto quirúrgico de la resección (protocolo pre-radioterapia), ofreciéndonos este último excelentes ventajas pero también algún inconveniente. Otra cuestión no solventada es la dosis límite de radiación para garantizar el éxito del implante. El tiempo de espera desde la radioterapia hasta la colocación del implante no parece claro y va desde los 6 hasta los 24 meses. Lo que sí parece claro es que en maxilar la tasa de éxito disminuirá con respecto a la mandíbula, y lo mismo ocurre en el sector posterior frente al anterior. El tipo de implante y de prótesis, influyen aunque no está claro cuál debe emplearse, y en cuanto al tiempo de carga debe aumentarse, pero no se ha establecido cuanto. Deben llevarse a cabo más estudios para poder solventar todas estas cuestiones no aclaradas (AU)

Through this literature review is to assess whether radiation affects carrying out implant treatment and if so what are the parameters to be followed by every clinician to obtain a good rate of long term success are. To do this, a literature search was performed in recent years. It is considered that treatment with implants in radiated patients is not a contraindication, although the success rate will be some what lower than if the patient did not receive radiotherapy. Account shall be taken a number of parameters. One is if the implant isplaced after the radiation therapy (radiothe-rapy post- protocol) or in the same surgical resection (pre - radiotherapy protocol), the latter offering excellent benefits but also some problems. Another issue is not solved the radiation dose limit to ensure the suc-cess of the implant. The waiting time from radiotherapy to implant placement is not clear and ranges from 6 to 24 months. What does seem clear is that the success rate of maxillary decline from the jaw, and so does the posterior from the previous. The kind ofimplant and prosthetic influence although itis unclear which should be used, and as to the charge time should be increased, but has not been established as. Should be carried out more studies to resolve all these issues not clarified (AU)