Impact of osteoporosis in dental implants: A systematic review.

AIM: To assess the failure and bone-to-implant contact rate of dental implants placed on osteoporotic subjects. METHODS: Extensive examination strategies were created to classify studies for this systematic review. MEDLINE (via PubMed) and EMBASE database were examined for studies in English up to and including May 2014. The examination presented a combination of the MeSH words described as follow: "osteoporosis" or "osteopenia" or "estrogen deficiency" AND "implant" or "dental implant" or "osseointegration". Assessment of clinical and/or histological peri-implant conditions in osteoporosis subjects treated with titanium dental implants. The examination included a combination of the MeSH terms described as follow: "osteoporosis" or "osteopenia" or "estrogen deficiency" AND "implant" or "dental implant" or "osseointegration". RESULTS: Of 943 potentially eligible articles, 12 were included in the study. A total of 133 subjects with osteoporosis, 73 subjects diagnosed with osteopenia and 708 healthy subjects were assessed in this systematic review. In these subjects were installed 367, 205, 2981 dental implants in osteoporotic, osteopenic and healthy subjects, respectively. The failure rate of dental implant was 10.9% in osteoporotic subjects, 8.29% in osteopenic and 11.43% in healthy ones. Bone-to-implant contact obtained from retrieved implants ranged between 49.96% to 47.84%, for osteoporosis and non-osteoporotic subjects. CONCLUSION: Osteoporotic subjects presented higher rates of implant loss, however, there is a lower evidence to strengthen or refute the hypothesis that osteoporosis may have detrimental effects on bone healing. Consequently, final conclusions regarding the effect of osteoporosis in dental implant therapy cannot be made at this time. There are no randomized clinical trial accessible for evaluation and the retrospective nature of the evaluated studies shall be taken in account when interpreting this study.

Transplante de periósteo e gálea aponeurótica para reconstrução de maxilas atróficas: acompanhamento de 4 a 17 anos / Transplantation of periosteum and aponeurotic galea for reconstruction of atrophic maxillae: a 4- to 17-year follow-up report

Enxertos ósseos de grande volume podem apresentar dificuldades quanto ao seu recobrimento cirúrgico, risco de exposição e manutenção do volume. Para minimizar os riscos e melhorar a previsibilidade, os autores idealizaram uma técnica de transplante de periósteo pediculado da calota craniana, para recobrir enxertos ósseos maxilares extensos, e são apresentadas as bases teóricas sobre o procedimento. A técnica é apresentada em formato de caso clínico e consiste na abertura do escalpo do paciente, descolamento e transposição da gálea aponeurótica e periósteo para recobrir enxertos ósseos maxilares. Com 18 casos realizados e acompanhamento de 4-17 anos, a técnica se mostrou previsível e segura para casos de enxertos ósseos maxilares de grande volume.

Considerable bone grafts may present complications regarding its surgical risk of exposure and volume maintenance. To minimize risks and improve its predictability, the authors developed a technique to transplant pediculated periosteum of the skull to cover large maxillary bone grafts and present the theoretical basis of the procedure. The technique is presented in consecutive case reports and consists in opening the patient’s scalp, detachment and transposition of aponeurotic galea and periosteum to cover maxillary bone grafts. With 18 cases performed and 4-17 years of monitoring, the technique is predictable and safe in cases of maxillary bone grafts of large volume