Jawbone quality classification in dental implant planning and placement studies. A scoping review.

Aim: Cone beam computed tomography has become an attractive method for implant planning. However, in most cases, not all the information is taken advantage of and often the radiographic evaluation of bone quality is based on subjective assessment by the individual clinician. Therefore, the aim of this study was to examine classifications of bone tissue characteristics and methods for assessing them in dental implant planning and placement studies. Materials and Methods: Three databases (Pubmed, Scopus, Web of Science) were searched using specific index terms: "Bone quality, bone quantity, bone density, cone-beam CT and cone-beam computed tomography". Three reviewers selected titles and analyzed abstracts according to inclusion and exclusion criteria. Some descriptions of bone tissue characteristics (bone quality, density, and quantity) used before or during dental implant placement were selected and categorized. Results: The search yielded 442 titles. A total of 32 articles were selected and read in full text. Seventeen articles were considered relevant. Different classification systems were found to evaluate bone tissue characteristics as well as different examination protocols. Thirteen publications included in this review reported on bone quality and quantity using the Lekholm and Zarb classification. However, only four studies implemented and/or proposed modifications of the Lekholm and Zarb system. Four other publications described bone quality according to different classification systems such as Misch, University of California Los Angeles (UCLA), or Trisi and Rao. The assessment methods were often briefly described (or not described at all in one publication). Of the articles analyzed, five presented observer performance, whereas three presented diagnostic accuracy of the assessment method. Conclusion: Currently, there are different classification systems applied to dental implant planning and placement, particularly regarding whether bone quality or quantity affects treatment outcomes. However, most authors have not validated the diagnostic accuracy and reproducibility of the classification used. Therefore, it is necessary to develop a classification system consistent with characteristics of bone tissue, taking into consideration an adequate description of bone tissue assessment methods, their diagnostic accuracy, and observer performance.

Effect of fibrin-rich plasma and collagen sponge on healing of the palatal mucosa.

Background: The purpose was to evaluate the variation in thickness and early healing of the donor area of the palate with the placement of a collagen sponge and the use of fibrin-rich plasma (L-PRF). Material and Methods: Thirty patients who required mucogingival surgery treatment were selected and distributed into 2 groups. After obtaining the free palate graft, L-PRF was placed in Group A, and a collagen sponge was placed in Group B. The healing process of the palate was evaluated at 24 hours and 7, 14, 21 and 28 days postsurgery. The thickness of the donor area (palate) was evaluated using an acrylic splint. These measurements were made before and 4 months after surgery. Results: In the collagen sponge group, less gain of the palatal mucosa was observed, with a mean difference of 0.1 ± 0.8 mm (CI: -0.341-0.518) (p=0.691), whereas in the fibrin-rich plasma group, a mean difference of 0.0 ± 0.5 mm (CI: -0.229-0.229) (p=0.934) was found; however, when comparing the gain of the palatal mucosa in both groups, no significant difference was observed (p=0.932). The healing index at 24 hours indicated the presence of clots, on Day 28 vascularisation and total epithelialisation (100.0%), and finally, the collagen sponge group on Day 14 presented 93.3% partial vascularisation of connective tissue and 33.3% L-PRF (p=0.001). Conclusions: There was no statistically significant difference in the thickness of the palatal mucosa after the use of L-PRF and the collagen sponge. Key words:Palate thickness, connective tissue graft, fibrin-rich plasma, collagen sponge, palate healing.

Antimicrobial Photodynamic Therapy for the Treatment of Peri-implantitis: A Literature Review.

Aim: The aim of this article is to describe the existing scientific literature on photodynamic therapy (PDT) effectiveness for peri-implantitis treatment. Materials and Methods: A date-restricted electronic search strategy was performed in PubMed and Scopus databases. The following words were used: "peri-implant photodynamic therapy," "photodynamic therapy in implantology," "effectives of photodynamic therapy in peri-implantitis," "Antimicrobial Photodynamic Therapy," "Photodynamic Therapy for the treatment of peri-implantitis," and "Mechanical debridement and photodynamic therapy in implantology." Results: Of the 15 articles, 13 articles were selected, of which 11 were prospective and experimental studies and 2 were longitudinal. The PDT effectiveness of peri-implantitis inflammation treatment was the most reported and investigated. Conclusion: There is scientific evidence that may support the use of PDT for peri-implantitis treatments. However, even more studies would still be needed to have solid evidence.

Trends, characteristics, and impact of global scientific production on mental health of health workers in the context of coronavirus disease 2019 (COVID-19).

BACKGROUND: Healthcare workers are under significant constant stress as a result of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study, therefore, was to analyze bibliometrically the impact, trend, and characteristics of scientific production related to the mental health of health professionals during the COVID-19 pandemic. MATERIALS AND METHODS: A bibliometric analysis of the scientific production on the mental health of health professionals and COVID-19 in Scopus from December 2019 to December 2021 was performed. An advanced search was designed using Boolean operators in Scopus and applied in April 2022. The metadata was entered into Microsoft Excel for the elaboration of the tables, SciVal to obtain the bibliometric indicators, and VosViewer to plot collaborative networks. RESULTS: A total of 1393 manuscripts, 1007 of which met the eligibility criteria, were found on the mental health of health workers and COVID-19. The country with the highest academic production was the United States and Harvard University with 27 manuscripts as the most productive institution. The scientific journal with the highest scientific production was the International Journal of Environmental Research and Public Health with 138 manuscripts and 1580 citations, and the author with the most citations per publication was Carnnasi Claudia with 69.8. CONCLUSION: The countries with the highest economic income occupy the first places in scientific production on the mental health of health workers during the COVID-19 pandemic, with the United States as the leader. There is a gap in the scientific knowledge on the mental health of healthcare workers during the COVID-19 pandemic in middle- and low-income countries.

Effect of Abutment Geometry and Luting Agents on the Vertical Marginal Discrepancy of Cast Copings on Implant Abutments: An In Vitro Study.

AIM: Vertical marginal discrepancy (VMD) influences the success of implant-supported restorations. However, there is little literature that has investigated the influence of geometry and cementing agent on changes in VMD of metal copings on implant abutments. The objective was to evaluate the effect of the geometry of the abutment and cementing agents on VMD. METHODS: Cast copings were cemented on implant abutments customized cylindrical (4, 5.5, and 7 mm) and on hexagonal implant abutments (4 mm) cemented or uncemented molded copings were placed (n = 4, totally 64 samples) with different luting agents. The VMD of the copings were measured in the coping-abutment interface at three reference points using a stereomicroscope. The independent Student's t test was used for comparison between the two different abutment walls. The post hoc statistical analysis was performed by the Tukey test. RESULTS: There was a significant VMD increase between noncemented and cemented cast copings using different luting agents. Abutment geometry and luting agents significantly influenced the VMD (p ≤ 0.05). Cylindrical abutment at 7 mm in height cemented with different luting agent tested showed significantly higher VMD values than cylindrical abutments of 4 mm (p=0.019). Hexagonal abutments with a 4 mm height showed significantly higher VMD values than cylindrical 4 mm abutments using zinc oxide noneugenol and glass ionomer cements (p=0.032). CONCLUSIONS: Abutment geometry and luting agents influence the VMD of cast copings cemented on implant abutment. The higher the cylindrical abutment, the greater the VMD, and hexagonal wall abutments promote greater marginal gap.

Vertical Marginal Discrepancy of Retrievable Cement/Screw-retained Design and Cement-retained Implant-supported Single Metal Copings.

AIM: To compare the vertical marginal discrepancy of retrievable cement/screw-retained design (RCSRD) and cement-retained (CR) implant-supported single metal copings cemented on implant abutments. MATERIALS AND METHODS: Single metal copings were fabricated for 20 4.5 × 10 mm titanium dental implants. Two groups of 10 implants each were randomly allocated. One group received RCSRD metal copings and the other group received CR metal copings. Both types of restorations were fabricated on solid abutments with 5.5 mm of diameter. The copings were cemented with resin cement. After the cementation procedure, cement excess was carefully removed in both groups. Inspections of coping-abutment vertical marginal discrepancy were measured using scanning electronic microscopy (SEM) under 800× magnification. The independent sample Student's t test was used to detect differences between groups (p < 0.05). RESULTS: The RCSRD implant-supported metal coping group (57.80 ± 2.34 µm) showed statistically better vertical marginal discrepancy than the CR implant-supported metal coping group (64.40 ± 2.23 µm) (p = 0.001). CONCLUSION: The RCSRD implant-supported metal copings offer less vertical marginal discrepancy than the CR copings group. This new technique would decrease the marginal discrepancy with less bacterial filtration and biomechanical problems. CLINICAL SIGNIFICANCE: Retrievable cement/screw-retained design is another alternative technique for dental implant rehabilitation that combines the advantages of CR and SR prostheses. The hybrid design offers less vertical marginal discrepancy for better control of bacterial filtration and biomechanical problems.

Fracture Resistance of Cement-retained, Screw-retained, and Combined Cement- and Screw-retained Metal-ceramic Implant-supported Molar Restorations.

AIM: To compare fracture resistance between the cement-retained (CR), screw-retained (SR), and combined cement- and screw-retained (CCSR) metal-ceramic (MC) implant-supported molar restorations and the fracture mode after vertical loading simulation. MATERIALS AND METHODS: Thirty MC molar restorations were fabricated on thirty tilted dental implants that were repositioned using prefabricated or universal castable long abutments (UCLA) with 15° of angulation divided into three groups of ten specimens each. Group C: CR, group S: SR, and group CS: cement- and screw-retained. The crowns in group CS were adhesively bonded extraorally, and composite resin was used to fill the screw access holes (SAHs) in groups S and CS. Subsequently, all the specimens were tested for fracture resistance. A scanning electron microscope (SEM) evaluation of the fracture mode was also performed. Mean values of fracture loads were calculated and compared in Newtons (N) using one-way ANOVA and Tukey post hoc test (p < 0.05) for each group. RESULTS: Mean fracture load values were 2718.00 ± 266.25 N for group C, 2125.10 ± 293.82 N for group S, and 2508.00 ± 153.59 N for group CS. Significant differences were found between group S and the other groups on fracture load values. However, no significant differences were found between groups C and CS (p = 0.154). The failures were at MC framework interfaces on mesiolingual cusps. CONCLUSIONS: Cement and CCSR MC molar restorations showed comparable fracture resistance using abutments with 15° of angulation. However, SR design showed significantly the lowest values of resistance. Screw access hole did not significantly affect the fracture resistance of cemented MC molar restorations. All the specimens exhibited mixed adhesive fractures at the mesiolingual cusps. CLINICAL SIGNIFICANCE: Combined cement- and screw-retained restorations (CCSRRs) incorporate the simplicity of the cement method and the retrievability of the screw method, offering good resistance, allowing the removal of the excess of cement before clinical placement of the restoration, and providing another alternative for dental implant rehabilitation.

Implant Rehabilitation Partial Maxillary Edentulism with Onlay Autogenous Chin Bone Grafting and Prosthetic Gingival Restoration: A Case Report.

BACKGROUND: Atrophic anterior maxilla rehabilitation can be a challenging procedure due to multiple factors that influence clinical decision making. After a prolonged loss of teeth, the residual bone often impedes the use of standard implant placement protocols and additional procedures are needed. AIM: The aim of this study is to describe the multidisciplinary approach for the diagnosis and treatment of a 50-year-old woman with prolonged use of a removable maxillary partial denture. CASE DESCRIPTION: This article presents a full-mouth-phased rehabilitation of an atrophic anterior maxilla with three surgical stages. First, onlay autogenous chin bone grafting was used to return the lost tissue. After the consolidation, dental implants were placed in a second stage. A few months later, a connective tissue graft was used to improve the keratinized mucosa width. In the mentioned stages, leukocyte- and platelet-rich fibrin (L-PRF) was used to improve healing and promote tissue regeneration. Finally, prosthetic gingival restoration was used in the anterior region as an alternative to overcome the limitations of hard- and soft-tissue grafting. CONCLUSION: The use of autogenous grafts obtained from the chin in combination with xenograft and then covered with an absorbable collagen membrane represents a predictable procedure for the rehabilitation of the long-term partial maxillary edentulism. Prosthetic gingival restoration is an alternative technique to overcome the limitations of hard- and soft-tissue grafting. CLINICAL SIGNIFICANCE: The treatment of a patient with high and width alveolar bone loss needs a multidisciplinary approach. Autogenous grafts obtained from the chin in combination with xenograft and then covered with an absorbable collagen membrane represent an effective procedure. Also, prosthetic gingival restoration can be used as an alternative technique to overcome the limitations of hard- and soft-tissue grafting.

Representaciones sociales de la salud infantil y sus determinantes socioeconómicos y culturales en las familias de la feria de Alto Comedero / Social representations of children's health and socio-economic and cultural determinants in families from Alto Comedero street market

INTRODUCCIÓN En algunos lugares, la feria es un espacio donde las familias llevan adelante gran parte de sus actividades cotidianas, configuran conceptos sociales y en base a ellos desarrollan estilos de vida. OBJETIVOS Conocer las representaciones sociales acerca de la salud y los determinantes socioeconómicos y culturales que configuran las familias trabajadoras de la Feria Tonino de Alto Comedero, San Salvador de Jujuy. MÉTODOS Se realizó un estudio cuali-cuantitativo descriptivo de corte transversal en la Feria Tonino de Alto Comedero entre mayo de 2012 y febrero de 2013. Las técnicas usadas fueron cuestionario, observación simple y entrevista en profundidad aplicada a las muestras (madres, padres y/o tutores de los niños feriantes). RESULTADOS La investigación reveló que las familias feriantes poseen una concepción integral de la salud infantil. Desde la vida cotidiana, decodifican las señales de salud y enfermedad de sus hijos, las interpretan y buscan soluciones a pesar de sus limitaciones. DISCUSIÓN Las condiciones de pobreza, exclusión y desigualdad social de las familias y niños feriantes afectan directamente la calidad de vida y la salud infantil. Sin embargo, las familias poseen una visión integral de la salud infantil y actúan en función de ella.