Pre-operative measurement of the volume of bone graft in sinus lifts using CompuDent.

OBJECTIVE: The aim of this study was to calculate the volume of graft necessary for rehabilitation using varying lengths of implants, and to evaluate the usefulness of the planning dental software in determining the pre-operative volume of bone graft in maxillary sinus floor lifts. MATERIAL AND METHODS: Using the CompuDent program, we calculated the volume of graft necessary for 62 sinus lifts. This volume was measured to raise the floor of each sinus to 13.4 and 15 mm in height. RESULTS: The average volume of graft to achieve a lift of 13.4 mm was 2.61 ± 0.69 cm³ for the right maxillary sinus, with the range of 1.38-4.1 cm³, and 2.68 ± 0.81 cm³ for the left maxillary sinus, with the range of 1.1-4.25 cm³. The average volume of graft to achieve a lift of 15 mm was 3.13 ± 0.75 cm³ for the right maxillary sinus, with the range of 1.59-4.81 cm³, and 3.29 ± 1.02 cm³ for the left maxillary sinus, with the range of 1.48-5.11 cm³. The statistical results showed a significant inversely proportional correlation between the average of the heights and the volume of graft in the right sinus. CONCLUSIONS: The planning dental software is an effective tool in determining the volume of bone graft given the tool's simplicity, rapidness and possibility of standardization in all pre-surgical procedures.

Meta-analysis of the increase in height in maxillary sinus elevations with osteotome.

OBJECTIVES: To compare the different variations of sinus elevation techniques with osteotomes, to evaluate the increase in height achieved, and to quantify the osseointegration periods and the success rates for the implants placed. STUDY DESIGN: A meta-analytic study with descriptive statistics was carried out on sinus elevations using osteotomes, analyzing a total of 11 articles published between the years 2003 and 2008. RESULTS: Summers' classic technique for performing sinus elevations with osteotomes differs from the current techniques being used with respect to the use of drills, the manner in which the sinus floor is fractured and how the sinus membrane is lifted, and especially on the type of graft used-the most current tendency being not to use a graft. The maximum gain in height is 4.62 mm, and the minimum gain in height is 2.07 mm, starting with a maximum residual bone height of 8.8 mm and a minimum of 4.1 mm. The osseointegration period is 4.9 months and the success rate is 95.5%. CONCLUSIONS: Performing sinus elevations with osteotomes is a predictable technique that enables achieving an increase in bone height and successful results, similar to those of other techniques used, in the placement of implants.

Quantification of growth factors by using a new system for obtaining platelet-rich plasma.

OBJECTIVE: To verify the performance of a new method for obtaining platelet-rich plasma, while avoiding contamination of the sample during its processing. STUDY DESIGN: Twenty healthy patients were selected, from whom 21 ml of blood was extracted. We then proceeded to study the platelets and growth factors in basal blood after centrifuging the sample by using a new closed system for obtaining platelet-rich plasma (PRP). RESULTS: After centrifuging the blood sample, double the amount of platelets as that found in basal blood was obtained. Of the four growth factors analyzed, only the factor similar to insulin (IGF) contained the same concentration after the centrifuge process. The platelet-derived growth factor (PDGF) and the vascular growth factor (VGF) were multiplied by six with respect to the basal values and disproportionately increased the levels of the transforming growth factor ß (TGF-ß). CONCLUSIONS: The new closed method for obtaining PRP, after avoiding contamination of the sample following its use, offers levels of platelet concentrate and growth factors necessary for regeneration.

Meta-analysis on the survival of short implants.

OBJECTIVE: To evaluate the success and failure rates of short implants (10 mm or less) for oral rehabilitations in cases of limited bone height. STUDY DESIGN: Review of the articles published on the topic between the years 2000 and 2010, and development of a descriptive meta-analysis of the results. RESULTS: The majority of the studies obtain a cumulative success rate (CSR) similar to that of longer implants (92.5%-98.42% for machined and rough-surface implants, respectively). The studies that record lower cumulative success rates (CSR) are later studies that analyze implants with a machined surface. Almost none of the studies compared the success/failure rates with the bone quality or location of the implant (maxilla or mandible). Thus, the results obtained are from a mixture of these parameters. CONCLUSIONS: In view of the results analyzed, rehabilitations with short implants are a reliable treatment; however, the lack of consistency in the study designs as well as the presence of bias in all of the studies reviewed make it difficult to analyze the data.

Pre-operative evaluation of the volume of bone graft in sinus lifts by means of CompuDent.

OBJECTIVE: This study aims to evaluate the usefulness of the CompuDent program in determining the pre-operative volume of bone graft in maxillary sinus floor lifts, and to calculate the volume of graft necessary for rehabilitation using varying lengths of implants. STUDY DESIGN: Based on the CompuDent program, we calculated the volume of graft necessary for 47 sinus lifts. This volume was measured in order to raise the floor of each sinus to 13.4 and 15 mm in height. RESULTS: The average volume of graft in order to achieve a lift of 13'4 mm was 2.42 cm(3) for the right maxillary sinus, with a range from 1.4 cm(3) to 4.1 cm(3), and 2.50 cm(3) for the left maxillary sinus, with a range from 1.04 cm(3) to 3.79 cm(3). The average volume of graft in order to achieve a lift of 15 mm was 3.01 cm(3) for the right maxillary sinus, with a range from 1.78 cm(3) to 4.59 cm(3), and 3.09 cm(3) for the left maxillary sinus, with a range from 1.42 cm(3) to 4.49 cm(3). The statistical results provided by the Pearson Correlation show a significant inversely proportional correlation between the average of the heights and the volume of graft in the sinus. In addition, there is a clear correlation between the average volumes to be grafted for the respective heights 13.4 mm and 15 mm. CONCLUSIONS: The CompuDent program is an effective tool in determining the volume of bone graft given its simplicity, rapidness and possibility of standardization in all pre-surgical procedures.

Observational study of 67 wide platform implants treated with avantblast surface. Results at three year.

OBJECTIVE: This paper shows the results of the clinical and radiographic behavior, at 3 years, of 67 wide platform implants undergoing prosthetic load. STUDY DESIGN: This is an observational prospective study of 67 implants in 49 patients within the range of 54-69 years of age. Screening was performed after a radiological study with panoramic and tomographic radiographs followed by the implantological treatment with prosthetic load and clinical (15 days, 1, 6, 12, 24 and 36 months) and radiological control follow-up (6, 12, 24 and 36 months). RESULTS: During the healing period 1 implant failed, representing a 98.5% survival. After placing the prosthesis, it was not necessary to remove any implant, therefore 66 implants remain successfully in place. CONCLUSIONS: The favorable results and follow-up after the prosthetic load of 66 implants (CSR of 100%) attest that wide platform implants can and should be applied after careful planning and case selection.

Observational study of 67 wide platform implants treated with avantblast surface. Results at three year

Objective: This paper shows the results of the clinical and radiographic behavior, at 3 years, of 67 wide platform implants undergoing prosthetic load. Study Design: This is an observational prospective study of 67 implants in 49 patients within the range of 54-69 years of age. Screening was performed after a radiological study with panoramic and tomographic radiographs followed by the implantological treatment with prosthetic load and clinical (15 days, 1, 6, 12, 24 and 36 months) and radiological control follow-up (6, 12, 24 and 36 months). Results: During the healing period 1 implant failed, representing a 98.5% survival. After placing the prosthesis, it was not necessary to remove any implant, therefore 66 implants remain successfully in place. Conclusions: The favorable results and follow-up after the prosthetic load of 66 implants (CSR of 100%) attest that wide platform implants can and should be applied after careful planning and case selection (AU)

Relationship between oral Kaposi 's sarcoma and HAART: contribution of two case reports.

Two HIV infected patients not receiving Highly Active Antiretroviral Treatment (HAART) presented with epidemic Kaposi's sarcoma of the oral cavity. One patient initially refused HAART, but when the lesion became large enough to be noticeable he agreed to HAART associated with excision of the intraoral lesion by CO2 laser. The other patient developed KS and progressed to AIDS at two years after ceasing HAART due to adverse effects; he was referred to hospital for renewed administration of HAART. In both cases, the lesions observed in the oral cavity were the first clinical manifestation of AIDS. These reports underline the close relationship between the use of HAART and the control of KS lesions, highlighting the important role of the dentist in the identification and early diagnosis of these oral lesions.

Metaanalysis of the epidemiology and clinical manifestations of odontomas.

OBJECTIVE: To evaluate the epidemiological and clinical aspects of the different types of odontomas. STUDY DESIGN: A metaanalysis was made of 3065 odontomas obtained from a literature review of 30 articles published in recent years. RESULTS: Odontomas show no gender predilection, and are most often diagnosed in the second decade of life. They are preferentially located in the upper maxilla, particularly in the anterior sector. Compound odontomas are more prevalent than complex odontoma, and show no predilection in terms of patient gender, age or location. Most such lesions are asymptomatic and constitute casual findings in X-ray studies indicated for other reasons. The most common clinical manifestations are the retention of permanent teeth and the presence of a tumor. Treatment consists of surgical removal of the lesion. The prognosis is very good, with a scant tendency towards relapse. CONCLUSIONS: Odontomas are the most common odontogenic tumors. Their most significant characteristics comprise alterations in tooth eruption, and the diagnosis is casually established in the course of routine X-ray studies.

The use of methylprednisolone versus diclofenac in the treatment of inflammation and trismus after surgical removal of lower third molars.

OBJECTIVE: To compare the efficacy of methylprednisolone (corticoid) versus diclofenac (nonsteroidal anti-inflammatory--NSAID) in the treatment of inflammation and trismus after the surgical removal of lower third molars. STUDY DESIGN: Prospective study on 73 patients for the surgical removal of their lower third molars. These patients were separated in two groups at random: the diclofenac group and the methylprednisolone group. A record card was filled in with preoperative and postoperative epidemiological and clinic data about inflammation and trismus (three facial measures and mouth opening). In order to make a broad study of data, BMDP program was used for statistics. RESULTS: 24 hours after surgery, patients in the diclofenac group showed a more severe inflammation in one of the facial measurements (<0.05). Trismus was very similar in both groups. CONCLUSIONS: There were no differences in trismus depending on the antiinflammatory used. Patients in the corticoid group showed less inflammation but the difference was not as important as to justify their use.

A comparative study of direct mandibular nerve block and the Akinosi technique.

A study is made of 56 patients subjected to lower molar extraction, comparing the efficacy of the Akinosi technique as an alternative to direct or conventional mandibular nerve block in two groups of 28 subjects each. The parameters evaluated were pain in response to puncture, percentage positive aspiration, latency, pain during the intervention and complications. Patient pain in response to puncture was comparatively less intense and frequent with the Akinosi technique. The latency to anesthesia was briefer with conventional mandibular block than with the Akinosi technique (2.9 versus 3.8 minutes). Pain during the intervention and the duration of the anesthetic effect were similar for both techniques. The patients anesthetized with the Akinosi technique required more buccal nerve reinforcement infiltrations to complete the procedure. The anesthetic failure rates were 10.7% and 17.8% for the conventional and Akinosi technique, respectively. It is concluded that while the Akinosi technique can be used to extract lower molars, direct mandibular block offers superior anesthetic performance.