ABSTRACT
Para garantizar el éxito de los implantes dentales, es necesario conseguir la formación de una adecuada mucosa periimplantaria que permita el rápido sellado biológico periimplantario, que es crucial para el éxito del implante, minimizando la capacidad invasiva de microorganismos a través del surco gingival. Por ello, la adhesión del epitelio y el tejido conectivo a la superficie de los pilares protéticos, es muy importante para la viabilidad de un implante dental. En este sentido, en los últimos años se ha modificado la morfología de los pilares protéticos, tanto a nivel del tamaño del cuerpo del pilar (diámetro), como en el cuello de estos, llegando incluso a incorporar surcos para mejorar la salud del tejido periimplantario. Sin embargo, el diseño de pilares estrechos cuyo diámetro a nivel de la conexión es menor que el de la plataforma del implante, comúnmente conocidos como platform switching (PS), parece ser el que mejor sellado mucoso proporcionaría al implante, al reducir el componente vertical del ancho biológico, y crear una mayor distancia horizontal. En la actualidad, el desconocimiento de cómo la modificación del diseño geométrico de un pilar protético, con un cambio en el diámetro del cuello tipo PS, puede influir en la formación de una adecuada mucosa periimplantaria; nos motivó al desarrollo de este proyecto de investigación. En el presente ensayo clínico, pretendemos comparar la composición, distribución y estructura de los tejidos peri-implantarios alrededor de los pilares protésicos intermedios con geometría axial recta (control) y cóncava del tipo PS (test) del fabricante Galimplant® (Galimplant S.L., Sarria, España). El objetivo es estudiar qué diseño de pilares obtiene un mejor sellado biológico desde el punto de vista clínico e histomorfométrico. (AU)
To guarantee the success of dental implants, it is necessary to achieve the formation of an adequate peri-implant mucosa that allows rapid peri-implant biological sealing, which is crucial for the success of the implant, minimizing the invasive capacity of microorganisms through the gingival sulcus. Therefore, the adhesion of the epithelium and connective tissue to the surface of the prosthetic abutments is very important for the viability of a dental implant. In this sense, in recent years the morphology of prosthetic abutments has been modified, both in terms of the size of the abutment body (diameter) and in the neck of these, even incorporating grooves to improve the health of the peri-implant tissue. However, the design of narrow pillars whose diameter at the connection level is less than that of the implant platform, commonly known as platform switching (PS), seems to be the one that would provide the best mucosal seal to the implant, by reducing the vertical component. of the biological width, and create a greater horizontal distance. At present, the lack of knowledge about how the modification of the geometric design of a prosthetic abutment, with a change in the diameter of the PS-type neck, can influence the formation of an adequate peri-implant mucosa; motivated us to develop this research project. In this clinical trial, we intend to compare the composition, distribution and structure of the peri-implant tissues around the intermediate prosthetic posts with straight (control) and concave axial geometry of the PS type (test) from the manufacturer Galimplant® (Galimplant S.L., Sarria, Spain). The objective is to study which abutment design obtains a better biological seal from the clinical and histomorphometric point of view. (AU)
Subject(s)
Humans , Mucous Membrane/transplantation , Dental Abutments , Esthetics, Dental , Dental ImplantsABSTRACT
BACKGROUND: The influence of dental treatment on oral health-related quality of life (OHRQOL) has rarely been evaluated in patients with intellectual disability (ID) through validated questionnaires. The aim of this study was to estimate the changes on OHRQOL in patients with ID after the implementation of an institutional dental treatment program under general anesthesia using the Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire (FHCOHRQOL-Q). MATERIAL AND METHODS: A prospective longitudinal study was conducted on 85 patients (mean age=24.85 years) classified according to DSM-V whose parents/caregivers completed the FHC-OHRQOL-Q. We analyzed the changes in the questionnaire's overall score and its dimensions from pre-treatment to 12-months of follow-up, considering effect sizes and minimal important differences estimated by the standard measurement error. The impact of clinical and therapeutic factors was evaluated using univariate and multiple linear regression analysis (p<0.05). RESULTS: Significant improvement of OHRQOL was found after dental treatment in oral symptoms (p0.001), daily life problems (p=0.018), parent's perceptions (p=0.013) and FHCOHRQOL-Q´s overall score (p=0.001). OHRQOL changes exhibited an intermediate magnitude (0.38-0.21) as estimated by effect sizes. Changes in oral symptoms showed positive correlation with DMFT index (r=0.375, p=0.002), decayed teeth (r=0.244, p=0.036), dental extractions (r=0.424, p<0.001) and number of treatments (r=0.255, p=0.019). The improvement was greater in patients with 4 decayed teeth (p=0.049) and undergoing 2 dental extractions (p=0.002). Multiple regression analysis demonstrated that dental extractions (p<0.001) and DMFT index (p=0.028) were significantly related to oral symptom improvement. CONCLUSIONS: Dental treatment under general anesthesia showed a positive effect on the overall FHC-OHRQOL-Q score and most of its dimensions. At 12-months of follow-up, the improvement of oral symptoms was significantly associated with DMFT index, decayed teeth, dental extractions and number of treatments. In our clinical setting, the implementation of a dental treatment program enhanced the OHRQOL of patients with ID.
Subject(s)
Dental Caries , Intellectual Disability , Child , Humans , Longitudinal Studies , Oral Health , Prospective Studies , Quality of Life , Surveys and QuestionnairesABSTRACT
Presentamos un estudio observacional sobre la relación entre niveles elevados de carboxihemoglobina (COHB) e intoxicación subclínica por monóxido de carbono (CO) en nuestra área sanitaria, realizado en febrero y marzo de 2000, en 228 pacientes de ambos sexos, mayores de 18 años, que acudieron a Urgencias por diversos motivos. Previo consentimiento informado, obtuvimos una muestra de sangre venosa para determinar COHB y recogimos datos antropométricos, consumo de tabaco y tipo de calefacción domiciliaria. Los valores límite de COHB obtenidos fueron: en no fumadores, 1,9 por ciento; en fumadores de 1-10 cigarrillos/día, 5,1 por ciento; de 11-20, 6,9 por ciento y de > 20, 9,6 por ciento. El 25 por ciento de los pacientes presentaban una COHB elevada independientemente del hábito tabáquico, siendo el brasero de cisco la fuente de exposición más frecuente a CO (AU)
Subject(s)
Middle Aged , Adolescent , Adult , Aged , Male , Female , Humans , Tobacco Use Disorder , Spain , Carbon Monoxide Poisoning , Carboxyhemoglobin , Cross-Sectional Studies , HeatingABSTRACT
We present an observation study on the relatioship between high levels of carboxyhemoglobin (COHB) and subclinical poisoning by carbon monoxide (CO) in our health area. The study was carried out in February and March 2000 in 228 over 18-year-old patients of both sexes who went to the Emergency Room for various reasons. After an informed consent was conceded, a venous blood sample was obtained in order to determine the level of COHB; later, we collected the anthropometric data, the data relative to the tobacco use, and the data of the type of heating at home. The values limit of the COHB obtained were the following: in non smokers, 1.9%; in 1-10 cigarettes/day smokers, 5.2%; in 11-20 cigarettes/day smokers, 6.9%; in >20 cigarettes/day smokers, 9.6%. A COHB high level was observed in 25% of the patients regardless of the smoking habits, being the coal-dust slack brazier the source of most frequent exposure to CO.
Subject(s)
Carbon Monoxide Poisoning/epidemiology , Carboxyhemoglobin/analysis , Smoking , Adolescent , Adult , Aged , Carbon Monoxide Poisoning/blood , Cross-Sectional Studies , Female , Heating/adverse effects , Humans , Male , Middle Aged , Spain/epidemiologyABSTRACT
A lo largo del tiempo se han descrito distintos métodos para conocer y registrar la dinámica mandibular. En el presente trabajo exponemos un nuevo método basado en la emisión y recepción de ultrasonidos que nos va a permitir trabajar en tiempo real con reproducciones digitales de los movimientos que hace el paciente. Este sistema, recientemente creado por la empresa alemana KaVo, puede ser una gran ayuda, no tan solo para acelerar y mejorar el montaje y ajuste de modelos en articulador, sino para conocer en el momento, y antes de enfrentarse a un trabajo de restauración, las características de los movimientos mandibulares del paciente y poder dejarlo registrado en nuestra historia. Del mismo modo, esta posibilidad de trabajar con gráficos de movimiento mandibular en tiempo real tiene, a nuestra forma de ver, infinidad de posibilidades en el área de la educación, investigación...etc. Por tanto, el primer paso es presentar y conocer las posibilidades del ARCUSdigma® de KaVo (KaVo elektrotechnisches, Werk, GMBH, Leutkirch,Germany) (AU)
Throughout the time different methods have been described to know and to register temporomandibular dynamics. In the present work we expose a new method based on the emission and reception of ultrasounds that is going to allow us to work in real time with digital reproductions of the movements that the patient does. This system, recently created by the German company KaVo, can be a great aid, not so single to accelerate and to improve the assembly and adjustment of models in artieulator, but to know in the moment, and before facing a work of restoration, the characteristics of the patient jaw movements and to leave register red it in our history. In the same way, this possibility of working with mandibular traffic diagrams in real time has, as we think, infinity of possibilities in the area of the education, investigation ... etc. Therefore, the first step is to present and to know ARCUSdigma® (KaVo elektrotechnisches, Werk, GMBH, leutkirch,Germany) possibilities (AU)
